All-Star Moms

Day 27

This sweet look between an aunt and her niece has been making our hearts soar. Today, we'd like to tell you their story. 

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When they arrived at the recovery center, Judeline had been caring for her newborn niece, Joalyne, for just 21 days. Joalyne's mother had died just 6 days after her birth, likely due to complications from an unassisted delivery. 

Without access to breastmilk, Judeline had no choice but to feed the baby from the foods that were available to her. Judeline was an experienced mother; she had already given birth to three healthy boys herself. However, this situation was a new one. 

She knew that the pharmacies in the city sold special milk for newborn babies, but when she asked someone about the price, she realized that  a single can cost more money than she had to feed her entire family of five for a week. 

She simply did not have the money to purchase expensive formula. 

Instead, she did her best, making plaintain porridge and splurging on cans of Gerber baby food when she could. Inevitably, these foods were too harsh for a baby not yet a month old and they weren't providing enough nutrition. Rather than gaining weight like healthy babies should, Joalyne was loosing it. 

 Joalyne - 27 days old, 5.2 lbs

Joalyne - 27 days old, 5.2 lbs

A friend and former graduate of Second Mile Haiti, Yglie Pierre, began to take note. She knew the signs of malnutrition and she knew that babies who did not breastfeed were at risk. She also knew that feeding a newborn solid foods too early could lead to malnutrition. She had unknowingly made the same mistake with her own daughter. 

Her own experience with malnutrition had left Yglie acutely aware that if things didn't change, her friend's newborn niece would not have much longer on this earth. She told Judeline about the recovery center, where she knew that education and infant formula would be available to help.

When they arrived at the center, the baby had been without adequate nutrition for 27 days. She weighed 5.2 lbs. 

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Though she was 7 months pregnant herself, Judeline agreed to participate in the recovery program. They stayed Monday through Friday until Joalyne made a full and complete recovery. She gained 4.7 lbs.

Judeline became the caretaker of her infant niece the moment her sister succumbed to complications of childbirth. Her bond with Joalyne began during those first 21 days while she was doing everything in her power to keep the new baby alive. 

But when she got to Second Mile Haiti 'everything in her power' changed drastically. And so did her relationship with her niece. 

 November 22, 2017 - Judeline and Joalyne at the Recovery Center

November 22, 2017 - Judeline and Joalyne at the Recovery Center

Each day that Judeline watched Joalyne grow and respond to her loving care, their bond grew deeper.

Their bond grew the more she was able to relax into her new knowledge about how to care for a baby that didn't have access to her mother's milk. 

 December 8, 2017 - Judeline shows off her health education post test. A perfect score. 

December 8, 2017 - Judeline shows off her health education post test. A perfect score. 

Their bond grew again when she was able to take her niece to the local hospital's Pediatric clinic where her fears about the baby's health were put at ease. 

And their bond grew even more, each and every time Judeline responded to Joalyne's cries, smiles, and new motor developments, made possible now that Joalyne was receiving adequate nutrition. 

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Haiti has a unthinkable number of children growing up in orphanages. More than 30,000 children don't live with their families. This happens when families like Joalyne's don't get the support they need to care for these vulnerable children at home. 

Haiti also has one of the highest infant mortality rates in the world. More babies die during the first month of life in Haiti than anywhere else in the Western Hemisphere. So high, in fact, 1 in 40 children won't live beyond the first 30 days of life. 

Joalyne arrived at Second Mile at day 27. 

Because of the many individuals who support our work we were able to provide all the infant formula and medical care she needed to recover. 

We are also able to help Judeline's family with a business kit that will increase the family's income and help them cover the additional costs associated with caring for the newborn. And though Judeline will give birth in just a few weeks, her husband, mother, and 13 year old daughter are ready and able to help both with the new baby and the business.

It won't be easy, but this resilient family is determined to make it work. Our support will follow.

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This Holiday Season and we want nothing more than to be able to do the same for each new family that finds their way to our center. 

To do so, we need to see our online Holiday Catalog funded in full.

Each year, during the busy season of parties and presents, traditions and traffic, we post about the impact of your contributions to Haiti and ask you to consider making a year-end gift to support our work. 19 gifts categories remain with gifts like Literacy Kits ($25), Infant Formula ($75), and Business Kits ($250). This week, we're looking for 100 new gifts. Every gift, no mater how big or small, makes a difference for families like this one.

 December 8, 2017 - Judeline and her niece on their last day at Second Mile

December 8, 2017 - Judeline and her niece on their last day at Second Mile

Success at home - Part 2

Success at home - Part 2

Each time we send a family home, out and away from the structure of the recovery program to the uncharted waters of post-malnutrition existence, we have to wonder: will they be okay?

Will the problems that ailed the family prior to their arrival, continue to weigh them down?

Will disputes cause disharmony? Will the kids get sick again?

Will the business fail? Will disaster strike?

After Adeline left Second Mile Haiti she enjoyed success in business, but that wasn't her only achievement. 

