Getting ready for Christmas!

MERRY CHRISTMAS - KERESEMESE E MONATE

Mokhotlong is getting green, the flowers are in bloom and there's excitement in the air....that can only mean one thing - the countdown to Christmas in Lesotho is on!

Little Mamosa shows us her Christmas cheer.

Christmas in Mokhotlong means spending time with family and friends and cooking meals to share with loved ones. Some of the children in the Safe Home will stay with us for the Christmas season in order to continue growing stronger and healthier. We look forward to spending the the holidays with these amazing children. We are also excited for the little ones who are preparing to be reunited with their families in the days coming up to Christmas.

This time of year helps remind us what we are thankful for and motivates us to give to those who need it most. At TTL, we are dedicated to providing children with the nutrition, support, and love that they need all year, and most especially at Christmas.


We hope that you will take some time this season to reflect on your blessings as we continue to care for the greatest gifts in Mokhotlong.

World AIDS Day 2014

December 1st is World AIDS Day, where people around the globe come together to raise awareness for the achievements that have been made, the work that is currently being done, and highlight the importance of continuing the fight against AIDS.

At TTL, we deal with the effects of HIV/AIDS on a daily basis as we work to mitigate the impact on Lesotho's vulnerable children under-5.

In a country of 2.1 million people --

• Almost 1 in 4 are living with HIV - that's nearly 25%, making it the 2nd highest HIV prevalence in the world
• AIDS is the #1 cause of death 
• 1 in 3 children are orphans
• 37,172 children under-14 are HIV-positive
• Life expectancy at birth is 48.7 years

The 2014 theme for World AIDS Day is “Focus, Partner, Achieve: An AIDS-free Generation". No one can do it alone, and we at TTL rely on our community partners to make a difference in the lives of the children of Lesotho. This World AIDS Day, please show your support for those infected and affected by HIV/AIDS and wear a red ribbon, make a donation, volunteer, or spread the word!

TTL staff show their support for World AIDS Day by wearing red!

 A message from the voices of Lesotho -


"It looks like a losing battle but we have hope, and it's stronger than fear".

#worldaidsday2014

Food Crisis Christmas Appeal

This year has been incredibly difficult for our 330 clients in Mokhotlong and Thaba Tseka. Failed harvests and a late rainy season have left them in dire need of seeds, bumper food packages & access to medical care. We are currently overwhelmed by the number of people needing our help and our resources cannot be stretched to cover them all. Please, give the gift of life this Christmas by sending us a small donation which will go directly towards buying more maize meal, seeds and protein-rich food for our clients. 

On August 30th 2014, the General Lieutenant of the army led a military coup against the Prime Minister of Lesotho. Ongoing problems (contained to the political elite) have devastated the productivity and efficiency of local services. The Department of Agriculture, Food Security and Public Health have crumbled in the highlands, leaving NGOs like TTL to pick up the slack. Without the Departments' help to cultivate land (the use of combine harvesters, tractors, ploughs etc) people have been unable to harvest crops this season. We are doing everything we can to help our clients access food, whilst taking on new clients daily. Therefore, your gift will go directly to feeding a child not only at Christmas but until the next harvest season. 

Please help us to continue to save lives, one child at a time.

Thank you, bless you and Merry Christmas.

Rea leboha Gem Diamonds!

TTL's MD with District Education Secretary,
CEO of Gem Diamonds, Director of Sentebale,
District Administrator, Prince Seeiso,
UNICEF Representative &Minister of Health, 

On November 12th, Touching Tiny Lives and our partners Sentebale hosted a fantastic event at the Mokhotlong Hotel to show our combined appreciation for a generous donation by Gem Diamonds. We were very honoured to have the pleasure of hosting Prince Seeiso of Lesotho, Dr Pinkie Manamolela- Minister of Health, Ms Mazvi Maharasoa- CEO of Gem Diamonds, Mr Motsamai Mokoto- Mokhotlong District Administrator, Representatives from the Ministry of Education, Health Officials from Mokhotlong Hospital, The Child Protection Officer of the Lesotho Police Headquarters and group of honoured guests from Sentebale at the event.

Minister of Health and Prince Seeiso listening to
TTL's MD explain what we do at TTL

Dr Pinkie learns about our
ECD and nutrition schedules

The food crisis in Lesotho continues to reach unprecedented heights, causing many of our clients to suffer gravely from late harvests and lack of food. But Gem Diamonds' donation has brought hope to Mokhotlong and Thaba-Tseka. With their help, TTL has added extra maize meal to our Outreach food packages and provided the necessary health care to help the children and families through this tough time. Outreach has also been able to to launch our 'Needs for Seeds' initiative, distributing packages of cabbage, carrots, spinach and squash seeds to each TTL client family. Along with providing some direction on how best to use the land available for a garden, our Outreach staff will collaborate with the Lesotho District Ministry of Agriculture in Mokhotlong to make sure families are receiving information on proper planting techniques.  

