Happy Holidays!

From the staff and children here in Mokhotlong, we wish you a happy holiday season!  Here's a smattering of photos from our holiday celebration on Friday.

TTL gets a new Fellow

Hello! I am Becky Dale, the newest TTL Fellow here in the stunning mountains of Lesotho.

Sani Pass overlooking the Drakensberg Mountains

I have just arrived from the much flatter (and much warmer!) West African country of Ghana where I spent six months working to improve the quality of primary education in the Volta Region. That position was a departure from my previous work and studies that have focused on central African history, conflict, and development. Needless to say, I am once again about to experience a very different story during my time in Lesotho.

The next year will be a great learning opportunity, and I am both eager to get started and humbled by my ignorance. Yet life in Lesotho will not wait for me to catch up; the work at TTL must continue each day.

I am excited to be joining the staff of TTL, spending time with the babies and their families, and meeting the visitors who make the trek to Mokhotlong. For those unable to visit our Kingdom in the Sky, I look forward to sharing plenty of stories and memorable experiences along the way!

- Becky

World AIDS Day - A Wish

I remember the world before HIV became part of our vernacular. 

My first memory of HIV is the story of Ryan White, a child close to my own age, fighting discrimination and misunderstanding and creating a voice for persons, especially children, living with HIV and AIDS.  I remember outrage; I remember fear and I remember, to a lesser extent, support. 

I remember, 10 years later while working at a hospital in the US, encountering a teenage girl diagnosed with HIV and Tb.  She was the first person I met living with HIV; I now realize that she was dying from AIDS. 

Off and on throughout my healthcare career, I occasionally encountered people of all ages living with various stages of HIV and AIDS.  However, I did not fully comprehend the devastation wrought by this virus until I arrived in Sub-Saharan Africa in 2011.  There is no person here unaffected by HIV; the virus does not discriminate, though the impact is most keenly felt among the world’s destitute.

Regularly, I witness an already taxed healthcare system struggling to cope with the increased demands of HIV.  I witness insufficient resources in every sense of the word:  a scarcity of doctors and nurses; a scarcity of medication; a scarcity of medical supplies; a scarcity of clinics, health centers and hospitals; a scarcity of knowledge and power.  When I first arrived here from a place characterized by consumerism and excess, I was judgmental and I perceived apathy on the part of the health workers.  “Why aren’t they doing more?  Why don’t they care?” were my silent accusations and questions.  Having lived and worked in this resource poor setting for some time, I now realize that the apathy I perceive is more insidious; it is a global apathy towards the world’s impoverished.  HIV is exacerbating the situation.

This global indifference is felt most acutely by the infant whose mother died unnecessarily in childbirth, it is felt by the caregiver who arrives at a health facility after hours of travel only to learn that life-saving medication is not available, it is felt by the nurse or doctor who determines treatment based not on the best interest of the patient, but on the prudent use of limited supplies.  I feel it as I struggle to make sense of this dichotomous world.  I feel it every time I witness the senseless death of a child served by TTL; however, my questions and accusations have shifted, “Why aren’t we doing more?  Why don’t we care?”

There is a philosophy in Lesotho, “Motho ke motho ka batho.” This Sesotho phrase translates to, “A person is a person through other people.”  This is the language of the interconnectedness of all living things; the language of faith in humanity.  It is the ethos that brings the Basotho together to care for one another; it is a life of resilience and unity.  It is the giver of hope to those silenced by poverty and oppression, and to me. 

It is my wish for World AIDS Day, for everyday, that this belief be understood and embodied by all of humanity.  It is my wish that we all identify with and choose a life of global solidarity.  In the brave words of one of my Masotho co-workers, “My plea is that a cure for HIV/AIDS be found.  It is killing us, especially those living in developing countries.  I am realizing that one day it would be like a history that the Basotho nation once existed.”

Outreach Staff, Bo'M'e Kokonyana and Mantja

Safe home kiddos, 'M'e Mapoloko and 'M'e Maliphoofolo

Safe home and administrative staff in red for World AIDS Day

A Field Trip!

The caregivers for the safe home work hard!  Their work requires a combination of day shift and night shift, seven days a week.  It is a challenge to give the group time off of work because there always seem to be little ones here that need their care and support.

