Monday, July 28, 2014

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.

Friday, July 18, 2014

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!

Friday, July 4, 2014

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.

Wednesday, July 2, 2014

Bianca Garcia: Impressions of Basotho culture

For two months, TTL hosted Bianca Garcia, a graduate student from the Notre Dame Eck Institute for Global Health, as she conducted research in rural Lesotho. This is the last of a 3-part blog series of Bianca's research and reflections.

Throughout my time surveying, I have heard a lot of about the health-related and economic ordeals that many Basotho caregivers face. I am always impressed by their resilience and their kind, welcoming demeanor in the face of challenges.

I spoke to many bo-‘m’e (women caregivers), who did not have a job or other form of income, that were supporting 6+ children, taking care of cattle, and maintaining fields or gardens. This work has certainly taken a toll on their health. These women are so strong and, as many have recounted on this blog, are definitely the backbone of the Basotho society. The duty of ensuring the health and livelihood of all its members usually falls on these women. 

The bo-‘m’e would welcome me into their home and offer me a chair (even if they only had one) and would listen and respond tentatively to my survey. The stories they had to tell about their daily challenges are heart wrenching as well as inspiring. Sometimes I was emotionally overwhelmed by the situations that these individuals faced, but I had to remind myself to bounce back. I would be doing these individuals a disservice by getting not completing my work. I want to tell the story of these caregivers, usually women and often grandmothers, and hopefully see future interventions that improve their health and economic standing as well as the health of the children they raise. 

I am amazed and grateful to these women for agreeing to take time out of their hectic schedule to talk to a complete stranger and share their knowledge and kindness. I only hope that one day I can repay them.

I like to think that this experience has humbled me some and helped me remember not to complain as much about my daily trivialities. While I joke about timeliness, bumpy roads, and long walking distances, these are just everyday things the Basotho caregivers do not even fret about.

I want to thank the Basotho people, specifically the caregivers and children, for their time, stories, willingness to help, as well as their patience and acceptance of me and my research. Without their enthusiastic and willing participation my research would not be possible. Thanks also to the TTL staff for their assistance in coordinating my surveys and helping my research to progress as much as it did in such a short period of time. Kea leboha!

My research will not change Lesotho immediately, or even substantially, but I hope that in some small way I can contribute to change in the lives of these strong Basotho caregivers, just as they have had a profound impact on me.

As we say in Lesotho: Khotso. Pula. Nala.

Tuesday, July 1, 2014

Five tips for research in Lesotho

For two months, TTL hosted Bianca Garcia, a graduate student from the Notre Dame Eck Institute for Global Health, as she conducted research in rural Lesotho. This is the second of a 3-part blog series of Bianca's research and reflections.

Lesson #1: Time is not always of the essence

While this does not always apply just to research, here in Lesotho things move a little bit slower. You should be willing to wait a little while and have plenty of good reading material. Whether it was recruiting with the TTL Outreach team, waiting for the driver in the morning to take us to conduct surveys, or simply just ordering pizza from Mokhotlong Hotel, things just take a bit longer.

Although frustrating at times, it taught me to be more patient and, ironically, to better manage my time, doing other things while waiting. Also maybe you just tell your driver to arrive thirty minutes earlier than intended or order that pizza at 4:30pm instead of 6pm. 

Lesson #2: Lesotho has some amazing off-road drivers (and I am not being sarcastic)

They are fantastic. Often I would look ahead to see a steep hillside complete with jagged rocks and a stream flowing through it and I would get ready to disembark so I could hoof it the rest of the way. I was always surprised when the driver would put it in gear and we would begin the slow and steady crawl up the hillside. All the while the driver would keep a steady hand regardless of the bumpiness or incline of the road. 

Lesson #3: Reliable walking shoes are essential

Surveying caregivers in the villages of Mokhotlong district requires a lot of walking. If you do not have a contact number or other way to reach someone by word of mouth, then you will be traveling to their village and hope they have not gone to the fields or into town yet that day.

Also, despite my comment earlier some of the roads are all but impassable except for on foot.

Lesson #4: Make friends along the way

It has been a great experience getting to meet so many wonderful people. The caregivers I have surveyed have inspired me. I returned to the TTL campus each evening with stories – some difficult, but many more that I will keep as fun, fond memories of my time here.

Lesson #5: Play with babies

A great thing about staying at the Touching Tiny Lives campus is getting to spend time with the adorable and fun-loving kids of the Safe Home. These children have continuously put a smile on my face and have brought me much joy, and they have pushed me to work hard and put out quality results from my research.