Prince Seeiso captivates the audience

TTL was thrilled to have our guests visit our campus in Mokhotlong camp town in order to see the many ways in which the generous donation from Gem Diamonds will help local children and families. A tour of the Safe Home and some play time with the kids was a highlight of the day. 

Minister of Health meets the children
and Bo'm'e of the Safe Home

We want to express our gratitude to Gem Diamonds for assisting us to help save lives, one child at a time.

Planting seeds for change

Tanki gets into the gardening spirit!

Responding to the chronic food shortage, TTL focuses on preventing and improving childhood malnutrition rates in the Mokhotlong and Thaba- Tseka districts of Lesotho. Many rural families face the ongoing risk of food insecurity given that many people do not have access to agricultural land and those that do may not have the necessary equipment and seeds. Situations like this have resulted in a stunting rate of children under-5 of almost 40% in Lesotho according to the World Food Programme.

The TTL Outreach Program has been providing children under-5 with food packages on a monthly basis consisting of, amongst a variety of other items, canned vegetables. We are always looking for ways to improve our services, and we strive to support our families in achieving food security and self-sustaining food sources -  plus we want to spread the word about how good vegetables are for a child's balanced diet! So we are excited to introduce our newest project - Needs for Seeds!

At the start of the Spring season this September, TTL Outreach staff began distributing packages of cabbage, carrots, spinach, and squash seeds to each TTL client family. Along with providing some direction on how best to use the land available for a garden, our Outreach staff will collaborate with the Lesotho District Ministry of Agriculture in Mokhotlong to make sure families are receiving  information on proper planting techniques.

We are looking forward to watching the children grow along with the new family gardens!

Happy UN Day 2014

Today marks the 69th anniversary of the United Nations, an organisation founded on the very principals of peace and prosperity. UNICEF, a programme of the U.N devised which provides long-term humanitarian and developmental assistance to children and mothers in developing countries, has long been a partner with Touching Tiny Lives. So, we would like to take they time to show our thanks and appreciation for all they have done for us over the years. 

Cheers to the next 69 years!! 

United Nations' International Day of Rural Women

A Basotho grandmother brings her little one for a check up with TTL.

Every year, the UN invites us to celebrate the word-wide unsung heroes by celebrating International Day of Rural Women on October 15th.

This is a day to mark the important work done by rural women in the areas of agriculture and rural development by improving food security and eradicating rural poverty.

TTL works in the most rural and under-served areas of Lesotho. The women (or Bo'M'e) of Lesotho are truly the backbone of the country. At TTL, we witness Bo'M'e work tirelessly to provide for their children, grandchildren, families, and neighbors. Whether it's trekking over mountain terrain to get their children to a clinic, collecting wood, tending the garden, or cooking for the family, the Bo'M'e in rural Lesotho never cease to amaze us.

Bo'M'e are our biggest partners at TTL and today we say a huge REA LEBOHA for everything you do!

Local Bo'M'e making the journey with their children to one of the rural health clinics.

Pledge Your Birthday

Birthdays can be a nightmare. The incessant WhatsApps, emails and calls asking what you want for your big day? What on earth do you ask for when you've everything you could possibly need? 

Our newest volunteer, Ntate Thabo, has come up with an incredibly awesome, generous and selfless answer! He's decided to pledge his birthday to Touching Tiny Lives! Instead of asking for gifts from his family and friends, he has asked that they donate the money directly to TTL! 

It got us thinking, 'What if other people could do the same?' If you have a birthday coming up, and can't think of anything you want, could YOU help us to mitigate the effects of HIV/AIDS in children under the age of 5 in rural Lesotho?

What does it mean to pledge your birthday? Ask all your family and friends to donate the money they would have spent on a gift/ birthday drinks to us via this link. You can either choose to set up your own fundraising account, specifically for this campaign, OR you can ask them to simply DONATE and select the Pledge Your Birthday project.

Why us? Why Touching Tiny Lives? Let me explain our story and why we desperately need your help. We work in the Mountain Kingdom of Lesotho, the land where 1/4 of the population are without work and a further 1/4 of the population have HIV or AIDS. Children are born facing life-threatening challenges from day 1. TTL started ten years ago in response to the crisis of children dying of malnutrition before their first birthday. We work within our limits to rescue one child at a time from the clutch of malnutrition and to face a brighter future. We are the only organisation serving a population of 230,000 people to mitigate the effects of HIV/AIDS in children under the age of 5. Mothers, Grandmas and Fathers walk and ride their horses for miles to reach out to us. There are few paved roads and so they are travelling across very mountainous and tough terrain. If their child is critically malnourished, we take them into the Safe Home and care for them until they are well enough to return home. We then continue our support through the Outreach team. These guys are my heroes. They drive for hours and hours every day up mountains and over ridges to deliver food packages and provide medical, nutritional & development support to families who struggle to put food on the table.