Last week, those of us in a more administrative role risked encounters with kaka and exhaustion to allow the Bo’M’e of the safe home to take a field trip to Beautiful Gate, an orphanage here in Lesotho.  The caregivers wanted to share a little bit about the experience with you!

Group shot in front of the Beautiful Gate building

As we got to Beautiful Gate we were welcomed and started moving places. This is when we were brought together to be told how the organization was started and its operation on a daily basis. Next, we moved around the campus and that’s where we discovered that children who stay there are divided into families being Khotso, Pula and Nala (Peace, Rain and Prosperity).  Tours like this one are very helpful to us because this where we are able to exchange ideas with those who are in the same field with us. Even once in year can be appreciated for us to pay a visit to other orphanage homes.

First and foremost, we pass our gratitude to our managing director ‘M’e Nthabeleng Lephoto who raised the point that we, safe home mothers, should visit Beautiful Gate to go and learn how it operates as far as the kids welfare is concerned.  Apart from that, we also thank our dear fellows Jennifer and Brad whom we do believe that in collaboration with our director also liked the idea.  This is why this was successful.

Furthermore, we pass our thanks to all those who played a major part in looking after the kids and other office duties while we were away.

We are so glad that you enjoyed the trip and brought back ideas to share about how to improve TTL!  I’d like our readers to note that Brad conspicuously returned to America days before the outing occurred. 

‘M’e Nthabeleng and myself have a new respect for the work of the safe home caregivers!  Our efforts to institute group naptime, workers included, were not successful. 

Village Health Workers...Our Eyes and Ears

For many Basotho, health clinics are a multiple day journey away via foot, horseback and / or motorized transport.  Village Health Workers (VHWs) are the eyes and ears for both health clinics and TTL; they are an indispensable resource within the community.  VHWs are community members specially trained by the Ministry of Health to help ensure identification of, and timely referral for, myriad childhood illnesses.

Often, trainings for VHWs are far and few between.  Recently, thanks to a donation from The Caring Network, TTL has been able to help VHWs in the Thaba Tseka and Mokhotlong districts receive additional training.  The trainings have two components:  a refresher component about identification of children suffering from malnutrition as well as new training about timely identification of common childhood illnesses, including appropriate referral and how to support the infant or child in the event of a multiple day journey to a health facility.

Though we can’t change the terrain of this beautiful ‘sky kingdom,’ we can help diminish the challenges faced by those living in the beautiful, but remote, mountain villages by ensuring that all available VHWs are empowered with knowledge to make life-saving referral decisions.  

Thank you, 'Me Malefu, for facilitating the session!

Linakaneng VHW training (Thaba Tseka district)

Toddler Time and UNICEF

The safe home is a frenzy of bustling activity these days!  We are currently caring for six active and inquisitive toddlers, as well as a few quiescent infants that pass their time observing and smiling at the whirl of motion surrounding them.  It’s not surprising that, although we serve children age birth through 5-years, most of our clients are under the age of 3.  Malnutrition is most likely to impact the 12 to 36 month age group.  This period of vulnerability is partly linked to the transition from exclusive breast or formula feeding to complimentary feeding.  Complimentary feeding begins at age 6 months, the age when breast milk or formula alone fails to meet the nutritional demands of the growing infant.  For healthy growth and development, complimentary foods need to be appropriate, accessible, affordable and adequate.  For many families in Lesotho, this seemingly simple recipe for growth and development is unattainable.

Malnutrition that is not corrected in a timely manner leads to stunting (decreased height) and impacts all aspects of child development; in acute cases it can lead to death.  In fact, malnutrition is the underlying cause of death for approximately 50% of children under the age of five; their nutritionally stressed bodies and immune system are unable to cope with the added burden of illness.  

Very recently, TTL was awarded a partnership grant from UNICEF to strengthen our nutrition and child development activities.  We are thrilled by this opportunity!  This project will enable us to tackle malnutrition, and its sequelae, in a more holistic manner.  We will be able to provide more individualized developmental and nutritional knowledge to the caregivers of the children supported by both the safe home and the outreach program.  

Khotso, Arabang and Liebo are all recovering from acute malnutrition.  When Arabang arrived to the safe home 6 months ago he was significantly behind on his developmental milestones and unable to roll over or crawl.  Now, thanks to the support of the TTL safe home caregivers, he is rolling around, crawling and standing with support!

Everyday, we witness the amazing resiliency of infants and children as they flourish when provided with adequate nutrition.  We watch children who have fallen behind on their developmental milestones surge forward as their strength and energy are renewed.