 

The Trouble With Poverty, The Second Mile Approach

The Trouble With Poverty, The Second Mile Approach

A few days ago while putting together a status for our Facebook page, I found myself captivated by one family in particular. 

To learn more about them, I took a terse spin through our electronic database, chasing the answer to one question after another and marking my journey with mental bullets. 

It was all VERY interesting. 

For the next 24 hours, those mental post-its persisted to flash in my brain like internet pop-ups, beckoning to be made into a story that could be shared. To buy time, I wrote them down with a pen, in a notebook. And now here I am, not two day later, engaging in the most permanent form of note-taking: blogging. 

More lessons from Marie Ange

This.

This is the picture that's making me all happy-feely inside. There's just something about it. Maybe it's the mom's smile. Maybe it's the sparkle in her eye. Maybe it's the way she holds her baby, cheek to cheek, or the obvious pride she takes in dressing him to the nines. Maybe it's the way she's standing, all 17 years of her, erect with confidence.

This image drips with hope and promise. The economic kit that rests at her feet represents an unlimited number of opportunities. With it she will eat. Pay rent. Help her family. Put money in the offering basket. Take her baby to the hospital when he's sick. Take herself to the hospital when she's sick. Heck, she might even buy herself a brand-new pair of third-hand shoes when her plastic sandals refuse to be repaired, not even one final time. In a few years she'll send this baby to school. She'll be lauded as a smart and successful young person. She'll make good choices. She'll rise up from the flood-waters. She'll remind us that there is hope.  

How can I be so sure? How can I sit here and tell you that 50 lbs of rice, a few gallons of oil, and some dried up fish will really take her to such hopeful places?

Because she came to the center every Monday and stayed Tuesday, and Wednesday, and Thursday and Friday for 9 weeks!!! She wanted this opportunity and worked hard for it.

Nothing was more important to her than getting that sick baby healthy. It was obvious in the way she recorded every ounce of infant formula he drank and the way she cared about every gram of weight he gained. It was present in the way she dutifully checked his [cloth] diaper for signs of diarrhea, and the chipper way she sprang for the wash basin every time he soiled his clothes.

For me, the tell-tale sign was how she carried her kid. She had mom-swagger. Her 4 month old baby was sick because she had been ill-advised to stop breastfeeding and without mother's milk she didn't have the resources to keep him healthy. But at Second Mile, with some guidance and the right resources available to her, she was killing it. The way she carried her things to and from classes, a notebook and pen in one hand, the baby tucked into the crook of her arm, a spare blanket dangling from who knows where, and the baby's bottle with an ill-fitting couviture expertly balanced in the grip of hand #2. The way she masterfully utilized all 10 fingers and an elbow-armpit for crying out loud the way normal people (people who aren't moms) use only their two hands, told me this:  she will be just fine. No, she'll be better than fine. 

But even more compelling than mom-swagger is the fact that more than 40 other women have stood in that same spot, posed for a photo under that same tree, and then went home to "take care of business" with a new sense of "can do" and candor. 

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I'm so proud of the staff because they have to be doing a million things right for us to be able to see this much success with a program that could just of easily turned a million shades of wrong. But it's working. Follow-up visit after follow-up visit we see that children are getting better and better and with each passing month families are becoming stronger and more self-sufficient. 

I had the great privilege of spending a few hours at the center, yesterday. I had to pick up some boxes of Medika Mamba and bring them out to the site. Normally Jenn handles that, but she's in the States, fundraising. During this season of fundraising, and goal-setting, and end-of-the-year reporting, I typically work from my "home office" more often than not. The land has too many tempting distractions. I'm simply not strong enough to work at a computer when I could be having conversations with the world's greatest moms, or watching our amazing staff work (which is mesmerizing, by the way), or playing with babies of the goat, canine, and human varieties. Basically, if I hope to get anything done I steer clear of the snare and work from the silent haven that is my kitchen. Except that yesterday I didn't. I made the 25 minute drive out to the site and these are a few of the things I witnessed while I was there. 

Moms ministering to each other 

I was trying to get my computer unfrozen so that I could share some information with our health workers. I was sitting in the clinic where two moms were waiting. Both women are program graduates and their time at the center had overlapped briefly. "I asked about you" said one mom to the other. "They told me you were at Milot (a hospital)." "No" the mom replied. "I was at Limbe (a different hospital). We were there for 11 days."  She shakes her head and looks down at her daughter who has been doing well since the hospitalization.

"She had to be on serum (IV fluids). Every time they put in an IV, she ripped it out...(pause)... I cried" she confesses, still shaking her head. 

"It was good for her" the other mom piped in reassuringly. "She needed it. The serum did what it was supposed to do."

Although they were discussing a difficult experience, it was a beautiful moment. I was struck by the fact that two women who live nearly four hours apart (one lives two hours from the center in one direction while the other lives nearly two hours away in the opposite direction), could share this moment of vulnerability and compassion. I was shocked to hear a mom speak so freely about her child being in the hospital for 11 days. Sometimes I sense shame. It's easy for a mother to feel like she's failed her child if she ends up in the hospital. But these moms have a good sense of self. They know they're doing a great job as moms. They know that illness happens and that sometimes it's preventable and sometimes it's not, but that it's never their fault. And I think they know that these sisters, the ones they met through this program, understand that better than anyone else. These friendships are built on the shared experience of crisis and triumph. 

