Second Mile Haiti

Welcome to our blog! This is a place for us to keep friends and supporters up-to-date with the latest 'Second Mile' happenings! Check in often. Things are moving fast!

Tuesday, April 29, 2014

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...

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
during - Shenaida's auntie helps her eat Mamba
leaving Second Mile - 4/25 - 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.

Friday, April 11, 2014

And then there were 11

Well hello there. How are you? 

It feels like we haven't posted in a long time! I hope you got our newsletter in your email. If you didn't you can sign up for our e-newsletter on the website or view it here

So much has been happening here in Haiti, it's hard to know where to begin! Most days are either really hard or really exciting. Every day is full. Those of you who have been following since the beginning have seen Second Mile grow from the ground up. You heard from us during our first 3 months when we were sharing our vision in the States and stuck with us during the next four months of getting our bearings in Haiti. You watched us (and helped us) buy land and spend a full year building the facility, pushing ahead with construction only so long as we had the funds. Then on Mother's Day 2013 we opened our doors and started to walk alongside our first mother.

Can you believe it? On Mother's Day 2014 we will have been functioning for one year! 
Wow... it sure feels like it's been longer than a year... 

We still follow-up with the very first moms. Their children are doing very well and many still have thriving businesses. Those that don't, are still making it work somehow. Their not-so-successful business ventures have helped our business program director come up with better ways to get moms on their feet and to help them succeed even though the odds aren't stacked in their favor. All the moms that stuck through the recovery program are still bringing in healthy children for follow-up visits. That means that not only are their children alive, they also aren't living in an orphanage or institution. Those statistics are pretty good right now. We know we will encounter harder, more challenging cases in the future where family preservation actually won't be the best solution. But if the first year has been any indication of what's to come, then those cases will be few and far between. There have have been just 2 women that weren't capable of staying at our facility and caring for their children there. These kids were referred to another program. And there was one child whose father pulled her and her step-mother out of our program because a visiting group of short term missionaries, without knowing exactly where she was, told her that they were the ones helping his daughter and that she didn't need to be anywhere else. I could insert something here about why that kind of stunt will give short term visitors a bad rep among those who are working to find sustainable solutions for families in poverty but I think I'll skip it today. ;) 

Not including the three cases I just mentioned, we've worked with 26 mothers and have nutritionally rehabilitated 30 children.  And guess what! 

We still love moms.

 We are still passionate about empowering women. 
And we still believe in caring for mothers of malnourished babies in this unique way. We are still doing the same ol' things but it looks a lot different with so many more women in the mix! 
Our process is still to come alongside women during their child's health crisis, offering a place of recovery, nurturing that mother-child bond, and offering educational and skills training opportunities through which women can begin to bring themselves further away from that scary place where their kids are experiencing undernutrition, hunger, and illness. 

I've spent a lot of time with our photos lately. We have got to get our act together and share some of the amazing images with you. I hate to admit it, but we don't even have a single page on our website that shows what we actually do, now, present-tense. The pages on our website that describe our facility were written when Second Mile was just a dream of an idea. That's got to change! Until it does, this small photo collection will have to serve as an update. We've chosen the photos that reveal moments of hope, courage, and joy. As you linger on these photos and read their captions I hope you will consider what improved health, empowerment through education, and new economic opportunities can do for women in Haiti. 

Baby Daniel had his first follow-up visit. Way to go mom, he gained weight during his first week back at home!
The moms participate in an infant massage class taught by our health educator Ms. Kerline
Ms. Kerline is a newly certified Infant Massage Instructor

Using infant massage to connect with their babies and have some fun. 

Helping a new mom adjust. 
The women gather around a mom who will spend her first night at Second Mile.
Natalie and Mom. No one else can make her smile that big. These two recently concluded their stay at Second Mile. 
Kerline works with a new mom while two babies play in the background.  Their moms are over in the education building sitting in on one of their final business classes before they "graduate" and leave Second Mile at the end of the week.
Morning weights.

Friday. Waiting for the final weight of the week.

Around 8 am each morning, the moms mosey into the clinic gallery and chat with one another while Ms. Prestina (nurse) weighs the children one by one and takes their measurements. For most of the children the goal is to gain weight. But for the children that come to us with swollen limbs [a sign of acute malnutrition], weight loss is actually an indicator that the child is making good progress.  The child below is a good example. He was admitted with swollen limbs and face. We began by teaching the mother how to make [and administer] a special stabilization formula of therapeutic milk. The formula is made using sugar, oil, milk, water, and cereal flour in amounts set to offer precisely the right nutrients and calories to stabilize him without any adverse effects. At first the milk was given in small volumes (according to his weight) every 2 hours, then he graduated to every 3 hours, and eventually every 4 hours. His mother was the one giving him each milk feed. Her happiness, and his, is truly a byproduct of much patience and perseverance.  

Edlin lost all his edema in the first 10 days. He is now eating Medika Mamba 

Moms are involved and hugely invested in their child's progress. Many of the moms remember their child's weight from day to day. They are empowered to think critically and troubleshoot feeding method, or timing, or hydration.
8 month old Judeline. 8.5 lbs. Week 2 at Second Mile. 
1 year old Estherline making great progress. 
Esther and mom. 
Walking back from a morning business course. 
The facility is set up so that moms can always be close by their kids whether that means taking them to classes or letting them sleep with another mom nearby. This helps the kids gets meds and feedings right when they need them no matter what else is going on. 

Above- mom takes her health education post-test. Her daughter is well and she's about to leave our program so she answers questions about the topics that were covered during her stay. She describes concepts of child and maternal health, nutrition, and disease prevention and proves that she's heading back to her community with a lot to share.
In the photo below, a mom requests that photos be taken to commemorate her daughters 1st birthday. 
Speaking of birthdays, $3,800 was raised during our recent Birthday Fundraiser. A sincere thank you to those who donated.


An older brother follows mom to "school."

Evening Literacy Class.

Goats get brought in for the evening.

Playtime with mom.

The family bond stays strong. 18 month old, Shanai, sits in the clinic with her aunt. They get some quiet time away from the other moms and babies and Shanai gets to finish her sachet of Medika Mamba.

This last photo is what it's all about --  How can you empower a mother to care for her vulnerable child if that child is in an orphanage? How does she learn to apply life-saving behaviors (like giving oral rehydration fluids when her child has diarrhea), if mom and baby aren't together? This mom is 18. The mom next to her is 17. The mom next to her is also 18. It's just a coincidence that the young mothers sat together in the back row and all the women in the front are much older. The point is that the young mothers aren't done learning. The older mothers aren't either. I can't quite get what's happening in this photo into words, but it's good and it's powerful.

A mom sits in literacy class with her baby and a pitcher of oral rehydration fluid which she made earlier in the morning when the baby first began to have diarrhea. Next to her notebook is a piece of paper where she is keeping track of how much the baby drinks. All the moms at Second Mile learn how to make oral rehydration solution and the importance of giving fluids when your child is sick. They get hands on practice if their child has episodes while they are at the facility. Worldwide, diarrhea is responsible for more childhood deaths than any other cause.