Monday, April 27, 2015

Community Caregivers on Campus

A huge thank you to Sentebale is in order (again!). In January 2015, TTL's Safe Home program highlighted one of its biggest weaknesses: separation & attachment. Whilst we do everything in our power to save our clients from severe malnutrition, we fail to encourage the caregivers to visit their children whilst they are in the Safe Home

Research has demonstrated that meeting the psychosocial needs of children is a critical element of early childhood development (ECD), and is especially critical for the health and development of children living with HIV or the effects of HIV. Psychosocial support of children also includes the attachment needs of the child, by promoting healthy interactions and bonding with their caregivers, and limiting the amount of time spent away from the caregiver during the child’s most formative years. Given the country’s current HIV epidemic, high levels of poverty, and challenging and isolated terrain, many families find it difficult to have regular contact with their children during their Safe Home rehabilitation. In order for psychosocial support of children to be sustainable, it must be carried out by a child’s primary stable caregiver. An essential element of this is the empowerment of a child’s primary caregiver through training and supervision in order to develop expertise and confidence in supporting their child in a psychosocial as well as physical manner.

The project will be focused on involving children’s community caregivers in the Safe Home rehabilitation process by providing transportation and accommodation in Mokhotlong Camp Town for a 1-week period leading up to a child’s Safe Home graduation, along with monthly visits. During the time caregivers are present on the TTL campus, they will receive nutritional and ECD training support from the TTL Safe Home supervisor and staff. This will allow them to practice what they have learned in a supportive environment. Working off international rehabilitation programs with demonstrated success, TTL aims to foster the attachment between child and caregiver, and bolster the long-term sustainability of our services through caregiver training and empowerment. We are currently waiting on the funds to implement this project, with a possible start date sometime in January 2016. However, in order to address these issues as soon as possible, Sentebale provided us with funds to implement a cluster workshop to trial presentations and trainings before the pilot program begins. 16 community caregivers joined us for a three-day training session which featured presentations on nutrition, early childhood development, meal preparation, child protection, management of childhood illnesses, staging HIV, HIV medication and client compliance of TTL services. It was a huge success with all women partaking reporting that they learned a lot and look forward to the implementation of the pilot scheme.

Monday, April 13, 2015

Difficult Case to Crack

This poor little girl has had an incredibly difficult start to life. TTL has been with her from day 10, but 1.5 years on we are still struggling to diagnose what is wrong with her. Her body refuses to gain weight. She struggles to keep food down and fluids run right through her. We have worked very closely with Baylor hospital and her family to assess and examine her needs. She is HIV Negative. At 7 months we decided to bring her into the Safe Home to help her gain weight. However, she refused to settle in. She rejected all food, drink and attention. Changing tact, we took *Lerato home and continued with an intensive home-visit form of care. We have kept a very close eye on her over the past year and she seemed to do well at home.

However, last week when we visited *Lerato we found that she had deteriorated rapidly and was now -4SD on the WHO Z score. Prompted by her mother, we decided to bring *Lerato back to the Safe Home to try to treat her here again. We have had to handle the situation very carefully, knowing full well how she reacted to Safe Home treatment last time. However, she has been with us for 6 days and we are very happy to announce that she has settled in well and is starting to gain weight. In 6 days, on the F100 diet, she has gained 2kg. She will stay here, as long as she remains happy and comfortable, to receive constant care from the Baylor and TTL staff. During this time we hope to monitor her health more closely and assess her illness.

*Child's name changed to protect identity

Friday, March 13, 2015

Tongue-tied troubles at TTL

The TTL Safe Home welcomed one of our tiniest babies this week. At 5 weeks and just 2.7 kg, Leboneng has a z-score of -4, indicating critically severe acute malnutrition. Ideally, children should have a z-score around the median for their height/weight, but this little guy is 4 standard deviations below the median. Leboneng's mother had complications following his birth, and was only able to breastfeed for 3 days before being taken to the nearest hospital for medical attention. Little Leboneng was left in the care of his adult sister, who could not afford formula and supplemented Leboneng only with water and sugar. Fortunately, Village Health Workers in his village alerted TTL Outreach staff of the baby's need for assistance while they were doing assessments at a nearby clinic. Our Outreach staff quickly recognised Leboneng's critical level of malnutrition, and brought him back to the TTL Safe Home immediately.