While the women were talking, Fara sat happily on the floor, playing like the professional player she's become. But then her mom decided to step out. As soon as she left, happy Fara started to wail. Neither I nor the other mom could console her. So we waited. The look on Fara's face when her mom reappeared was priceless. She started rocking her body, flapping her arms, and making what I can only describe as a the cutest smiling noise I have ever heard. I'm not a mom, so the closest thing I can imagine is how excited my dog is to see me after I've been gone for a few hours. This child was ecstatic and her mom had been gone for less than a minute. I couldn't possibly imagine these two, one without the other. Fara is well-attached, well-loved, and a source of joy to her mother. 

 

Moms helping one another

"Who is that kid?" I asked Kerline as I tried to focus my gaze across that courtyard on the profile of a child I didn't recognize. I could make out the woman feeding the child. I knew her name was Cherline, but she was someone else's caregiver. Then another mom walks over and I realize who the baby is. Daniel has been coming to Second Mile with his mother every day for the past several weeks. He and his mom were program graduates back in March, but a few months ago her house was burglarized, her business stolen. We decided to employ her for a little while so that she could get back on her feet after the break-in. While she works, the other moms look out for Daniel. They feed him, play with him, and they call for her if he needs anything. I watched Cherline scrape the last of some rice out of the bowl and give Daniel one final spoonful. Then his mom picked him up and the two women smiled at each other. One went off to wash dishes, the other went off to wash her baby boy. Did that really just happen? Yes, yes it did. 

Women happy to see one another succeed. 

I was sitting with the cooks under the palm frond canopy that covers their space. We were talking about green charcoal and all the veritable ways Haiti has been moving forward in the last several months. There was a mom close by washing the pots from the afternoon meal. In my mind I pictured the freshly painted buildings I had passed earlier in the day, the solar powered street lamps newly installed in a highly populated but not-so-safe area of town, and the brand-new international airport just a few miles from where we were having this conversation. They spoke of education, aid, government, and NGOs. The underlying message was "now we know!" Jiji had an explanation. "Before people were just having a lot of kids and there wasn't a strong regard for education. But now people value education, they value family planning, they know how to do more. They know how to use the land better. They know that cutting down trees is bad."  She made it seem so simple. Everyone deserves to learn right? Knowledge IS empowering. Children are learning these things in schools. Adults are attending meetings in their communities. There are radio messages and announcements in church... Information is spreading and the entire country will be the better for it. It was an energizing conversation that got better because of what she Jiji did next. Guillouse was leaving with her 2nd commerce package. The second commerce package is $100 of product that each program graduate is eligible to receive 2 1/2 months after she leaves Second Mile. It's an incentive based system that places value on the first business package by making the second disbursement dependent on the success of the first. For an opportunity to grow their business, the moms must be judicious with what they've been given, they must show that their business is growing because of the work they put into it, they must attend follow-up visits at the center and their baby must be meeting certain health markers.  I watched Guillouse walk over to the gate and open it so Herode, who would take her home, could drive through. The moto was piled high with her stuff. Just as she was about to draw the gate closed Jiji called out to her. "I'm happy for you. Your life is changing." Guillouse smiled and nodded. 

Capable. 

"Andy!" everyone said in unison when a recent program participant came through the gate with her grandson in toe. They were here for a follow-up visit. "Andy's been sick," the grandmother announced before greeting everyone in the room. Several mothers were sitting in the clinic and she knew most of them. "What did he have" I asked. "Diarrhea and vomiting" she replied. "I've been at the hospital with him. It was so bad I though he had cholera. They even put us in the cholera treatment unit."

"How long were you there?"

"Two nights," she answered. "The pregnant mom, with the boy... What was her name? She was there too. The boy had cholera."  As she finishes her account of the Hospital, she opens her bag and takes out a plastic thermos of clear liquid presumably ORS. (oral rehydration solution), that she had prepared before leaving their home. She gives Andy a drink and the moms start to talk about something else. This was all I needed to see. She came with ORS which means that a) she knew that it was important, b) she knew how to make it and c) she had clean water and something to store it in for the trip. At this point I wasn't worried about Andy.  I wasn't even worried about "the boy" (whom we determined to be another program graduate's younger brother). I was simply proud. This is exactly what is supposed to happen. Parents, and in this case, grandparents, are supposed to have the resources they need to get the help they need. Andy's grandmother and the mom she encountered at the hospital knew where to access healthcare, they knew when to access healthcare, and they could afford to access healthcare. 