Relebohile and Tsepiso are best friends!  Relebohile is recovering from acute malnutrition while Tsepiso is recovering from micronutrient malnutrition.  Both are catching up on their milestones:  Relebohile is now actively crawling and Tsepiso pulls herself up to standing and walks with help!

Making babies fat!

Malnutrition is a reality for 50% of infants and children in Lesotho.  Malnutrition is a broad term that encompasses both quantity and quality of food consumed.  Malnutrition can be chronic or acute and can result in growth failure, macronutrient and micronutrient deficiencies.  If left untreated, the effects of malnutrition can be irreversible.   

Around Mokhotlong camptown, TTL is known as the organization that, ‘makes babies fat.’  We are proud of our reputation and happy to see the infants and children in our care flourish.  Infants and children that are supported in the safe home spend, on average, four months receiving intensive nutritional, medical, emotional and developmental support – but we’d like to see that length of stay reduced.  Recently, we reviewed and changed the safe home diet to make it more nutritionally complete while still utilizing locally available foods and adhering to cultural preferences.  We have increased the amount of healthy fat in the diet, added more fresh fruits and vegetables, increased the amount of animal protein and created age-specific dietary plans.  Although there is nothing quite like walking into a safe home full of thriving infants and children, we are hopeful that these changes will result in a more timely reunification process.  We look forward to monitoring and evaluating these changes and hope to enjoy the fruits of our efforts!

'Me Manthati providing a little taste testing along the way

'Me Maliphoofolo scooping some avocado to add to the mashed potatoes

Lehlohonolo, affectionately nicknamed Ntate Makoenya for his chubby cheeks, likes the new diet!                            

How environmental sustainability projects promote TTL's long-term sustainability

Solar water heaters and new gutters for roof water catchment

New Gutters directing water to tank 1

Over the past couple of years, the Town of Gummersbach, Germany (and more specifically die Aktionsgruppe Gummersbach der Welthungerhilfe /Initiative für Kinder in Lesotho) has helped Touching Tiny Lives (TTL) become more “green.” They have supported several environmentally friendly sustainability projects, including a solar electric system for the safe-home, three solar water heaters (geysers), and recently a roof water catchment and storage system.

The new roof water catchment and storage system was finished this week and is comprised of gutters on two buildings directing water to two 5000 liter (about 1300 gallons) storage tanks. The water captured from the roof will be used to wash TTL vehicles and water TTL’s expansive vegetable garden and plants. Not only do the gutters help direct the water to the storage tanks, but they also have the added benefit of preventing soil erosion around the buildings’ foundations. 

Why are “green” or environmentally friendly projects so important to TTL?   

• The first, and perhaps most obvious reason, is that TTL is being a responsible local organization by using less of the Lesotho’s limited resources. 

• The second reason is these projects promote TTL’s long term financial sustainability and ultimately help save baby’s lives.   This is a bold statement, but here is the bottom line: by reducing overhead costs such as water, heat, and electricity, the more TTL can spend directly on resources to save the lives of beautiful Basotho babies.

'M'e Mamosa, Outreach staff

TTL takes pride in how donor money is utilized and the creative ways we save and earn money. Double sided printing, selling vegetables from our garden, using food from our garden in the safe home, and having guest housing available for rent are all ways to put money towards where it belongs: on resources that save children’s lives - like medical supplies, food, and caregiver education.

We appreciate Gummersbach for helping with our “green” projects – because we know, ultimately, the savings realized goes directly towards saving lives, one child at a time.  Vielen Dank to Gummersbach!

Gutters directing water to tank 1

Ntate Tumisang, Gardener 

Bring on the Rain!   

Check Out This Video and the Work You Make Possible

Touching Tiny Lives and Touching Tiny Lives Foundation would not be where we are today if it wasn’t for your generous support.  We, along with the children and families of Lesotho, thank you.  We hope you enjoy this montage of happy faces that you helped to create!  Rea leboha!



Thank you! from TTLF on Vimeo.