Without TTL, there would be no focused help. Without TTL, these children would have no future. Watch the video below or click here to read their stories and decide whether you can donate your gift this one year and help us continue to support children of their community,one child at a time.

How does it work? Ask people to send what they would normally spend on a gift to TTL using GivenGain! It’s best to start fundraising a few months prior to your birthday to get the ball rolling. First and foremost, give your TTL fundraising page a catchy title, for example ” £8 for my 8th Birthday!” Include your reason for pledging your birthday and maybe even a photo. Once your page is up and running, email a link to your friends and family, inviting them to donate to your page. Don’t forget to reach out to your social media network as well. Keep your donors updated about your fundraising total up until the big day and then do one last push. People will give whatever they can give and 100% of it will go directly to helping us to support more children, one child at a time. 

So, if you can, please do this to help us to continue making a difference in one of the poorest regions in the world.

Thank you from the bottom of our hearts and good luck with your fundraising!

Independence Day

Good Riddance, Brits!

October 4th has come around again, bringing with it Besotho celebrations of independence from the British! Formerly Basutoland, the Kingdom of Lesotho had been a British colony for almost 100 years before it was finally granted its independence on October 4th, 1966. A huge cause for celebration. the Besotho celebrate with style across the kingdom, and this year was no different!

Independence Day celebrations

People from all over dress up in the colours representing their district and traditional songs and dances are performed throughout the day. The members of the royal family of Lesotho together with the Prime Minister and his Cabinet ministers, Heads of Diplomatic Missions, Senior Government Officials and delegates from other countries within the South African Development Community region all come to participate in the Independence Day celebrations. 

A Bit Of History

Once upon a time, Basutoland was a united country and free from foreign influence and rule. King Moshoeshoe I had unified the country into one single territory by bringing together various Sotho groups who had fled the wandering Zulus. However, it all went to pot in the 1830s when white settlers called Afrikaners, or Boers, began to encroach on Moshoeshoe's territory, Numerous border skirmishes ensued as the Basotho fought off these unwelcome settlers. Moshoeshoe lost some of his land in the 30 years of fighting between his forces and those of the Afrikaners. He had few options ahead of him and so he decided to ask the British for help in 1868, which led Britain to make Basutoland a protectorate. Moshoeshoe passed away in 1870 which is where the story gets a bit more tricky and complicated. With Moshoeshoe's death, Basutoland was places under the control of the Cape Colony in 1871. Britain resumed direct control in 1884 after a war erupted between the government of Cape Colony and the Besotho. In 1910, the Cape Colony and other British colonies united to form the Union of South Africa (which we now know as the Republic of South Africa.) According to British history books, the British government was under the impression that Basutoland would eventually be incorporated into South Africa. However, this idea was thwarted as the Basutho consistently refused to integrate. Long story short, the Basutho eventually achieved their independence from the British in 1966 after 50 years of asking the British for internal self-government. Better late than never!

Evacuation and ELMA Conference

What a month, Lesotho!

Where to begin? Perhaps the alleged political coup or the Prime Minister flitting to and from South Africa like he's running a relay race or the renegade General-Lieutenant refusing to accept his dismissal or the full scale evacuation of American residents/ American Peace Corps and TTLF's Fellows from Lesotho! Phew. Not your average run-of-the-mill month!

Political Headache

Politically, things remain as uncertain here as they did at the beginning of the month. Who knows what is really going on! Nobody seems to know. Parliament remains closed, despite promises to reopen it last week, and the political elite remain very disgruntled. However it doesn't seemed to have affected the public much. At the very least, it hasn't really affected us here in Mokhotlong so we've carried on business as usual. The fellows are now back in country and very pleased to be home. Mokhotlong has bloomed into Spring: the peach blossom decorates the mountains and the temperature has soared to a very warm 80-85F. It is a beautiful time of year here and we hope that the ugliness of political instability will keep away from us in our Mountainous haven.
.
ELMA Relief

'M'e Nthabeleng (Managing Director of TTL) joined the exiled Fellows in Johannesburg last week for a conference hosted by ELMA Philanthropies. It was absolutely wonderful, on so many levels, which makes it hard to condense what we learned into one blog. Let's just say that we each came away empowered, inspired, motivated and chomping at the bit to implement some of our new skills at TTL! The focus of the conference was 'Resource Mobilisation' or, in layman's terms, fundraising and organisation growth. We learned about the importance of financial sustainability, community involvement and multi-partnership to the success of any organisation. We met so many other NGOs/NFPs/charities from across Southern Africa during the conference. It was very reassuring to learn that the challenges we face are not unique to TTL. Almost every other organisation is at a different stage of dealing with the very same issues. Those who have overcome the same challenges we experience on a day to day basis inspiring and have given us a lot of hope for the future! We want to thank you ELMA Philanthropies for hosting such a wonderful workshop and networking event. We look forward to the next annual meeting!