Isn’t it incredible that for less than $500 per pair, we can meet the physical needs of a child while supporting the child's guardian with food, a safe place to re-nourish, and assistance with medical care.  And as things take a turn for the better, we're able to offer empowering education and supportive community, both of which help the caregivers feel confident in their ability to care for their child whether sick or healthy. The gardening classes inspire the moms and get their creative juices flowing. At the center/farm they get to participate in the growth-cycle of food and can take the skills (and the seeds) home with them. The business classes that caregivers attend give them a real-life chance to change their situation and remove some of the factors that contributed to malnutrition in the first place, namely the lack of income-generating activity. Then we get to see them doing their mom-thing. They come for follow-up visits with food. This is such a big deal! I can feel my ability to articulate flying out the window as a type this…I can feel something water-like in my eyes. It’s such a big deal. Mothers in desperate situations don’t have diaper bags. They don’t bring juice and snacks when they leave the house with their kids because they don’t have those things. But these moms do. It’s working. 

 Sanchez and his mom 2 months after Leaving second Mile... 1 month after starting a business.

Sanchez and his mom 2 months after Leaving second Mile... 1 month after starting a business.

And finally...

 May 2013

May 2013

Remember this kiddo? Maybe you don't. If you are new to our story you won't recognize these people. This is Jenn and I with Claire and her daughter, Marie Ange. This was our first mom on her first day. This was the beginning. We all got incredibly close to these two individuals. Their names have come up over and over again in our blogs. Marie Ange was 18 months when she and Claire came to stay at the center. She weighed just around 8 lbs at the time. A few weeks before this photo was taken she had been admitted to Children of the Promise (an inpatient care center for infants). They began caring for her when her life was on the line but when our doors were open they sent baby and mom our way. We're so thankful that she survived and that she responded to medication, therapeutic food, and the love and affection of her mom. She's a miracle, the first of many that we've been able to witness since then. 

This picture was taken a few weeks ago. Marie Ange is  now 3 years old and she has a baby sister.  We may take a ton of photos at Second Mile to document a mom's journey through the program but this here is the most important photo. This is the one that really matters. This 18 months later- at home- eating something yummy- sitting next to her sister photo. This is what we work for. 

Want to be a part of these stories? Check out our Holiday Catalog.

it's time

It's time to write a blog post about time. 

I'll be honest. I don't really want to be "blogging" right now. It feels a bit obligatory. It also feels a bit like forcing happy when in actuality I'm feeling far from it. My better half/partner in crime is far away in America and going through a hard time. Jenn left Haiti on the 13th. Her grandmother passed away 3 days later at far too young an age and far too soon after Jenn and her siblings had to face the death of their father (in March). Today is the memorial service for 'Mimi' and Jenn is giving the eulogy. I wish I could be there. I could have joined the family for the services, of course. But I simply didn't get up and go. Leaving Haiti tends to be more difficult than staying. 

Still despite the rainy, dreary week (and the broken vehicle, and a new baby with a heart condition, and a new baby with TB, and sickness, and death, and the events happening in Texas, and the wrath of Chickengunya that seems to be ravaging Port-au-prince and creeping it's way up the central coast to the North) I really must blog. The tricky thing about time is, it's fleeting. 

If you don't take advantage of a moment, it's gone. 

So in this moment I'd like to recognize that it has been 1 year since Second Mile Haiti opened its proverbial (and literal) doors. That's right! On May 15th, 2013 a 31-year-old mother of two arrived at our facility with her 9-lb 19-month-old baby girl. Those first few nights she was the only momma at the facility until, a few days later, we got a call about another mother and child. This mom had 5 children but it was her youngest, and only daughter, who was struggling with malnutrition.

Moms Claire and Rosna with daughters Marie-Ange (then 19-months) and Witchana (then 15 months). 

 May 2013 (one year ago) Claire sits by Rosna in the Education Center to support her on her "going home, graduation day" 

May 2013 (one year ago) Claire sits by Rosna in the Education Center to support her on her "going home, graduation day" 

 Two girls 

Two girls 

These two moms laid the foundation. They showed us what it would look like to partner with moms. They were genuine, receptive, patient, and kind; wise, resilient, and strong. With their children they were self-less, nurturing, and affectionate.  We loved them (and still love them) a lot. We are grateful that they shared there lives with us for a little bit. Claire and Rosna are seriously good people. 

 Claire offering Marie Ange some yummy mamba! 

Claire offering Marie Ange some yummy mamba! 

 Rosna with Witchana at home, a few months after their short 15-day stay at Second Mile Haiti. 

Rosna with Witchana at home, a few months after their short 15-day stay at Second Mile Haiti. 

The two women had a lot in common and became fast friends. They live in two different towns at least 30 minutes apart. But we know they call each other on the phone to check in and sometimes they'll show up for a visit to Second Mile on the same day. 

That's what happened last week. Both Claire and Rosna came with their girls on the same day!  The moms were happy to see each other and I think Witchana would have been eager to play with Marie-Ange...but not so much the other way around. When we tried to get a picture of the two girls sitting together MA was not having it! It would have been the ultimate then and now shot, something like recreating an old family photo. But Marie Ange is so attached to her momma that no one was going to be able to get her to sit by herself (although Witchana did make a valiant attempt to hold her friend still).

I shouldn't have deleted those photos. They were hilarious. But unfortunately, I did.  

