Rebuilding Communities

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Photo: Dr. Martina C. Fuchs, RMF Founder/CEO, making new friends at the Lwala, Kenya Community Hospital, October 1, 2011

We are so grateful to all our friends, supporters and teams around the world and wish everyone a fantastic 2012!

Having wrapped up another successful  we want to pause and say a huge THANK YOU to all of you who supported our work in 2011.  You have helped us achieve so much, and we give our deep thanks to everyone for your generosity and support!

In 2011 we..

  • In Japan, post-earthquake and tsunami, RMF reached over 33,000 people in Ishinomaki City with supplies, debris/sludge cleanup, and community center support.
  • In India, in RMF’s Malnutrition Eradication Program, our field staff of 75 Community Nutrition Educators diagnosed and treated 85,016 cases of Acute Malnutrition in more than 600 villages since our program started in 2010.
  • In Uganda, we provided healthcare, education and vocational training support to 55,000 refugees at the Kiryandongo Refugee Settlement.
  • In South Sudan, 40 Nurses and Midwives at the RMF sponsored first-ever accredited Nursing and Midwifery College in Juba, are beginning their 2nd year of training.
  • In Pakistan, RMF treated more than 25,000 flood victims at our free medical camps, 32,000 patients at our clinic in Gulbella and provided healthcare in Talhatta for more than 150,000.
  • In Haiti, our free clinic at Hôpital Lambert Santé provided public access to 24-hour emergency and general healthcare to a community that is home to more than 100,000 displaced persons.
  • In Kenya, we upgraded the only hospital for 1,000,000 people in Lodwar, Turkana, starting with the pediatric ward and also continued to provide medical support, food and water to thousands through mobile and stationary clinics in the poorest and most drought ravaged regions in Kenya.
  • Closer to home, in South Los Angeles, RMF provided 70 children with new backpacks filled with school supplies and personal products, and just threw a Holiday Party for these children on December 17th.

From all of us at RMF: Have a Happy, Healthy and Prosperous 2012!

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Real Medicine Foundation and the Florence Western Medical Clinic in South Los Angeles will be hosted its 4th Annual Children’s Holiday Party on December 17, 2011. Each year, RMF provides toys, sports equipment, books and grocery cards for holiday dinners to meet the needs of these often-overlooked families.

Over 60 bags of gifts were given away at this Saturday’s Holiday Party for kids in South Los Angeles!-To read more about our programs at the Florence Western Medical Clinic, click here.

Photos from our event below:

 

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by Jonathan White and RMF Partner Fumiko Tanaka at Japanese Emergency NGO

Geographic Locations

Ishinomaki City, Miyagi Prefecture

Taking Care of Local Students during Summer Vacation

Beneficiaries

Approximately 1,690 individuals, employees of 7 local companies, 11 households and the residents of 11 communities of Ishinomaki were reached by JEN’s activities during this period.

Activities

1) Volunteer Dispatch

  • Supported by 2,890 volunteers, JEN has completed removing rubble and sludge from a total of 196 buildings in Ishinomaki City. JEN dispatched volunteers to clean places such as houses, an office and a factory.

 

  • JEN was requested to send volunteers to help hold a sports event at Oshika Junior High-School. The tasks involved weed removal, setup for the event, food tray service and participation in the event.

 

  • Starting of an Aqua-Farming project in the Sameura area of the Oshika Peninsula, 108 additional JEN volunteers were dispatched to help fishermen on the port.

 

2) Psychosocial Care through Community Space

JEN has been providing community spaces where evacuees can gather for activities and share their experiences as psycho-social care. There are currently 3 places where activities have begun as pilot projects in the existing communities, and 8 at transitional shelter compounds.

<Nakayashiki Space>

 

  • Homework support for children by university students from Tokyo has been ongoing throughout the reporting period. In addition to homework support, classes for Japanese calligraphy and balloon art were held for the children. This space held between 10 and 20 students every day during the summer vacation.

 

  • JEN provided soup kitchen and massage services for the local people including residents of temporary housing. On September 13th, nearly 50 meals were provided and relaxation services were offered to 10 people.

 

  • Some new services including health checkup and a handicraft class began during the reporting period. The handicraft classes have been popular especially among housewives.

 

  • JEN proceeded with the preparation for the first workshop on September 17th.

 

  • JEN contributed an article to a monthly social educational magazine on its community support project in Nakayashiki that will be published on September 15th.

All photos JEN Copyright

 

<Kazuma Space>

  • The Kazuma festival was held on August 20th and attracted a large number of local residents. 4 food stalls were opened and all their food was sold out. In addition, a famous singer gave a performance to encourage the residents.

 

  • The meetings regarding the construction of a community café in Kazuma Space were continuously arranged with donors and local self-governing bodies. A “jichin-sai”, a Shinto ceremony to purify the building site and offer prayers, was also held.