Military coup in Lesotho? What on earth is going on?

It’s not often that Lesotho makes it to the international news scene. Not until now that is. 

Street vendor sells newspapers headlined
 "Lesotho in turmoil coup attempt" in Maseru, Lesotho.

Read more here: http://www.star-telegram.com/2014/09/02/6084002/police-abandon-posts-in-lesotho.html?rh=1#storylink=cpy

Last weekend the political situation in Lesotho descended into a state of turmoil that some are calling a military coup. Political grievances have been bubbling away in the capital city Maseru for months due to a disgruntled three-way coalition government, but those grievances all came to a head on Saturday.

In the past week, the Prime Minister fled the country, police services have been suspended, radio stations corrupted, and news reports contradictory. Some foreign embassies are evacuating citizens and many more have issued a red flag. But who knows what is really happening!

A Lesotho Defence Force member displays arms
confiscated from police at army barracks in Maseru.

Read more here: http://www.star-telegram.com/2014/09/02/6084002/police-abandon-posts-in-lesotho.html?rh=1#storylink=cpy

Now, TTL is about 300km away from Maseru, tucked away in the majestic Maluti mountains, so on the whole it's business as usual. All being well, this quarrel won’t reach us. But the current state of affairs has made our Outreach visits a little more precarious and perilous.

So, what’s the deal and how long will this go on (as far as we understand it)?

In June, Lesotho's Deputy Prime Minister and leader of the Lesotho Congress for Democracy party (LCD) Mothetjoa Metsing suddenly announced that he would be removing his party from a three-way political coalition that had brought Prime Minister Thomas Thabane to power two-years ago. Thabane, in retaliation, suspended parliament and effectively avoided any vote of no-confidence that could threaten his leadership. South African President Jacob Zuma travelled to Lesotho to host talks with the country’s leaders to find some middle ground; however, two months later it seems Zuma's talks did little to quell discontent.

On Saturday 30th August, Basotho soldiers allegedly seized weapons from several police stations and surrounded Prime Minister Thabane's residence. One police officer was killed in the ensuing struggle and several injured. Thabane commands the loyalty of the police and Metsing has the support of the army, so Thabane's supporters have accused Metsing of trying to overthrow him. The deputy premier and the military have denied any coup attempt. 

Government spokesman Ramakhula Ramakhula says Thabane had sought a military intervention by the Southern African Development Community (SADC) in Lesotho to restore order. Apparently Metsing opposed the proposal, arguing there was "no serious problem" in the southern African kingdom. Which man is telling the truth? You can see the confusion!

However, things seem to be starting to improve. The Prime Minister, his deputy and the leader of the third coalition party, Sports Minister Thesele Maseribane, released a statement on Tuesday to say that they are "committed to working together" to restore stability. SADC has also pledged to help the parties create a road map to reactivate parliament. So, for now, we’re keeping our fingers crossed that good ol’ democracy will shine through and work.

Think of us and keep your fingers crossed that the quarrel is settled soon and doesn’t reach us here in Mokhotlong & Thaba-Tseka!

Importance of Staging HIV

When it comes to HIV, the aim of the game is to beat the virus by identifying it, attacking it, containing it and stopping it from progressing to the next stage by prescribing the right ARVs. Whilst only a small percentage of our kiddos at TTL are HIV+, we need to be on the lookout for tell-tale signs that their ARV meds are not working and thus that their HIV is progressing to the next stage.

Baylor Clinic at Mokhotlong Hospital

TTL staff in the Baylor waiting room
for the lecture to begin!

This is where the wonderful Dr Divin and his staff at Baylor Clinic at Mokhotlong Hospital come in. Dr Divin regularly holds lectures for TTL staff to keep us up to date on the latest treatments and research on HIV/AIDS and TB. We went to one of these special events on Tuesday 19th August and here is what we learned:

So, in a very small nutshell, HIV attacks proteins in our body called CD4 and this makes the body incredibly susceptible to infection. If we are able to identify the virus at an early stage we could save our clients a lot of pain, hassle and extensive treatment. So, what are these different stages and what do we need to look out for?:


STAGE I  This is a tough one to catch as there are hardly any symptoms. But if you have a constant cold
                  or swollen lumps on the face and groin then get the kid to a doc to get checked out!

