New moms, new stories

I've written my fair share of long-over-due posts but this one takes the cake.

It's 10 p.m. on a Tuesday and it already feels like 1 a.m. on a Friday but we simply can't put this off any longer.

Here are some updates.

Probably our biggest update, aside from all the new cases, is the restructuring of our program to allow the moms to go home on Fridays and return on Mondays. It makes so much sense that we wonder why we didn't think of it before... but that's the beauty of being able to change things as we go. We now arrange transportation for the moms and babies to go home on the weekends. It gives them time to be with their other children. Most of the moms don't have cell phones and they are relying on neighbors or other relatives to keep an eye on their older kids. This new weekend thing, helps keep their worries at bay knowing they will be back in just 5 days. It also gives them time to do household chores and check in with their friends/family. Let's face it, as cool as we are, most people don't want to be away from "home" for long stretches of time so this breaks things up nicely. We are even experimenting with business practicums on the weekend. For example, a mom might take home a few cartons of eggs to sell between Friday and Monday. This way she gets to test her market and we get to see how she does applying the lessons learned in the official "School of Business."


Friday morning

Now for the moms.

This is Lovelie and her daughter, Loudjina. Meet the wisest and most patient 20 year old  person, I know.


Her daughter Loudjina is 15 months old and is living with a condition called hydrocephalus. Hydrocephalus is a common neurological condition that is usually swiftly repaired upon diagnosis anywhere you can find an operating room and a brain surgeon. Hydrocephalus, an accumulation of fluid in the brain, is more common than brain tumors and more surgeries are performed to correct hydrocephalus than any other form of neurosurgery. The presence of hydrocephalus is often identified at birth, but it can even be identified antenatally. As far as brain surgeries are concerned (since I'm pretending to be such an expert) correcting hydrocephalus is a simple procedure. A shunt is placed between the brain cavity and the abdomen to drain the excess fluid. Unfortunately, for Loudjina and others like her, in Haiti, these surgeries are offered only a few times a year when US-based surgeons come to a hospital in Port-au-Prince.

Loudjina did have this surgery when she was 3 months old but she was supposed to have a second surgery a few months later. Because the family didn't have enough money to travel all the way to Port au Prince (the bus ride takes 6 hours and costs $30 round trip + the cost of food), she was never able to attend that appointment. We are now waiting for the next surgical team to travel to Haiti to see what they have to say. In the meantime I am working on several pressure ulcers that have developed on the back of Loudjina's head. Because these wounds can take several hours to dress, and because transportation is difficult, it makes sense for Lovelie and Loudjina to spend their weekdays at Second Mile. This mom is awesome. I've gotten to know her pretty well over the past three weeks by spending so much quality wound care time with her and in driving them to and from their home twice a week. If you asked me to think of someone who blesses me, just because they are who they are, I'd choose this mom (and Loudjina's pretty awesome too).


In case you didn't notice, Lovelie is expecting. After she decided to stay at our facility we sent her to her first prenatal visit. She thought that she was maybe 3 months pregnant but learned that she is actually due in December! We're happy that she's getting some prenatal care, good prenatal nutrition, and some extra help with her daughter during her final months of pregnancy.

This is Loudjina's fourth week at Second Mile. We don't really know how many more she will stay. Mom is doing all the business, health, and gardening classes with the other women.


Two sassy girls and a breastfeeding baby that won't gain weight! 

We also have four lovely Roses staying with us. This is Rosenie and her 3 month old daughter, Roselourdes. Her twin daughters, Roseline and Roselore, will be 3 years old in December.

Day 1 @ Second Mile

This Mom is kind of famous right now. She has a lot of people invested in her well-being. She was referred to us by a small clinic in a "slum" area of Cap Haitien. Meds and Foods for Kids, the organization in Cap Haitien that produces Medika Mamba (a.k.a Plumpy 'Nut), has been working closely with that clinic to provide them with their products. They provide both Plumpy 'Nut, for severely malnourished children and Plumpy Supp' for moderate malnutrition and pregnant and breastfeeding women. While Rosenie was pregnant with Roselourdes, she was enrolled in a pilot Plumpy Supp' program at the clinic. The idea behind the pilot is that pregnant women in this particular area aren't getting enough nutrients during their pregnancies. As a result, they are giving birth to low-birthweight babies who are born on a path towards malnutrition. The program is designed to test whether giving the pregnant women a Plumpy Supp' (a peanut butter-based paste supplement, packed with vitamins and mineral) will lead to better outcomes both for the women and for their children. The women in the pilot continue to receive Plumpy 'Supp for 6 months following delivery (while breastfeeding).