 

<Koganehama Space>

  • The first workshop at the Koganehama Space and neighboring areas was held on September 4th. The workshop focused on the things to do right now and the long-term reconstruction plans.

 

  • JEN provided massage service for the local residents. Acupuncture practitioners were invited this time and their service was quite popular among the residents. Moreover, new programs such as cooking or handcraft class are being considered.

 

<Transitional Shelters>

As part of the community space projects, the following events were held in the temporary housing areas: tea party, massage service and legal counseling. Some tea parties called ‘Ochakkonomi’ in local dialect were held inviting local elderly mothers to chat over the tea for socializing purposes.

Economic Recovery Assistance

Rubble Clearance through Assisting Local Waste Management Contractors

JEN lent 4-ton garbage cars to Katsumata Transport, the Watanabe Cleaning Service Company and the Suzukyu Recycle Shop. A 4-ton damp car will be handed over to the Ishinomaki Waste Disposal Center.

Assistance of Small to Mid-size Local Businesses

JEN has decided to conduct assistance for building temporary shopping streets in Ayukawahama. The meeting on the contents of the project and how the project will develop in the future was held between JEN and the commerce and industry association in the area on August 23rd. To acquire cooperation from the public administration, the meeting with Mr. Okada, a head of the Oshika Branch of the Ishinomaki City Council, was also arranged. JEN confirmed the project site and gained the agreement on the implementation of the project from Mr. Okada. The next steps for the project will be: acquirement of permission in writing on the use of the town-owned land, selection of contractors, cost estimates on prefabricated houses, order for construction work and arrangement of contract documents and minutes.

Material Distribution

JEN distributed vegetables to 80 households (260 people) in the Higashihama area of Oshika Peninsula. 280 loaves of bread were also distributed to the area from a bread factory in Ayukawahama.

For more information about our Japan Relief Efforts click here

If you are interesting in donating to the earthquake/tsunami relief efforts with our partner JEN in Japan, click on Donate below.

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“From Mud Huts to the Cutting Edge of Technology”

by Michael Matheke

In March 2010, Caitlin and I were driving around Khandwa district on a motorcycle desperately searching for staff to begin operations of our ambitious “Eradicate Malnutrition” program. In our heads, we had a checklist of criteria for potential new staff, mostly focusing on education levels and any experience in the health, nutrition, or NGO sector. As we drove from hamlet to hamlet, over dried streambeds and through fallow, dusty farmland, the checklist was whittled down to one item: literate.

In July of 2011, 5 of our amazing CNEs from Khandwa are now on the cutting edge of technology, helping Microsoft design their Digital Slate technology for data collection in the field. At the same time, the rest of our Khandwa team is collecting information with an application on their phones specifically designed from RMF called Commcare. After a 3 month study, Microsoft Research will publish a paper based on the inputs of our team comparing these solutions to data collection problems. It seems that my initial pessimism, as it so often is, may have been a bit misguided.

On a motorcycle in 100 degree heat, it was hard for me to imagine solutions to the multitudes of challenges our program would face. How would we train our staff? Would they understand the material and the importance of our task? Would they be able to accurately report what they were seeing and doing, and, if so, how would our small team process this information? We knew that none of our team was lacking in passion or enthusiasm, but how well would we adapt to new challenges? I couldn’t imagine, in my own head, solutions to all of the problems I could invent. I should have had more faith in the Korku women of Khandwa.

After our initial consultations, the team from Microsoft decided that a two day training session would be the best to cover all the topics and ensure that our CNEs know how to use the device, since it is a prototype of new technology. It took our team an hour. The rest of the weekend was spent by our CNEs training every member of the hotel staff where the training was held. After that, they also held an impromptu malnutrition awareness raising session, educating everyone and anyone who would listen about our program and the needs of the surrounding community.

As has always been the case over the past year and a half, I am constantly amazed by the abilities of our staff to process new information and technology. Besides the children we help in our program, the empowerment of tribal women is one of the most satisfying aspects of our program. With just a small push, and the framework of opportunity, all of our CNEs continue to inspire us on a daily basis. Their ability to master new technology far exceeds that of even myself; on the long trip back from our initial visit in Khandwa in 2010, I managed to neatly deposit Caitlin from the back of the motorcycle into a rather large pile of mud in front of about 50 people.

Real Medicine Foundation Mobile Data Collection

Currently The Real Medicine Foundation India is running the largest community based malnutrition program in Madhya Pradesh, covering a total of 600 villages across 5 districts with over 65 field staff. RMF’s “Eradicate Malnutrition” program covers over 65,000 children, diagnosing cases of Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM) and providing linkages to government of MP treatment services, such as referrals to Anganwadi Centres (AWCs) and Nutritional Rehabilitation Centres (NRCs) for inpatient treatment. RMF’s Community Nutrition Educators (CNEs) also provide counseling services to communities and families at risk or affected by malnutrition.