STAGE II  A tad easier to notice. It normally affects the upper respiratory system and skin. So you need to
                   look out for sinus issues, easy bleeding, abnormal skin rashes or pox and big old swellings
                   on the face and groin. We've posted some pics of common HIV Stage II-related skin
                   problems.WARNING- They ain't pretty!

   

PPE- one of the Stage II skin infections.

STAGE III- This is where the virus starts to attack the poor lungs. We're talking Pulmonary TB, unexplained anaemia, moderate malnutrition, bacterial pneumonia and oral candidiasis. Don't know what oral candidiasis is? Look below for a lovely photo of how it affects the body..you're welcome.

Oral Candidiasis- Stage III symptoms

STAGE IV- We don't want to see this stage of the virus as it only means bad news. Bad news for the lungs, skin, eyes, blood. Bad news all over. Full blown TB, Meningitis, blindness in the eye, sores all over the body. You name it, this stage brings it.

This is why staging is so important. Like us against the virus in a game, we we want to stop it from getting to the final stage. If we can do that we can save ourselves a whole lot of hassle and time in a hospital.

Now, we are by no means clinicians. We would never presume to know how to diagnose a kid with HIV. However, if we notice these signs in any of our clients we now know to get them to a doctor as soon as possible.

We want to thank Dr Divin and his colleagues for their engaging and interactive lecture and we look forward to the next!

The Brit arrives in Mokhotlong!

Greetings from the gorgeously sunny Mokhotlong!

This is just a quick blog to introduce myself as TTLF’s newest fellow here in Lesotho. My name is Harriet Doughty and I’m an International Relations graduate from the UK. I studied in London for my BA but moved to The Hague, NL, to do my Master’s where I was predictably pulled into a world of international politics, food security and international aid.

The Brit touches down on TTL Campus!

I kept myself busy during my studies by working on a few projects. One was to help organise events, lectures and conferences hosted by Dutch Foreign Office, the UN, European External Action Services and Hague-based NGOs. I learned a lot from this experience and I look forward to applying that knowledge to supporting TTLF this year. The second project was to continue building and developing a Non-Profit I had helped to start in 2008 in a Peruvian prison. I was only 18 when we started the project so, as you can imagine, I met a lot of seemingly insurmountable challenges in attempting to start her up. It required a lot of (hastily-learned) skill in project management, communications, fundraising and income generating. But with a bit of time, help from good ol' Google and help from friends we got Maki International up and running and we now support almost 200 prisoners and their families through sustainable education and rehabilitation programmes. I'm excited to use this work experience to boost TTL’s online presence and to develop their income generating prospects.

First day in the Safe Home

I'm really looking forward to this year and I'm so chuffed that everybody here is so friendly and generous!

Hope to hear from you all as the year goes on!

Warmest wishes,

Harriet

It takes a village

VHWs at the Manemaneng Clinic greet TTL staff with song and dance.

An important role for any NGO is to strengthen their collaborations with local partners. TTL maintains partnerships with several different community groups, including hospital and clinic staff, local government officials, and other NGO staff. One of our most important partnerships is with the Village Health Workers (VHWs) who serve their home communities in rural and hard-to-reach areas across Lesotho.

VHWs act as the first points of contact for those whose access to health services can be challenged by remote locations and costs associated with transportation. In an effort to provide rural children and families with frontline health service, the Government of Lesotho has recruited a dedicated group of volunteers to provide health information and service recommendations for rural communities. VHWs are trained to recognize signs and symptoms of various common medical conditions, to counsel mothers on options to maximize healthy and safe pregnancies and deliveries, to monitor the health status of adult and child community members and to provide health service recommendations, based on level of severity, including urgent or non-urgent referrals to the local hospital or clinic. These Basotho men and women recognize the fundamental right of every person to access health care and health education, and they provide this service without compensation.

TTL supports the enormous efforts of the VHWs by providing monthly training sessions in alternating clinic catchment areas around Mokhotlong and Thaba-Tseka districts. By sharing critical health knowledge with the VHWs, TTL encourages them to react confidently and appropriately when consulted on child health situations in their communities. With an expanded knowledge base, VHWs can provide an enhanced level of care and identify health complications before they become acutely problematic.

                    

TTL Outreach worker M'e Mamosa introduces the training topics to the VHWs.