The Safe Home Supervisor 'M'e Lehela feeds Leboneng using a medicine syringe. 
Once Leboneng arrived at the Safe Home, we realised that there was another obstacle in the way of his eating and gaining weight. Leboneng has ankyloglossia, which is also known as being 'tongue-tied'. There is a short band of tissue tethering the bottom of his tongue's tip to the floor of his mouth. It is a condition which is present at birth, and it restricts the tongue's range of motion. This can result in difficulty eating, speaking, swallowing, and breast feeding. Sometimes the band of tissue can loosen over time and resolve on its own, and other times needs to be treated with surgery. We are already noticing the difficulty Leboneng has when bottle feeding as the process appears distressing for him. To make sure this little guy is getting the nutrition his vulnerable body needs so desperately, we are feeding him formula through a syringe. With 9 other children in the Safe Home, the Bo'm'e have their hands full. No matter what it takes or how long it takes, the team here will ensure that Leboneng grows stronger and healthier everyday!

Tuesday, March 10, 2015

Cleft Palate Conundrum

Two year old Seeiso waddled into our lives in November 2014 with severe malnutrition and an untreated cleft palate. At 7 months old a doctor visited his local clinic and identified the cleft palate and recorded it in his health book. However, the condition was not explained to the clinic staff and, as they did not know what it meant, it was ignored.

We found Seeiso whilst on Outreach and, at -3SD below median, we immediately admitted him to the Safe Home. Outreach staff reported that he was regurgitating food through his nostrils. We ran a full assessment on Seeiso and reviewed his health book, which is when we saw the doctor's comment about the cleft palate. TTL Safe Home Supervisor, 'M'e Lehela, got right on the case and reported his condition to Queen Elizabeth II Hospital and scheduled a surgery. It is now March and finally the time has come for his surgery. Seeiso has stayed with us at TTL Safe Home since October and we have monitored his health, nutrition and development very closely. He is now a healthy young boy, ready to withstand the wear and tear of surgery. We picked up Seeiso's mother from her home in Thaba Tseka and she stayed with us on campus over the weekend, rekindling her relationship with her son after almost 5 months apart. We then transported both mother and son to Maseru for the operation yesterday. We have arranged accommodation and return transportation for Friday when both mother and son will return to their home village.

We hope this will be a life changing surgery for little Seeiso and we will continue to monitor his recovery and development as we go.

Thursday, February 12, 2015

Flash flood devastates TTL Campus

It is true that things can change in an instant. Out of nowhere yesterday afternoon, the TTL campus in Mokhotlong was hit hard by an intense storm that produced golfball-size hail, massive winds and rain, and floods. The quiet creek running alongside campus turned into a raging river taking trees and everything else in its path. Heavy rains, lightning and thunder carried on for over an hour and a half. Flood waters poured into campus, uprooting and devastating all of our crops. Braving the elements to run to a different building resulted in navigating knee-high currents moving not just mud but rocks, bones, crops, and garbage.  Literally all we could do was watch as Mother Nature went rogue.  

We were all very fortunate to be safe and despite the fact the flood waters reached such a height that they flooded the Safe Home, we were able to get the babies to safety. After looking around campus in the daylight, we realised the depth of the damage done by the storm. TTL staff, Fellows, and visitors all came together with spades, rakes, and wheelbarrows to relocate our pathways and walks. It took over 6 hours for the job to be complete, with many more days of work on campus left to do. Most upsetting is our beautiful garden, which has been completely washed away by the rain. The garden that provided fresh food for the children in the Safe Home has now disappeared and won't be salvageable before the fall arrives. 

We are thinking about all of our community clients and partners now as they too struggle to cope with the aftermath of the storm. Food security is a chronic issue here in Lesotho, and TTL has attempted to lessen the burden by providing our client families with seed packages for their own sustainable gardens. We realise with heavy hearts that like our garden on campus, the gardens of many families in and around Mokhotlong will have washed away. Now more than ever, the work of TTL is essential for those who are most vulnerable. 

PLEASE, if you can, please help our clients to get back on their feet and see them through until the next harvest. Donate here if you are from North America, and here if you are from the rest of the world, so that TTL can buy canned vegetables and meat to see them through this incredibly devastating and difficult time. 

Thank you.