Healthcare and Human Rights

According to the World Health Organization (WHO) Constitution:  “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being…”.  Yet here in Lesotho, and other developing regions of the world, this right is infringed upon almost daily, both directly and indirectly.  Treatment decisions are frequently based on prudent use of limited supplies, rather than the best interest of the patient.  Health clinics in the rural areas are few and far between and provide only very basic services.  Hospitals are found only in district capitals and, especially here in the Eastern Highlands where TTL is based, are a multi-day journey for many.  For those fortunate enough to reach a hospital in a timely manner, treatment is further delayed by long queues or indirectly denied secondary to resource allocation, damaged or missing equipment and / or poor staff to patient ratios.  Destitution and sickness, a deadly combination; a literal dead-end.

Here at TTL, we witness the inadequacies of this fractured healthcare system on a regular basis.  We work tirelessly to advocate for the infants and children in our care, to give a voice to those silenced by poverty.  We advocate, one child at a time.  Yet, far too often we encounter premature deaths:  death from pneumonia because there is only one working oxygen tank at the hospital, death from dehydration because of lack of intravenous access supplies, death from an internal injury due to time and distance; each incident a rebuke that falls on deaf ears.  Until equality in healthcare is a global priority, stupid deaths will occur all over the world. 

They believe that access to healthcare is a basic human right, do you? 

One Village at a Time

In more developed regions of the world, reaching out to potential consumers or clients can be straightforward:  television commercials, newspaper or magazine advertisements, cell phone applications and myriad methods of communication via the almighty internet.  But how, in a country where less than 20% of the population has electricity, do you reach out?  How do you let people know that a service exists, that help is available?  How do you reach the remote villages that lack electricity and cell phone signals; that lack shops that sell newspapers?  How?  By face-to-face communication, that’s how!

Public gathering at Maloraneng

TTL reaches out to village chiefs and leaders person-to-person.  We choose a village where we don’t yet have a presence, we talk to the chiefs and other community leaders, we set a date, we set a time and we go.  We go with scales, length boards and tape measures in hand.  We talk about TTL, the safe home and the outreach program.  We empower people to make informed choices through basic health and nutrition education.  We weigh and measure, we sing and laugh.  Our local staff connects with people.  Through two public gatherings last month, we reached just over 300 potential clients.  Hopefully those 300 individuals will carry our message onward in their own person-to-person interactions.

TTL caregiver 'M'eMaretsipile reaching out to one attendee

we walked...

and we walked some more...

until we reached our destination

Relationship building may not always be the easiest way to market an organization, as evidenced by the 1.5 hour drive and subsequent 1.5 hour walk to one village inaccessible even with 4 wheel drive high clearance vehicles, but here, it works.  Here, where face-to-face interactions are highly valued, we spread the message of TTL, one village at a time. 

Exploring Mothers' Health Knowledge in Lesotho

We encourage volunteers, researchers, and friends to write blog posts while at TTL, and here is one by a great young lady doing research through her studies at Notre Dame.  May we present...drum roll please...Colleen Huml!
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Did you know that something as simple as a mother's education can have a profound impact on the health of her children?  Maybe you do.  Maybe this concept is something we possibly take for granted in the developed world, where the majority of women complete primary education, at the very least.  Sure, it makes sense that the more educated a woman might be, the higher her economic status, and the more likely she will be able to provide and afford the best care for her children.  This theory, more specifically, that mere years of a mothers' education can decrease child mortality and increase overall child well-being, has long been proven in the fields of international development and global health.  Yet, for many populations in which maternal education is scarce, the question has been raised whether simply maternal health knowledge might have an impact on child health, and whether this health knowledge could prove to be a key area of focus for the future.  My name is Colleen Huml, and I am a current graduate student in Global Health at the University of Notre Dame.  This summer, I am working with TTL to conduct my field research on this very topic, among the mothers residing in the villages of the Mokhotlong District in Lesotho.   

    As a former Gender Studies and Pre-Med major, and a long time proponent of women's health and empowerment, it is safe to say that I am personally invested in this topic.  In addition to my personal interests though, the international community has also come to hone in on women as the newfound key to success in development.  Studies have shown that in developing countries, directing initiatives toward women proves to have a significant return on investment for both families and communities.  This is not to say that men aren't important too, they are very much central to the picture, however, through recent focuses on women, education and health initiatives have found new success which begs for continued exploration. 