In July, a TTL-run VHW training took one TTL Outreach staff member, the TTL Managing Director, and a TTLF Fellow out to Manemaneng Health Clinic, about 2 hours away from the TTL campus. A group of almost 50 VHWs walked from areas near and far to attend and welcomed TTL with song. They then turned their attention to ‘M’e Mamosa, who explained in detail how to recognize the signs and symptoms of acute malnutrition in children under five. This training expanded on the one held in June for identifying acute childhood malnutrition by assessing anthropometric measurements using tools such as weighing scales, length boards, and MUAC tapes to measure Mid Upper Arm Circumference. The attendees were engaged participants and glad to part with improved knowledge and skill for taking on the task of preventing and monitoring acute malnutrition. Supporting the health of an individual child is not a job for the family alone - it really does take a village.

---

TTL Managing Director 'M'e Nthabeleng Lephoto welcomes the crowd.

Champions of Change

In this update blog, Gargi pulls from her final project report to explain many of the new alterations to the Safe Home and Outreach programs. You can read about some of the initial developments in her first guest post.

The past month at TTL was all about changes. Target, Train, Track, Test - the 4 T's and public health mantra for implementing change - helped guide the recent programmatic developments. Of course, changes are not always welcome, but the case is different for TTL where staff welcome changes in the best interest of the children they serve.  If public health experts have their 4 Ts, then TTL has its 4 Cs: Care, Connect, Change, Champion. We witnessed all of these in recent weeks.

Improving nutrition in the Safe Home

Often the only sign of severe acute malnutrition (SAM) in children is appetite loss or reduction. Their shrinking bodies experience a disruption in metabolism that interferes with their appetite, which may lead to further starvation and death.

Fortunately, appetite loss is easy to identify. All it takes is a spoonful of peanut butter and a little patience. 

Using this basic appetite test, if the child eats a ‘good’ amount of peanut butter he or she passes the test and can be fed normally in the Safe Home. A failed appetite test indicates a need for more intensive medical therapy before 'food therapy,' and the child goes to the District Hospital with convincing evidence of metabolic distress. There he or she can receive appropriate medical support before returning to the Safe Home for round-the-clock care.

The Safe Home Supervisor implemented this appetite last month and now uses it diligently for all incoming clients.

Focusing on growth and development

As TTL staff had already received nutrition training, we determined which areas needed strengthening based on a role-specific assessment. From their responses, Outreach staff were trained on using aids to counsel caregivers on child growth and development, and the Safe Home staff were introduced to an enhanced monitoring and evaluation (M&E) system for recording food intake and health danger signs.

In the Outreach training we emphasized educating caregivers on the developmental milestones of child growth. With the help of counseling cards, Outreach staff learned to help caregivers assess whether their child’s development was on track and to provide examples of activities that support age-specific development. 

Similarly, for tracking Outreach client growth we introduced growth monitoring charts to plot the child's weight each month. The charts show the client's trajectory of growth over time and allow comparison against a normal growth curve. One Outreach worker also suggested pinning the growth charts on the walls of each client’s house so that caregivers could compare ‘how their child is growing’ to ‘how their child should grow.’

Everyone agreed that instead of discussing weights in arbitrary numbers, a visual aid (with spikes, plateaus, and dips in the child's weight) would aid discussion to identify episodes of illness or other reasons for the lack of weight gain. TTL staff could then tailor their counseling to address specific issues - whether diarrhea management, using TTL food parcels for optimum child feeding, or the importance of hygiene & sanitation. Eager to use the growth charts, some Outreach staff have started plotting weights of children in the Safe Home and are practicing their counseling skills on the Safe Home caregivers!

For the Safe Home training we took a slightly different approach. With the help of two Sesotho-speaking interns, we conducted a quick survey among the 13 caregivers to understand the difficulty and amount of time spent on record-keeping during day and night shifts. Overall, we found that Safe Home caregivers understood the importance of record-keeping and did not find it burdensome. They all reported that maintaining daily records, whether it was detailed observations of a client's behavior or noting every time a diaper was changed, was easy. The only time-consuming or difficult activities were feeding fussy eaters or attending the doctor’s questions during health check-ups. (Of course the favorite activity was playing with the kids!) Encouraged by the survey results, we then piloted new M&E forms to monitor individual food intake and health danger signs.

In their monthly meeting, the caregivers discussed activities that some of them found difficult: for example, strategies to feed fussy eaters and time management tips to avoid wasteful activities. During this peer learning exercise, we oriented them to the new forms, which contain additional monitoring steps to provide more expert support to the Safe Home clients. The caregivers have already started charting individual food intake and health parameters flawlessly! They even reported that they now feel as knowledgeable as the hospital nurses. And should any problems arise, they know they can just ask each other for help.

Guest post by Gargi Wable, Nutrition Consultant for TTLF, who recently finished up work for a TTL grant from UNICEF.

Commonwealth Games 2014

The 2014 Commonwealth Games are happening right now in Glasgow, Scotland!