While we didn't get to recreate that photo from last May what we do have is a few photos that will show just how well these girls are doing now, 12 months after they first spent time at Second Mile. 

Marie Ange at 19 months and 31 months. 

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Witchana at 15 months and 27 months. 

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I know that today is actually May 22nd (actually it's now the 25th!) And here we are a week after our 1 year anniversary. But I think this is one of those better-late-than-never posts. 

Because... this. 

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Witchana looks great! (So does Marie Ange). And these moms are happy. 

So maybe Second Mile did make just an teensy-weensy bit of difference for these families. Maybe it was the nutritional nudge. Witchana gained 1.5 lbs in her 10 days at Second Mile. And Marie Ange made the most progress during her second stay at Second Mile where she gained 5.5 lbs in 7 weeks. Or maybe it was the follow-up, the education, or the business (i.e. income). It was probably the business.. or a combination of things. And just to be fair, these mothers unlike many of the others are fortunate to have access to healthcare services that are about 80% free to them. This means that both girls can get care when they are sick. That's a huge factor in their staying healthy and we need to recognize this particular hospital and the Haitian Ministry of Health for making those services available to them).

Still, I think it's fair to say that both of these girls were in pretty bad shape initially (especially MA). The rehabilitation they received at Second Mile was, in fact, a good and necessary intervention. The thing about malnutrition is that it causes you to be more susceptible (in a weakened immune state) to other infections. And the thing about other infections is that they can cause or worsen malnutrition.

Sick kids sometimes just aren't very hungry or don't want to eat. And even when they do eat, the calories they consume are directed towards fighting the infection rather than weight gain and growth.

It's clearly not ideal to stay in a malnourished state for any length of time.

40% of childhood deaths, world-wide, are of dual-cause: infection in the presence of malnutrition. That's kind of why it's such a big deal to be able to help families get medical care. Not all infections are easy to treat. Treatment for TB, for example, is a long and cumbersome undertaking for both families and health-care providers. The WHO believes that 74,000 children die from TB each year (WHO Global TB Report 2013). Severely malnourished children and children with HIV are the most susceptible to TB and the most likely to die because of it. And TB is just one example. There are plenty of yucky illnesses and infections ready to prey on the vulnerable. 

So, the getting healthy was important. 

But the moral of this story is the staying healthy. And our conclusion is that moms can. They absolutely can. These pictures in this post weren't before and after pictures showing the progress made when both mother and child were at Second Mile. These were taken a year later... The girls stayed healthy with their mothers and aunts and grandmas and uncles...at home... despite all of life's challenges and expenses.

So hat's off to you, mommas. And Happy Haitian Mother's Day! 

Urgent needs

If you've ever wanted to learn more about how Second Mile cares for kids and families this is the blog post for you. And if you ever wanted to know why we/they depend on your support this will be a good post to read, just beware of a few tough images towards the end.

If you were on Facebook yesterday than maybe you saw the status we posted last night with this photo. 

We were really excited because from the 6 moms that went home last weekend and came back to Second Mile on Monday all 8 of their children gained weight. Now wait, before you go around telling people I'm bad at math, let me clarify. Two of the moms had two kids each. That's 6 + 1 + 1. You may be wondering what about the others? Didn't you just have a full house and now you're suddenly down to 6?!

Actually yes. We did recently have an almost full house. Our current capacity is 12 women and at the time of our last blog post, earlier this month, we had 11. Two of those children were at the hospital on Monday. One has been discharged and came back to Second Mile today. That's good news. The other good news is that 3 of the moms "graduated." That is, their children reached a healthy weight around the time that they finished all of their health education objectives and completed a business plan. They all learned how to plant things and what to do when their children are sick. Two of those moms were regulars in the literacy program which has been bumped up to 90 minutes of class every evening. These moms were writing and essentially reading by the end...

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It was a happy day sending them home.

Shenaida, the little girl (age 18 months), came to us as a referral from Hôpital Sacré Coeur in the town of Milot (just 15 minutes from our site). She was admitted to the hospital with kwashiorkor-type severe malnutrition and was held for 15 days before she was discharged. The family lives just a 10 minute walk from our facility. Initially it was Shenaida's mom that came with her to Second Mile but she had to leave mid-week due to ill-health. The hospital stay and many sleepless nights had worn on her immune system. The family decided that Shenaida's aunt would take her place. It was a fine solution. The aunt lives in the same house as Shenaida and her mother so she would be able to transmit information easily to Shenaida's mom and could continue helping with her care over the weekends. The aunt is the oldest sister in their family and definitely has "caretaker" in her blood.

