Keeping families together?

It's another one of those late Saturday work nights. I find myself sitting in the kitchen sipping cold coffee  both battling technology and singing it's praises. Computers (and tablets and cameras and all the cords and cables and funny business that allow them to work together) are responsible for both my biggest headaches and my most fulfilling moments. I could do without the crashed hard drives and the missing files and the ever present and terrifying possibility that I might accidentally delete something I've been working on for months [the wounds are fresh] but nevertheless I've had some success this year managing the beasts. Getting our database up and running may be my biggest accomplishment of the 2014-2015 year and keeping an uber-organized Dropbox would probably be my talent if I ever competed in a Miss America pageant. I mean I was going to go with #nursing but we all know how that would play out... #nursesunite

Earlier today I was moving a bunch of files from one hard drive to other so that I could sort our Second Mile photos and save them in their respective homes. The power went out at my apartment and I lost several hours of work. It sucked. I would have cried but the very same thing happened to me the day before so I'd already been there-- done that. This time I took myself out of the house and into the used clothing market in Cap Haitien's city center. There's nothing like a little market jostling to awaken my senses and remind me that I won't survive in life if I let myself get overly worked up by a few Mac-product mishaps. I picked up a few new-to-me dresses and had dinner with friends. When I returned to photo-sorting it didn't take long before the pictures themselves put me in a better mood. 

The best thing to do when I'm feeling excited about Second Mile Haiti is to write it out...There's only one way to harness all that feel-goodness: story telling and photo sharing. 

Perhaps too often I write blog posts highlighting photos of mothers and kids coming for follow-up visits. Since the focus of our program is to keep families together, every picture of a kid with it's parent is something to celebrate. All those pictures of healthy kids, playing, smiling, walking, and "breaking the scale" as we like to say in Creole, are just the icing on the cake. They tell us that recurrence of malnutrition, typically so common, has been abated, at least for now. They give us hope, because with each and every month that the child remains healthy, the likelihood that he or she will experience malnutrition again, diminishes. Perhaps now you see why we get so excited about those follow-up photos! 

But since I often share those stories, why don't I offer a few stories from inside the center. The following anecdotes will give you a peak into what it looks like to keep families together during the initial weeks of recovery and what it looks like for women to learn together. 

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This is Lovelie. She's 11 which makes her the oldest child to recover at Second Mile. She's staying at the center with her mom and her baby sister. 

Lovelie is recovering from Kwashiorkor-type malnutrition, the type of malnutrition that causes swelling of the face and extremities due to an absence of protein in the body. She weighed 29.7 lbs when she arrived. During the first phase of treatment, she lost two pounds of fluid-related weight. She is now three weeks into recovery and weighs 29 lbs.

This photo of Lovelie's mom and sister was taken during our afternoon Literacy class where Lovelie's mother is learning to read and write. She is 38 years old and her formal education ended after the second grade. Lovelie's mother has given birth to 7 children. 3 of these children died before the age of 3. When she describes the events leading up to their deaths it's clear that malnutrition was the culprit in all three circumstances. The family was referred to our center by another mom who, after learning that signs and symptoms of malnutrition, was able to speak to her what her daughter was experiencing. Both women live in a community 40 minutes from the center. They travel together when going home for the weekends and they arrive together on Mondays.

For this family, "keeping families together" means not having to lose another child to malnutrition.

This is Stevenson. And he's a teddy bear. 

His sweet personality and quirky facial expressions are so clearly a result of his mother's affection for him and her own kind-hearted and joyful temperment. Stevenson's mom is 18 years old. His dad is 19 years old and both parents are students. Mom and baby live with her parents and two siblings. 

Mom and Steve on their last day at Second Mile. 

Mom and Steve on their last day at Second Mile. 

He's a momma's boy and she's her boy's momma. 

As part of our admission assessment we always ask the caregiver what she does when her child is sick. Does she take the child to a clinic, or hospital? And if so, where? Stevenson's mom had already made several visits to local health centres.  This wasn't his first episode of Severe Acute Malnutrition. Twice he had been hospitalized. Once for 8 days when he was 4 months old and again for 30 days when we was 5 months old. When resources were dwindling and Stevenson was still suffering from poor health his mom was advised by people in her community to bring her son to Children of the Promise, an infant care center not far from our facility. In an effort to keep the family together, their social worker sent the pair to Second Mile. At 10 months old he weighed 11 lbs.  

Getting ready to go home

Getting ready to go home

While at the center Steve made a new friend and so did his mother. The pair shared a room with Judeline, a baby of the same age who's undiagnosed heart condition had made it impossible for her to thrive.  Her mother is just 2 years older than Steve's mom. The two moms bonded over the fact that they'd reached nearly the same level in school, 8 and 9th grades respectively, and that their babies, both of whom weren't even a year old, had already overcome so much in their young lives. I learned from Judeline's mom that even on the weekend she stayed in contact with Steve's mom. "She's the kind of person that will call you three times in the same day, just to check in. She's a good person." 

During their last week at the center, Steve's mom was seen using her 9th grade smarts to help two of the other mothers study for their exit exam. She humbly and gently led the group through a review of all 18 test question like it was her job, smiling the whole time. 