Rosenie's story is not unique. Before her most recent pregnancy, she was a single mom with 6 children to feed, clothe, and send to school. Then when she became pregnant with #7 it became even more difficult for her to feed her kids. The clinic director, who would sometimes help the family from his own pocket, decided to share her story and reach out to some of the local organizations for help. That's when Meds and Foods for Kids decided to refer Rosenie to Second Mile. At the time both she and the newborn weren't gaining weight as expected. Our main focus has been trying to determine why mom and newborn aren't gaining weight despite so many extra calories. We've ruled out a few possible problems and are looking into others. Our second biggest focus is getting Rosenie set up with business.

"life course" in the education center
In the 3 weeks they have been with us, we've seen the most improvement in these two little balls of fire. Check out their before and after pictures.

before

After - Sass! 
When they were admitted, the girls met the criteria for Moderate Acute Malnutrition. But not anymore! These girls have gained about four pounds in three weeks. We even had to privilege of saying "orevwa" to two very large tapeworms that Roseline (the taller twin) pooped out a few days after receiving de-worming medication. You'll have to excuse the poop-talk. We just get very excited about these types of things. 


An Aunt and a Dad

Rosenie, the mom above, had a neighbor. When Rosenie went home after her first week at Second Mile she learned that the neighbor had passed away. The woman who died was 2 months post-partum. When Rosenie returned the following Monday she suggested we might need to help the deceased's sister-in-law who was now looking after the baby, in addition to her own children. The baby had been hospitalized, but because the family didn't have money to pay for the hospitalization, and because the sister-in-law had her own children who needed her at home, they took the baby out of the hospital prematurely. Unable to afford infant formula they began feeding the baby. **I think I've got my facts straight now.. The babies mother actually died 8 days after delivery, not 2 months. 

Our health worker met with the aunt, who decided to come to Second Mile with both the baby and her own 18 month old daughter. While the 2 month old is technically "severely malnourished" according to criteria, its possible that it was born prematurely. Or maybe, his mother is an example of a woman who, lacking prenatal care and proper nutrition during pregnancy, gave birth to a tiny baby (as was noted with so many woman that live in that area) and then succumbed to a obstetrical complication. Whatever the case, we felt that our best bet for helping the family with a longer term solution would be to give the aunt a chance to go through all of the health, gardening, and business programs while providing infant formula for the baby. The aunt agreed, provided that the baby's dad, her brother, would ensure that her own kids were being fed. We met the baby's father on Day 1. We learned that he and his sister live in the same house along with one other sister. Combined, the three siblings have 8 children. They all live together under 1 roof. 

Day 1 @ Second Mile

The aunt seemed pretty close to leaving us on Day 2 not because she didn't want to be there, but because she learned from her sister that her brother hadn't brought home any money that day. Her children hadn't eaten yet and that was the deal; she would stay with her brother's baby if he would make sure that her kids didn't go hungry. But they stayed. And went home on Friday with the rest of the moms. 

The Dad had the baby during the weekend. He did his best to formula-feed the baby and record how much he drank. Some of the math is a little bit off, but I must say I was impressed by his efforts. When the aunt returned on Monday, I learned that the she had been summoned by another relative to travel to a town about an hour away. While there, she was hospitalized for a stomach ache and dehydration. 
...Just another example of how life can be brutally challenging for these individuals. 


We have one more case, a 9month old that weighs 4 kg (8.8 lbs), but I will save his story for another blog post. He just arrived yesterday and we are still getting to know him and his mom.

In summary, things are really busy in a good and challenging way. We just had solar panels installed (see newsletter), our gardens are doing really well (also, featured in newsletter), and today our cows got registered with little tags in their ears. That may seem random, but I think it's cool. And totally relevant.  We always need support so feel free to check the newsletter and/or recent facebook posts for our biggest needs. And please do pray for these moms, dads, grandparents, aunts, and kids.