She was an amazing interim mama for Shenaida. They stayed for a total of 25 days at Second Mile. During that time she lost the remaining edema, battled some bouts of diarrhea, and worked to gain appetite, weight, and red blood cells.

  day 1 at Second Mile- some swelling remaining in the legs, abdomen, and face

day 1 at Second Mile- some swelling remaining in the legs, abdomen, and face

 
  Shenaida's auntie helps her eat Mamba

Shenaida's auntie helps her eat Mamba

 
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  leaving Second Mile - healthy girl 

leaving Second Mile - healthy girl 

The key part of this story is that Shenaida was referred by the hospital. She got initial care there. There were blood tests and IV fluids and key interventions that happened initially, before we entered the picture. We don't have a true "before" picture because she was stabilized at the hospital, right where she needed to be. Severe Acute Malnutrition is not a game. Although it's fun to watch children improve and to know that a smile here and a cry there signal certain improvements, but we don't take little lives into our hands without the serious consideration. Part of that decision-making process is getting information about where the child is coming from and what kind of care he or she has already had. With each case we have to decide whether or not the child's condition requires a higher level of care and monitoring than we would be able to provide.

Most cases are simple. Take these sample cases for example. We admit a child after a referral from a partner organizations that oversees HIV positive children country-wide. They have recently discovered that the child is HIV+. We know that she is scheduled to begin anti-retroviral drugs at hospital A on a particular date and that they expect her back at this particular date for her next follow-up appointment and at any moment that her condition worsens.

Or, we admit a child that spent many months in a infant formula program at local creche. The mother brings the child back to the creche and they see that he is showing worsening signs of malnutrition. His legs have begun to swell. The referral is made because the creche case workers have been working with the family for months have identified some major concerns in terms of the mother's knowledge of nutrition and hygiene.

Or, we receive a child right after he has been seen by a doctor at rural village clinic 45 minutes away. The doctor plans to personally drive the child and mother out to our site that afternoon. She has know the child for many months and though she sends Medika Mamba with the mother every single week the child has not gained weight. He has no complications but the doctor thinks that mom needs to be taught how to feed her son. The child has cerebral palsy.

All three children have severe malnutrition.

In these situations we jump in. We begin to learn about the mother and child and how we can help support them with and through the health care systems and resources around us and in collaboration with these partner organizations.

There are other cases though, whom we meet, who don't come from a hospital, a doctor, or another program.

Like this child, who arrived with her dad yesterday evening.

 

Or this baby who arrived this morning.

 
 

This is where you come in. Hang with me.

We do not have a lab. We do not have a staff doctor. We do not even have an evening nurse. That level of care is not a part of our mission. Why? Because of hospitals like Hôpital Sacré Coeur--with trained pediatricians, state of the art laboratory facilities, and compassionate administrators. 

Our goal is to work with the local hospitals and health centers, not to replace the care they can offer.

Also, our goal is to empower mothers. Part of that is the sharing of information so that they feel equipped to make decisions about their child's health. So we made the decision not to have health staff during the night. Children that require round the clock monitoring need to be at the hospital anyway (which I will explain in a moment). Instead, we teach the moms how to respond to common problems. And while this is typically a pretty intuitive skill, we make sure that one of the first lessons we share with moms is the difference between ailments that require a trip to the clinic and the kinds of emergencies that merit a rapid trip to a well-equipped hospital. Every mom at Second Mile knows who to get in touch with if an emergency trip to the hospital ever became necessary. To-date, that's never been an issue but that's also because we really try to make referrals early and often. Our nurses are trained to assess the children and refer to the appropriate place, even before they spend a night at our center. We want the moms to understand how to use their local health centers and to be comfortable doing so. It's really important. After a stay in the hospital we continue with the family right where we left off.

For the out-of-the blue cases that come to us with no previous interface with healthcare personel we want to make sure we cover our bases and offer the child the highest chance of survival. With each critical case we ask the question, would a Haitian pediatrician decide to admit this child to an inpatient ward? And really the only true way to make that judgement call is to give the family an opportunity to go for a consultation with a pediatrician at the hospital.

 
 

The issue is not whether or not the mother can afford hospital care. The issue is whether the child needs it. And like I said before that's where you come in.

We know that sometimes the parents don't completely understand what malnutrition is and what is truly causing their child's ill health. If they did, would they have gone for help sooner? Maybe yes, and maybe no. Money is one of the major barriers to seeking care.

Today's blog post is a plee for help. We would very much like the opportunity to support the two families pictured above, and others like them. But to do so, we need to have healthcare sponsors. That is, we need to have a fund specifically to pay for medical care for cases of this severity. At our local hospital a typical hospital stay of 1 week is about $125 USD. We would like to get 5 sponsors of $100/month to meet this urgent need.

If you can help, please do. Even $15 dollars a month could make a difference.

Our hope is that one day, when these families have wonderfully productive businesses they will be able to go to a health center each and every time their kid is in need.

You can help break the cycle.

To make a donation click here. It is possible to set up a recurring donation through our website which can be made weekly, monthly, bi-monthy...etc. Second Mile Ministries is a 501c3 non-profit. Donations are tax-deductible.

happy day!

On Tuesday, after spending seven weeks at Second Mile, Daniel and Miselene went home!

This post is about what his transformation looked like, how it happened, and well mostly what it was like to provide a mom with a few basic tools and watch how she used them to care for her kiddo. 

This mom was a favorite. Let’s put aside the fact that I probably shouldn’t be admitting that and just agree to tell it how it is. ;) We all enjoyed her. In fact, she probably stayed longer than she and her baby truly

needed

to simply because she was so great to have around. 

