Second Mile Haiti

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Thursday, March 13, 2014

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


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