Second Mile Haiti

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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.

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