Miselene was extremely attentive in 

every 

class. I don’t know how she did it. She followed all the guidelines and didn’t complain. In fact, Miselene was the reason we started assigning a weekly chore to each mother... not that she needed to do more, but because she was doing 

so

much and the others needed to share the load. 

She was eager and smart. Pleasant. Kind. Sweet and respectful. And there wasn’t the slightest bit of doubt that she cared about the well-being of both of her children. This must be true of all mothers- deep down- it’s just that not all moms manifest their concern in the same ways. Some moms are simply so beat down that the emotions and reactions you would expect to see aren’t the ones that surface. 

That’s probably why I enjoyed Miselene so much. Her emotions were so honest. I could tell when she wasn’t feeling good and when she was feeling confident. She felt genuine joy in the growth and improvement of her baby. When he wasn’t doing so well you could see how much it pained her. She talked to him, kissed him, loved on him. Because of his age, Daniel was drinking infant formula. We weren’t giving him Mamba. We weren’t giving him enriched cow’s milk. Simply formula. He responded very well and gained weight rapidly. He cried whenever he was hungry and his mom promptly made him a bottle. Miselene was extremely cautious about hygiene. She washed her hands. She made sure the bottle was clean. And Daniel was never sick with diarrhea or vomiting. We never doubted that he would gain weight at a steady, constant rate yet Miselene was excited every, single, day when he did.

She had this way of saying, “ohhhhh Daniellllll” surprised, yet not really surprised, the way you would continue to praise a toilet training toddler each and every time he did his business in the right place. She really was so happy to see Daniel improve even the slightest bit. She bonded with him over each and every bottle. And she kept track of every single ounce. 

Daily weights plotted by the nurse and a record of Daniel's milk intake written by Mom

Honestly, Daniel was a really easy case. We didn’t have to do much for him yet for this family that little bit made all the difference in the world. 

Daniel's shelf: meds, formula, treated water, and Mom's lunch bowl

Daniel was referred by Children of the Promise. His mom went to COTP because she heard that her baby could be helped there. She went to their gate and asked that Daniel be taken into their creche. When they told her he’d be better of with his mother, she got desperate, asking if their was another orphanage she could take him to. 

She felt she had reached the end of her capacity to care for him. She wanted help. Mostly she just wanted him to survive. COTP thought that Daniel and Miselene would do well at Second Mile. 

When they arrived Daniel weighed 3 kg. 6.6 lbs. He was exactly 3 months old. Maybe you're thinking...

my kid weighed more than that when he was born!

Yes.. 6.6 lbs is tiny for a 3 month old. Daniel had been drinking tea and drinking formula when his mother could procure it. 

6.6 lbs - Day 1 

Daniel’s mom had not been breast feeding. She said she didn’t have milk. And after assessment of her own nutritional status it wasn’t hard to see that that was likely the truth. Her health was part of the problem. At the time when Daniel and Miselene came to Second Mile, she had been battling a cough for many weeks. Her body looked worn. She seemed weak and tired and hadn’t yet gotten to the bottom of her symptoms. 

She had gone to a clinic relatively near her home and was seen by a doctor who wanted to rule out Tuberculosis by doing a sputum test. The test was free and if in fact she had Tuberculosis the medication would be free as well. But it was the cost of transportation to the clinic (and the fact that her son was also not well) that kept her from following through. For the sputum test, she had to bring a series of three samples on three separate days. Meaning, that she had to assemble enough money to travel not once, not twice, but three days in a row. 

When we met her she had submitted 2 of the 3 samples. We arranged for Miselene to finish the testing and then arranged for her to go again, her fifth visit to the clinic, for the results. The test concluded that she did

not

have tuberculosis. I was so relieved! But why did she still seem so disheartened? 

Aw, yes, a negative test result meant she

still

didn’t have answers and answers cost money. When they told her she didn’t have TB they also told her she should return to the clinic the next day so that she could be seen by the doctor. The doctor would likely prescribe more tests or if she was lucky, just write her a prescription to treat her symptoms. Only those tests and those medications would not be free. 

In Mislene's mind, a sixth visit was out of the question.

Thankfully, after a few days of rest and a few high-energy meals, and some OTC cough syrup Miselene did begin to feel  better. 

By the second week it was much easier to look at Daniel.. he wasn’t the fragile little skeleton he had been on the first day.   By week four he was actually filling up the scale. 

By their 5th week at Second Mile Daniel had gained 4 lbs and had earned himself the nickname, “ti bout patat.” 

Little sweet potato. 

He was doing well enough to go home. He was no longer severely malnourished and had even reached the growth chart median for a child of his length. Very impressive, indeed! But on the day we began preparing his mom to go home, Daniel developed respiratory distress. Instead of sending him home we gave him a breathing treatment and sent him to the hospital to be seen. 

The doctor prescribed nasal drops, vitamin C, and an antibiotic. The total cost of the consultation, the laboratory tests, and the medication was $12.24. Totally affordable, right? Yet $12.24 would have been an inhibitory sum for this mom. 