      

Traveling to remote villages with the TTL outreach team, I have begun interviewing mothers about their own health, as well as their knowledge and behaviors regarding maternal health, hygiene, and nutrition.  We sit and talk, sometimes, well most of the time, straying from the interview questions, as they tell me about their health, their knowledge about caring for themselves and their children, and their obstacles in doing so.  With this data, I plan to create a baseline assessment of health knowledge and behaviors among the Mokhotlong mothers, and explore any possible correlation between mothers’ health knowledge, and the health of their children.  I’ve had a bit of time now to assimilate to Basotho life, tasting makoenas (the local bready treat), paying my dues attempting to converse in Sesotho, and spending time learning the routine of TTL outreach. 

    
My first few experiences on outreach have been difficult to describe.  I have witnessed extreme poverty amidst a backdrop of breathtaking scenery, beautiful and artfully crafted Sesotho huts, shocking medical cases that I felt helpless walking away from, and an appreciation of life at its simplest form.  I was nervous when I first began my study, worried that something might go wrong, or that mothers might not want to talk to the white ‘ausi’ from the States.  But things have gone surprisingly well, and I feel as though I continue to learn more and more everyday, about Basotho life and culture, the mothers whom I’m studying, and even a bit about myself.  I hope that in some way, I can make a difference with my research here.  At the very least, I hope that my research findings will have positive implications for future health education initiatives both within this population in Lesotho, and for the greater community of women in rural Southern Africa.    

16 June - Remembrance and Hope - the Day of the African Child

June 16 as defined by the African child:

A day of triumph over the long-standing regime of oppression over a people... Back in the day the likes of Hector Peterson, Steven Biko, Dr Mamphele Ramphele, Sol Plaatjie, Walter Sisulu fought for today. Today, a day of freedom of choice, fair opportunities for all and the right to basic health care and living standards we chant for.

This year’s theme of The Day of The African Child as designated by the African Committee of Experts on the Rights and Welfare of the Child (ACERWC) is Eliminating Harmful Cultural and Social Practices affecting Children: Our Collective Responsibility. At the core of this theme holds the principle of child care and protection.

As volunteers at Touching Tiny Lives who were born and raised in Lesotho, we know that social and cultural practices are the pride of many African countries including Lesotho yet a number of them are harmful. Lesotho is no stranger to some of the cultural and social practices common to many African countries that are both important by tradition and injurious to children. Men’s initiation school, one of the most significant traditional practices in Lesotho, is held with honour and dignity by families as their boys become men poised to become breadwinners and marry when initiation is complete. Unfortunately the boys go through very unhygienic cutting of their foreskins, after which they sometimes develop serious infections that take some lives. While there is a lot to be learned from traditional practices like initiation schools, awareness of the detriment of some of their routines should be spread so that they are aborted.

Most Basotho children have had, at least at one point in their lives, first-hand or second-hand experience with child abuse.  This experience has often ranged from corporal punishment, child labour, forced initiation, child molestation, forced marriages, female gender mutilation, statutory rape and being deprived of education. “My first-hand personal experience with social injustice to children has been in the form of corporal punishment during primary and high school years. I trust that children need to be spanked from time to time but the intense beatings I have observed as a student in Lesotho can traumatize children and leave scars behind.” says Jason. “My personal experiences having spent some of my childhood in the highlands on vacation at my grandparents have brought me to the realisation that most herd boys do not attend school. For the average Mosotho boy, years of toiling looking after domestic animals replace attending formal school which puts the child’s future at a disadvantage.” says Maseeng.

We firmly believe that it is our duty to filter some of the impeding cultural and social practices to build upon the progress of past generations. The law does play a part but it is more the responsibility of individuals because it is they who are personally challenged. On this Day of the African Child, take time to appreciate how far Africa has come to eradicate harmful practices and imagine how far it can go. What are you doing to bring social injustice to children in your community to a halt?

By Maseeng J F Masitha and Jason Saroni

Maseeng, from Maseru, Lesotho, and Jason, a University of Notre Dame Hesburgh-Yusko Scholar also from Maseru, Lesotho are spending two months at TTL to research the impact of traditional healers and medicines on HIV and AIDS.

Happy Birthday, TTL

Yesterday, TTL celebrated nine years of service to the children and families of Eastern Lesotho.  The idea for TTL can be traced to a cold, rainy Lesotho night in 2004.  A small child, orphaned by AIDS, was left outside in a thunderstorm to die, a desperate move by relatives unable to feed another mouth.  Neighbors heard the child's cries and brought him to Mokhotlong's social worker.  Later that evening, the social worker knocked at the door of former Peace Corps volunteer Ken Storen, asking for help.  Ken suggested that we "better buy some diapers," and the TTL safe home was born.