This is a pretty exciting time for everyone with a vested interest in Commonwealth nations as they watch the different countries compete for prestigious medals and prizes.

But you might find yourself wondering about a thing or two. For instance: ‘What exactly are the Commonwealth Games?’ or ‘What do these games have to do with TTL?’ Valid questions, to be sure. So to help ease your mind, we’ve compiled a short Q&A below!

1) What is the Commonwealth?

According to its founding Charter, the Commonwealth of Nations is a voluntary association of 53 independent and equal sovereign member states that collaborate through economic support and political strengthening to champion several key values, including: democracy, human rights, international peace and security, and more. Read the full charter here.

Moreover, all the participating Commonwealth nations share a certain degree of common colonial past with the United Kingdom, whose reigning monarch is currently their official head of state or perhaps was at one time. Today Queen Elizabeth II is recognised as the head of the Commonwealth.

2) What are the Commonwealth Games?

In 1891, an Englishman named Sir John Astley Cooper proposed a “Pan-Britannic-Pan-Anglican Contest and Festival…as a means of increasing goodwill and good understanding of the British Empire” – which it was at that time. The idea took a few years to organise, but since their initial round in 1930, the international athletic competitions now called the ‘Commonwealth Games’ have been held every four years (think British Olympics).

The events have expanded and changed over time, but the Games currently boast 21 able-body sports and 7 para-sports, which the host country sets with official approval from the Commonwealth Games Federation. The 2014 Glasgow Games include: Athletics, Badminton, Boxing, Cycling (Mountain Bike, Road, and Track), Diving, Gymnastics (Artistic and Rhythmic), Hockey, Judo, Lawn Bowls, Netball, Powerlifting, Rugby Sevens, Shooting, Squash, Swimming, Table Tennis, Triathlon, Weightlifting, and Wrestling.

3) How is Lesotho involved?

Wouldn’t you know it – Lesotho is a member of the Commonwealth, having joined in 1966.

Since 1974, Lesotho has attended the Commonwealth Games and sends most of its competitors to the running events (where their successes are no doubt a result of high-altitude training). For the 2014 Games, 27 athletes traveled to Wales where they trained and prepared to represent the Mountain Kingdom. Most of their events are scheduled for this week, so tune in to cheer them on with Basotho pride!

4) What else do I need to know?

Like many friendly competitions, the Commonwealth Games are an opportunity for the host city to put forth its best face and exhibit its unique history and amusing quirks. Certainly, Glasgow is not short of quirks, nor shy about celebrating them.

Dancing Tunnock's Tea Cakes (a half-biscuit, half-marshmallow, non-dancing Scottish treat)

The fabled Loch Ness Monster herself in tartan (plaid)

But Lesotho has its own claims to fame, some of which the Basotho athletes flaunted when parading in the opening ceremony.

For instance, the conical shape of the mokorotlo, or Basotho hat, is inspired by Mount Qiloane, one of the peaks in the Maluti Mountain range that give Lesotho its harsh climate – thereby justifying those beautiful Basotho blankets – and unique status as the country with the highest low point in the world: 1400m!

And because Lesotho is not lined up to host the Commonwealth games in the near future, we thought we’d highlight some other Basotho trivia worthy of your attention:

1. Lesotho is a land-locked nation and the only one in the world that is completely surrounded by one other country – South Africa
2. The most common mode of transportation is horseback
3. The country motto is ‘Khotso, Pula, Nala’ meaning ‘Peace, Rain, Prosperity’ and respectively represented by the white, blue, and green of the Basotho flag (which also features the indigenous Basotho hat.
4. Lesotho is home to one of the only two ski resorts in Sub-Saharan Africa. #AfriSkiFTW
5.  Lesotho has its own dinosaur – the Lesothosaurus discovered in 1978 by Peter Galton

And now you know.

Mokhotlong celebrates a birthday: King Letsie III

Each year when the calendar marks 17 July, the people of Lesotho mark the birthday of their beloved king, His Royal Majesty Letsie III. Each of Lesotho's 10 districts holds its own local celebrations on this special day (a national holiday, no less) and rotates hosting the official celebration. This year, for King Letsie's 51st birthday, Mokhotlong had the distinct honour of hosting their royal majesties.

Mokhotlong has a special tie to the royal family. Letsie's father, the late King Moshoeshoe II, was born here and a royal residence sits on a hill just outside of town. To welcome home their favourite son, hundreds of people from all over Mokhotlong district turned out for two days of events.

The Horse Races at Maligoaneng

On 16 July, the village of Maligoaneng held traditional pre-birthday activities: dancing, singing, and horse-racing. Basotho ponies are indigenous to Lesotho and South Africa and are the pride of the Mountain Kingdom. They serve functional daily purposes such as transporting goods and people, but once in a while they take a break to spruce up. Jockeys decorate their ponies with colourful harnesses, blankets, and occasionally masks, streamers, and balloons. Racing and high-stepping parades are quite regal!