Mama Stevenson scored a 93% on her exit exam. She scored a 39% on the pre-test

Mama Stevenson scored a 93% on her exit exam. She scored a 39% on the pre-test

For this 18 year old, "keeping families together" meant finding a solution to her son's health woes that didn't involve being separated from him. It meant getting answers, gaining confidence and making mom-friends. 

This is Givens. He was somewhat of a surprise admission to the Second Mile Haiti family. 

1 day old. 

1 day old. 

This is his big sister Gudelande 1 week into her treatment for severe acute malnutrition.

She had a rocky start. But things got much better.

When they arrived at the center Gudelande's mom was fairly pregnant and Gudlande, in the throes of severe acute malnutrition, was in very poor shape.

On their 3rd Monday at the center, Mama Gudlande arrived at the site with an extra bundle. Without making a fuss, or asking for help, she walked straight through the gate to the room she way occupying, Gudlande in one arm, the bundle in the other. 

Much to our surprise, Mama Gudelande had had her baby at home over the weekend and without missing a beat, she was back at the center to continue where she'd left off!

Because Gudlande's mom did not know how far along she was in her pregnancy and because the new baby appeared to be pre-mature, we sent them for consultation at the nearest hospital. After a few tests, the baby was admitted and spent 5 days in the neonatal unit. Gudelande stayed at the center. The other moms collectively bathed her, changed her, and brought her to and from the nurses who spent time coaxing her to eat and drink.

By Friday, Mama Gudelande still hadn't been released from the hospital with the newborn so one of the moms took Gudlande home with her for the weekend.

The following Monday the entire family was back at the center. 

Other moms smile at G. Happy to see her on the mend. 

Other moms smile at G. Happy to see her on the mend. 

What would have become of Gudlande? What would have become of her tiny brother if Mama G didn't have the knowledge she gained in just 2 shorts weeks at Second Mile?

Pre-mature feeding is common in Haiti. Families often give infants tea and coffee, sugar water, and porridge when they are days and weeks old. This harms the child's digestive tract making them more susceptible to infection and food sensitivities. This is especially true in the case of low birth weight babies. Unable to afford infant formula, and under the impression that breastmilk is not enough, the mother and other well-meaning relatives will try to supplement the baby's diet with mature foods that do more harm than good. If Gudelande's mother hadn't received the education she received at Second Mile she would have likely given him other foods to help him grow. And when she could no longer afford baby food she would have filled his belly with coffee, tea, and sugar water as she had done when Gudlande was an infant. 

While early feeding may have been a contributing factor in Gudlande's experience of malnutrition, her brother Givens won't have the same problem. Even though she'd been in the program only a short time before giving birth to her second child, she'd learned that exclusive breastfeeding for 6 months is an important step in preventing malnutrition. And the regular, nutrient rich meals she received at the center also set her up for a successful breastfeeding experience.  But today, at 3 months of age Givens weighs a solid 13 lbs. Just 4 lbs shy of what his 15 month old sister weighed before treatment.

For Gudelande and company, "keeping families together" meant being able to keep and care for a sick child while pregnant with another, giving birth to a low-birth weight baby but having the support system to help while her hands were full, and developing a new understanding of how to nurture her baby in a and a safe and economical way that promotes health for the entire family. Breastfeeding for the win! 

Mama Gudelande may have scored a 17% on her entrance exam but she scored 88% at exit and the difference shows. 

This is Fadelin.

He's 6 and his mom is 35. She gave birth to five children and lost one at the age of 2 to malnutrition. She also lost her sister. 

When Fadelin's mom arrived at Second Mile at the referral of another Second Mile graduate, Fadelin weighed 24 lbs. He wasn't the only one who was ill. Josie Fadelin's cousin was also unwell. He also had early signs of kwashiorkor type malnutrition. Both boys were lethargic. Both needed mom. 

We've watched these boys change drastically with improved nutrition. Fadelin is kind, quiet but smart. Josie is outgoing and cunning, a faithful friend. The two boys have an amazing mother in Fadelin's mom. Though Josie is her nephew she's taken him into her care without hesitation. The boys are brothers.

Meanwhile Fadelin's mom has been quietly and diligently taking advantage of all the classes offered at the center. She reached the second grade before her family could no longer afford to send her to school. She cannot read or write but is learning these skills in the literacy class. She makes her living selling food products like dried fish and tomato paste earning roughly $10 / month. She's eager to apply the skills she's learning in the business program and try her hand at managing the business she will be given when she graduates from Second Mile. With a larger supply of products her profit margin should be much better. 

For this family, "keeping families together" means investing in a mother who is already stepping out to support her family. In her case "keeping families together" means allowing her to continue to parent not just her own children but those of her late sister. It means equipping her with the tools and the knowledge to invest in and educate a community that is suffering greatly under a burden of malnutrition.

Already she has reached out to other women in her community to teach them about malnutrition and to help them seek treatment. Already she has opened her home. It's a privilege to stand with her.

Whether a mother is 38 or 18. Educated in a classroom or not. Living with her parents or parenting kids who aren't her own. Second Mile is a place where women are united by a common experience and everyone leaves empowered to share their knowledge with others.  

It comes back to education AND opportunity. At Second Mile learning takes place actively, in a safe place, among other mothers who are also learning. The child is recovery from a critical condition, in real time, which does something remarkable for the caregivers sense of can-do. The opportunity to participate in the business program which ends with a real business and the chance to earn a living once they leave the facility-- is priceless. All of this. It all makes a difference for the child and for the entire family.