In the following months, Ken and his now wife, Colleen Dunst, also a former Peace Corps volunteer, filled a home of children impacted or orphaned by HIV.  Ken, Colleen, and a dedicated Basotho staff committed to a vision in solidarity with Lesotho's families: that every child deserved every chance to survive, regardless of the odds, with proper nutrition, medication, and loving care.  From that vision TTL blossomed, one child at a time.  

In the past nine years, TTL has remained true to Ken’s vision of one child at a time and in doing so, TTL has provided support to over 1200 children to date.  Just yesterday, as the workday was about to end, we received a birthday surprise:  three infants arrived referred to the safe home by Mokhotlong Government Hospital after being diagnosed with severe malnutrition. 

Two of the infants are six-week-old twins weighing in at 2.2kg and 2.8kg; they weigh only a few grams more than they did at birth.  Their heads loom large over their skeletal bodies.  Their mother is unable to keep up with their feeding needs and cannot afford formula to supplement their diet; she did the best that she could and supplemented their feedings with porridge.  As we’ve seen time and again, however, mixed feedings do not provide adequate nutrition for newborns. 

The third infant weighs just over 3kg and is 4 ½ months old.  Her vacant eyes watched as we weighed and measured her, she was too weak to offer many cries of protest.  She is an orphan, being looked after by family members and has been stricken with repeat bouts of diarrhea.

We are thankful that these three infants, along with the others that TTL has served, will receive care and support that will improve their odds of survival to their fifth birthday, and beyond.  We celebrate the safe home intakes, the family reunifications and the graduations from the TTL program, one child at a time.

One of the three newcomers to the TTL safe home

The Faces of Motherhood

Today is mother’s day.  In Lesotho, the traditional concept of mother becomes as murky as the mountain rivers after a strong rain.  Lesotho has the 11^th highest maternal mortality rate globally with 620 reported maternal deaths per 100,000 live births.  If that figure isn’t staggering enough, consider that 27% of women of childbearing age are HIV positive with a life expectancy estimated between 41 and 49 years.  Furthermore, it is highly probable that all of these reports are gross underestimates considering that the vast majorities of women don’t have access to medical care and therefore simply fade away without report, leaving Lesotho with, per report, half of its children categorized as orphaned and vulnerable.

We don’t need to revisit statistics to remind us of the impact of maternal mortality and HIV/AIDS on the population served by TTL.  We experience the figures first hand when we receive a motherless newborn into the safe home, when our outreach team partners with extended family members to find a caregiver for an orphaned child.  We see it in the faces of children caring for children, the traditional idea of a mother no more than a photo or a vague memory.

Today in Lesotho, we celebrate mothers and all those who are caregivers.  We celebrate the caregivers that work tirelessly day after day and night after night in the TTL safe home to provide care for the infants and children.  We celebrate the grandparents, the aunts and uncles, the siblings, cousins and neighbors who come forward to care for the orphaned children of Lesotho.  We celebrate the resilience of the people that come together to care for one another, for whom no face will fade away without knowledge, without report.

Hello!

Greetings from the mountain Kingdom of Lesotho!  My name is Jenn Baker and I’m the newest Touching Tiny Lives Fellow.  I first stumbled upon TTL while taking a vacation from my work as a Peace Corps Volunteer in Swaziland in April 2012.  I was smitten with the organization, its mission and the safe home full of infants and toddlers always ready for some additional cuddling or playtime.  I had the good fortune to spend a couple of months here at the end of last year and I left with the knowledge that I’d be returning for a full year as the next fellow.  I am honored and excited to return and work alongside some of the most motivated, caring and friendly people in Mokhotlong.  I look forward to sharing this journey with the local staff, fellows, volunteers and other visitors that cross our threshold during my time here. 

I feel so fortunate to draw inspiration from both my co-workers and from the dramatic mountain landscape that surrounds us:  Waterfalls that trickle and roar feeding the cold streams and rivers that snake their way through the valleys they carved; sunsets that play with the mountain contours and clouds to create dramatic images full of vivid colors not found in any box of crayons and a night sky that mesmerizes with its abundance of stars, shooting and stationary. 

This next year, like the mountains and valleys of Lesotho, will be full of highs and lows.  I look forward to the journey.  Thank you for sharing this adventure.