The annual King's Birthday celebrations tend to follow a similar pattern and, curiously, the events receive little royal acknowledgement from stage. That is not to say that the king does not appreciate the gestures, but rather that a king has never partaken in the ceremony himself before. Yet this year King Letsie determined to break that cycle and issued forth a royal thank-you to the people of Mokhotlong who had clearly worked so hard to make the celebration special for him. Letsie is a fine speaker and had the crowd murmuring their approval and even laughing from time to time.

The King's Birthday

In contrast to the casual celebrations of the day before, the king's actual birthday is a formal affair, right down to the full military dress and 21-gun salute. The military parade is the holiday highlight, the event that hundreds of Basotho (and a handful of foreigners) turned up to see. Mokhotlong's Lesotho Defence Force troops had been practicing for days leading up to the 17th and their efforts paid off. Admittedly, it was pretty impressive.

By all accounts, Mokhotlong pulled off both days successfully and the town was alive with people - quite a change from the usual humdrum. It was a nice opportunity to thank the king for his leadership and to look forward to positive changes on the horizon. His Majesty was recently appointed the official AU Nutrition Champion and TTL certainly has a vested interest in what he does under his new title!

TTL looks forward to hearing his plans to help combat malnutrition and wishes him a very happy birthday!

Appetite to grow faster, better, stronger

Testing the feasibility to prepare F100 therapeutic milk at the Safe Home

After haggling through a US student Visa, a South African transit Visa and a temporary work permit for Lesotho, I finally left for Mokhotlong from India late in May. Delayed to start at TTL on a time-bound UNICEF project, I had 10 weeks to enhance the quality of TTL’s 10 year old nutrition program by developing individualized child nutrition & development protocols.

The time was short for a task too large. But the question that was really troubling me was this: Would a well-established, decade-old system have the appetite to change? The answer was a resounding yes. Fortunately, I had landed amongst people who were eager to learn what’s new and better to address malnutrition. For instance, there was curiosity about ways to provide better nutrition support to children diagnosed with TB and HIV, alternatives to the recipes that the staff had already mastered, how to provide therapeutic milks at TTL’s Safe Home instead of relying on the overcrowded District Hospital, and if there could be a better system to decipher small gains in a child’s weight. Rubbing my hands together, the nutritionist in me was more than happy to get cracking.

Lunch time at the Safe Home

In the first two weeks at TTL I examined the cycle of admission, management and graduation of TTL’s clients. This involved observing the use of anthropometric measures to assess nutritional status, an in-depth analysis of the nutritive value, variety and quality of the safe home diet, observation of caregiver counseling during outreach visits, and an assessment of the quality of monitoring and record-keeping.

To conduct these assessments, I relied on the latest WHO guidelines for management of Severe Acute Malnutrition (SAM), Lesotho Department of Agriculture’s ‘Lesotho Food Composition Table’ (a great compendium on indigenous foods and recipes), conversations with TTL fellows (past and current), interactions with the TTL staff during outreach visits, countless cups of coffee with Amarula, and, most importantly, play-time with about a dozen of the safe home kids!

For the next two weeks, my goal was to synthesize the assessments towards one goal: enable TTL to enroll clients at the right time in the right program (Outreach or Safe Home) and for the right duration. With the help of the fellows and the management, a week and a half was more than sufficient to accomplish the following entry-points:

• Up gradation of MUAC tapes and weighing scales to the latest global standards
• Develop a simple spreadsheet for detailed assessment during intake
• Gauge TTL's ability to convert assessment data into individualized nutrition, health and development plans
• Improve existing diet schedule to ensure daily provision of high-quality protein & micronutrients
• Introduce an ‘Appetite test’ to triage medically complicated SAM cases to the District Hospital
• Test the feasibility of preparing and providing timely doses of F-100 - a therapeutic, high-energy, high protein milk supplement
• Introduce an F-100 based diet for clients transitioning from the hospital to the Safe Home

And there’s going to be more! Next month, TTL will have a refresher training on how to develop and monitor individualized health, nutrition and development plans, how to chart and analyze weight gain, and last but not the least, how to manage food preparation, child feeding, and structured play time alongside record-keeping with minimal effort and time. With the gracious support of UNICEF, it is our hope that an individualized, well-rounded childcare plan would result in better and faster recovery of our clients from malnutrition and allow TTL to support many more vulnerable children.

Outreach team loading food parcels for household-level follow up visits

Guest post by Gargi Wable, Nutrition Consultant for TTLF, who is finishing up work for a TTL grant from UNICEF.