Monday, April 27, 2015

Community Caregivers on Campus

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

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

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

Monday, April 13, 2015

Difficult Case to Crack

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

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

*Child's name changed to protect identity