Best wishes,

Jenn

Alone we can do so little; together we can do so much.  ~  Helen Keller

Medical Students Visit TTL: Part 3

As a visiting 4^th year medical student with intention to become an Emergency Medicine physician, I have spent much of the past school year as a student learning in various Emergency Departments. During these rotations I have been taught the importance of gestalt and gut reaction, the importance of walking into a room and determining “sick” or “not sick”…and quickly.  This is most important in the case of young babies who cannot tell you what is hurting or why they feel bad. My experience at TTL has stressed the importance of this, especially here in Mokhotlong and surrounding villages where there are both communication challenges and limited medical resources.

The severity of illness and malnutrition seen here in combination with the limited medical resources has made for a particularly frightening scenario for a medical student from the U.S. who is currently oriented to the “better safe than sorry” mentality of teaching hospital physicians at home. Thorough work-ups, complete labs and empiric treatments become the standard, but here I’ve found it’s just not that easy, in fact it’s not really even an option.  Here the challenge becomes determining when the benefits of the safe-home will outweigh the risks of taking a child away from his family and community. When does a child require a visit to the Mokhotlong hospital versus staying home to be seen at their local clinic? When are they big enough? When are they too small? When is their heart rate or breathing rate too high? Then once the decision is made comes yet another challenge…now what can be done to help?

One of my favorite experiences while being here at TTL has been the opportunity to see the kids here at the safe-home beginning to thrive with consistent nourishment and the loving attention of the Bo’Me.  Initially I saw this and worried about how the children were able to adjust once returning home to the challenges of life without these consistencies. Thankfully, on one of our outreach treks we had the chance to check in on a 3 year old former safe home resident. He was quite possibly the happiest, healthiest-looking little guy we saw during the entire month out there. He was at home with his father who cared for him and was doing exceptionally well.  They both seemed so grateful for TTL; I loved the opportunity to see the hard work of the Bo’Me and all the staff at TTL really paying off. It’s also great to know that the wonderful kiddos we’ve had the chance to get to know here at the safe home can go home and continue to thrive and be happy like that little boy we saw.

Lastly, I would like to share a few of the small things the kids have taught me this month. 1.) When you hear music, just drop everything and dance it out. It doesn’t really matter if you were busy reading a nice book, throwing a ball or playing with a puppet or something…dancing is more important. 2.) If something upsets you, take 10 seconds to yourself, put your face on the floor and let out the frustration. Then just move on and go about your business. 3.) Crawling is a process that starts with keeping your head up and smiling a lot, and one day we will all get there, even Tsepang. 4.) Kids are learning even when it looks like they are paying no attention at all. Our attempt to teach some of the older kids the body parts necessary for the classic “head, shoulders, knees and toes” ditty took mere weeks. Success was finally achieved, however, about nothing is more rewarding than one of the little ones proudly marching up to you in the morning and pointing to the center of their face and asking, “nose?” Yes Tlatso, indeed it is! 5.) No matter what, smiling is always an option.  

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Kelly Hughes is a 4th Year Medical Student at the University of Indiana - Purdue.  TTL appreciates all her great work and will continue to reread and reread the last paragraph of her post for solid advice.  

A Drop in the Ocean

A Drop in the Ocean

As a medical student volunteering with TTL for the month of February, I met one of our recent new arrivals on my first morning at the safehome.  While playing with the children outside, one of the bo’me approached me and placed Thuso on my lap while she tended to another child.  I was immediately alarmed at how limp he was as he lay in my arms.  His body was thin and wasted and he had absolutely no muscle tone as he gazed listlessly into space.  Upon asking the bo’me his age, I was alarmed to learn that this child was already over a year old.  His growth was so stunted by malnutrition that he appeared several months younger and only weighed 5.5 kg (12 pounds).  Although my medical training in the U.S. had never exposed me to anything near this severity of malnutrition, Thuso’s stick-thin limbs, protruding abdomen, swollen feet and thin, discolored hair would quickly become familiar signs to me as I encountered more children suffering from malnutrition as they were brought to the safehome and during outreach trips.