She came back from the clinic smiling, not because it wasn’t an exhausting day (she was at the hospital from 7 am - 3 pm), but because she had something tangible she could do for her son. She had both answers and a solution. 

Daniel stayed the following week so that we could monitor him as he recovered from his respiratory infection. Again, at the end of the week we were ready to send him home but  coincidently Miselene was under the weather. She had a fever with body aches and a headache and well the thought of packing everything up and leaving made her cry. They stayed another week. Miselene worked just as hard and was just as attentive in all the classes as if it were her first week, not her 7th. But after that, we simply didn’t have any reason to keep them any longer (although we did try to think of something). 

Miselene had been a part of all the business training classes and was ready to tackle the obstacles she would face doing “

komes

.” She was ready to take on the challenge of maintaining a small operation of her own. As her first attempt to achieve positive cash flow she would be selling clothes. Errod had already been to town to pick up a bale (literally) of used closed. Clothes vendors, as Miselene would aspire to be, typically buy these bundles of thrift-store surplus straight from shipping containers that have travelled from the United States to Haiti. They make their profit by selling each article of clothing, individually. You never know what you’re going to get in a bale, except that if you buy a bale of kid’s clothes, as Miselene’s requested, you

should

theoretically get kid’s clothes. 

Miselene was also a star pupil in health education. She asked questions. Paid attention. And when all was said and done she scored 100% on her health post test. Most of the health education sessions had been taught by Ms. Kerline but this week she's been at a training seminar, learning how to perform infant massage. 

In her place, Ms. Prestina, our nurse and the newest member of our team, gave Miselene her parting exam. The exam is done orally. Kerline, or in this case Prestina, asks the questions and writes the mother’s response. There are about 20 questions such as What causes malnutrition?, What is a balanced diet and can you give examples from each of the three food groups?, What can be done to prevent your child from getting diarrhea?, What are the benefits of pre-natal visits when you are pregnant? etc. etc. When I saw Prestina immediately after she gave Miselene her test, she was practically speechless. She managed to squeak out some accolade in fancy french. A simple "she did a great job" just wasn’t adequate.

Magnifique. 

Most of the moms score between 20% - 60% on similar test given on their first or second day at Second Mile, before they complete any of the health education sessions.  Miselene scored a 59%. 

And after? 100%... We’ve never had another mom do quite so well. I felt like dancing inside. I told every person in my path and made a Facebook status when I finally got internet last night. It was 10 pm.. but the world needed to know! 

We grow to love these women and want so badly for them to do well. When something, anything, aligns in their favor it seems like an impossibly positive step forward. The likes of which, can happen so rarely for these women. 

Miselen, back center, and her daughter (3 years old)

On Tuesday Morning we did one final assessment to get Daniel's measurements recorded in his chart and to determine a good goal weight for his first follow-up visit (next week). Then we performed one last test. 

With a quick finger prick and a tiny drop of blood we can tell whether or not a child is anemic and the severity of it. Anemia and malnutrition march hand-in-hand wrecking havoc in little bodies, but some children are worse off than others. The hemoglobinnometer we funded through the Holiday Catalog is an amazing little machine that works in much the same way as those pocket-sized glucose monitors people use to check their blood sugar. On Day 1 Daniel’s hemoglobin level was so low it wouldn’t even register on the machine. After 7 weeks of infant formula and liquid supplemental iron, his hemoglobin had improved to a 9. Still low, but  on the rise. 

arm circumference indicates the severity of malnutrition

length lets us know where he falls on the growth chart and how much he has grown

"ti bout patat"

So what does this "recovery and empowerment" process come down to, exactly?  Each family's situation is of course unique to them. But the underlying issues are similar. Miselene and Daniel's story isn't all that unlike the rest. Lack of resources, limited economic opportunities, the inability to access healthcare, and competing demands for what little money the family may have... These things can tear families up and ultimately lead to more funerals than birthday parties. It's not quick and it's not easy but we'd like to think that in the grand scheme of things it really doesn't take that

much [money] to keep a family together and to nudge a child in the right direction, that is, the one of more birthdays. Here's what it looked like in terms of time and resources spent directly on this family.

Total days at Second Mile: 41 (not including weekends spent at home)

Total weight gained: 5.4 

lb

Total length gained: 6 cm

Total infant formula consumed: 22 cans of formula (each 400 g)

Total cost of infant formula:  $127.90 (at $5.80 per can) 

Total cost of transportation to and from Second Mile for 7 weeks: $16.20

Total cost of vitamins and medications + 1 visit to the clinic for Daniel and 2 visits to the clinic for mom:  $33

Cost of business (start-up):  $150

Mom and baby together in time of crisis: Priceless

The "priceless" bit might have been a bit cheesy. Sorry about that. But I think you get my point. 

Which is: Thank you for supporting Second Mile because when you do 

you are helping mothers like Mislene, babies like Daniel,

 and their big sisters too.. 

if you too want to support this kind of thing financially, here's the link to our 

donation page