Thuso’s mother had reportedly abandoned the family at 3 months of age, and he was being cared for by his grandmother before the TTL outreach team brought him to the safehome due to signs of severe malnutrition along with a fever and cough.  He spent a week in the hospital receiving antibiotics for pneumonia along with nutritional supplementation before returning to the safehome.  Thuso’s fever and cough have since improved and although it may take several months for him to recover to a healthy weight, he is already looking much better.  The boy who was too lethargic to even hold up his head when I first met him is now sitting up on his own, laughing, and interacting with the other children.

While working at the hospital, I have come to realize that many basic medications and diagnostic tests are simply not available here.   It is incredibly frustrating to know that there are patients dying every day because of a lack of what are in many parts of the world considered to be routine treatments.  Likewise, seeing children like Thuso who are dying of malnourishment produces a reaction of disbelief and outrage to those of us who are not accustomed to witnessing the effects of such a severe lack of resources.  While it is common knowledge that such problems are present throughout much of the world, it is difficult to appreciate the magnitude of the crisis until seeing it firsthand. 

The number of children in Lesotho impacted by malnutrition can initially seem overwhelming, but TTL’s motto of “one child at a time” reminds us that although we have a long way to go in combating HIV and malnourishment in the children of Lesotho, every child that TTL supports is worth the effort.  In the words of Mother Teresa, “We ourselves feel that what we are doing is just a drop in the ocean.   But the ocean would be less because of that missing drop.”  I continue to be impressed by the bo’me at the safehome who provide such loving care to the children of the safehome, and I know that they will continue to focus the same amount of effort and attention on each new child that arrives.  As TTL continues to expand, more and more children like Thuso who might not survive without assistance will be given the chance to flourish through the efforts of our outreach and safehome workers.   

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Teresa Backes is a 4th year medical student at the University of Missouri.  She spent the month of February volunteering at TTL and the Mokhotlong hospital.  TTL appreciates all her suggestions and love shown towards the children.  

Prince Harry and Prince Seeiso visit TTL!

Prince Harry and Prince Seeiso visited TTL today!  Exciting!

The two princes joined together to create Sentebale, a charity that generously supports TTL and other child focused Lesotho organizations.

Their visit was complete with arrival by helicopter and Prince Harry dancing with our very own Tsepo, who happily took center stage in the safe-home.

Medical Volunteers experience Outreach 1st Hand

Today the three medical students (Theresa, Kelly, and I) spent a day with one of the outreach teams visiting 5 different clients in a village about 30-45 minutes away by car. It was a great opportunity to see how outreach works, and I look forward to more trips with them in the future. 

On this trip, we stopped in different houses to bring food, weigh and measure kids, and count their ARV pills (HIV meds) to see if the children had received the appropriate amount. We saw quite an array of home settings on all of these visits. Everyone lived in the traditional round huts you see in Lesotho, but what we found inside each home was totally different. One house had nothing but a stove on the mud floor, a couple blankets stacked against a wall, and trash outside. This mother had 4 kids with 1 on the way, no husband, no job, and no food. The house and family were tragic to see; we wished there was more we could do for them. Conversely, the nicest house had a double bed, a small wardrobe, a table, an electric stove, pots and pans, and a solar panel hooked up to the house. The children at this house were fully dressed (compared to the previous house where the children had no pants), and the mother was upbeat and active in her children's healthcare.

All but one of these families had multiple children, but we were caring for only one of their kids who was malnourished (usually the youngest). I witnessed first-hand the huge difference that the home environment can make in a child's health outcome. The one mom with 4 kids seemed very depressed, and it was echoed in her kids' demeanors. Another child we met had lived at our safe-home when TTL first found him, and he had a strong relationship with his father, was interactive with all of us, and was back on target for developmental milestones. 

The WHO guidelines on malnourishment point out that malnourished children are developmentally delayed (crawl, walk, talk later than other children their age), and a crucial part of their treatment should be regular stimulation and encouragement of activity and interaction. I think the TTL safe-house is great for that: the kids have a consistent schedule every day with plenty of food, and there are many staff members and volunteers here to play with them all day. In comparison, most of the people living in the villages are farmers, so they are away all day, and kids are left at home if they aren't in school. If children are very young they are slung on their parents back all day, which doesn't encourage meeting physical milestones like sitting, crawling, walking, etc. I think in severe cases of malnourishment that the safe-home is a great place to nurse a young child back to health. I'm excited to be a small part of that process in the month that I'm here! 

****Rachel Hope is a 4th Year Georgetown Medical Student volunteering at TTL during February*******