One of the largest problems facing RMF’s management team is a timely compilation and analysis of data collected by our CNEs. Currently, each CNE uses multiple paper reporting formats covering interactions with the communities and families. These diaries are then collated at weekly meetings and the aggregate data entered into computers by data entry officers. The lag time from data collection to analysis under optimum conditions is 1 month, hampering RMF’s abilities to quickly adapt and respond to unique situations and efficiently supervise field staff.

Streamlining Data Collection with Dimagi’s CommCare Application and Microsoft’s Digital Slate

RMF is currently in the test phase of two new forms of data collection tools utilizing low end mobile phones: Commcare by Dimagi and a prototype of Microsoft’s Digital Slate.

Digital Slate by Microsoft

Microsoft’s Digital Slate is a new form of technology that allows paper records to be copied and the information sent to a central database instantaneously. The Digital Slate is a device that converts written text into digital data. As our CNEs conduct their routine work and record their information, every entry is converted into a digital file by the slate. We have developed a special diary specifically for this application that records:

  • Child’s name
  • Village
  • Mid-Upper Arm Circumference (MUAC)
  • Complications such as fever, cough, or rash.

There is also an open field for notes that converts written comments into images that are stored in each case file.

All of the information is sent instantly to our supervisors via sms. Once the information is recorded, we have the ability to instantly process data, giving RMF’s management team a clearer picture of which CNE is handling which case and how many children we currently have enrolled in our program.

Commcare by Dimagi

Using forms developed specifically for RMF’s program and installed on each mobile phone, the CNEs collect information by answering questions in each form that is sent via SMS to a central database in realtime. Commcare provides each CNE with:

  • Entry points for child registration such as child name and village, important indicators such as Mid-Upper Arm Circumference (MUAC) and complication history, and verbal prompts from the phone that instruct the CNE to refer the child based on these inputs;
  • Easily accessed case histories for repeat visits with children that track previous treatments and counseling given and improvement or deterioration of the child’s nutritional status;
  • Referral tools to track recommended treatment for SAM and MAM children and required follow up by dates.
  • Counseling and referral tools that follow Integrated Child Development Services (ICDS) and National Rural Health Mission (NRHM) guidelines.

RMF supervisors can access this information from any location anytime via an internet based dashboard. The dashboard provides realtime displays of each form submitted by each CNE, a list of cases currently registered by name, village and CNE, and a downloadable excel file of raw data for instant analysis by RMF’s M&E officer. Pockets of malnutrition and complications by village are flagged so that RMF may investigate further. In addition, RMF can monitor staff activities remotely as all entries are visible by CNE and stamped with a date and time, minimizing the need for spot checks.

For more information about RMF’s Malnutrition Eradication Program in India, click here

We can use any financial help you are able to provide on this project to continue our Education,Treatment and Outreach and help toward our goal of Malnutrition Eradication in this region of India.

To contribute to this initiative, please click Donate button or visit our website at realmedicinefoundation.org


 

 

 

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by Caitlin McQuilling

“Don’t automate a broken system”

Monitoring and evaluation is often the most difficult part of any development program.  It’s often an afterthought for implementers, too busy worrying about rolling out the immediate and the tangible to worry about how they’ll evaluate their work at some later stage.

It’s important that data is not something that’s just written down in a grid each month and never seen again.  The strongest programs are the ones in which ground level staff find their reporting useful in their daily work.  By making data helpful to ground level staff it makes their reporting in turn more accurate.

Even though RMF put a focus on our M&E from the beginning of our program, it has continued to be one of the biggest struggles in implementing our program on the ground.  As our program grows we are not only constantly assessing, analyzing and evaluating our data but also try to give the same level of analysis to the processes by which we collect data.

In this age where there seems to be a tech solution for everything, many development programs make the mistake of thinking that technology will be a “silver bullet” which will fix all of their challenges in the field.  The best advice we received from one of the technology experts we were consulting with when deciding which direction we should take our program was “don’t automate a broken system,” meaning that before introducing any new technology, an organization should make sure their fundamentals are solid.  As we moved forward with the planning of two innovative technology pilot programs for data collection integrating technology such as mobile phones or digital slates, we also needed to ensure that the fundamentals of our program are strong and that we understand and were honest about our strengths and weaknesses in data collection.

The following is a description of our current M&E system and the steps we went through to refine our processes and fix the problems we encountered.


M&E Process

Quantitative

  • Daily Diaries:  A simple book in which the CNEs freely record their daily activities and notes in the field
  • MUAC Diary:  CNEs each record in this daily register the names of SAM/MAM children they see and their Mid-Upper Arm Circumference.
  • Triplicate form: a triplicate carbon paper form which the CNEs use to refer children to the NRC and track the referral through the system.  One copy goes to the CNE, one to the family, and one is deposited at the NRC which we collect at the end of the month.
  • Weekly Reporting format:  Using the daily diaries, triplicate forms, MUAC registers the CNEs fill in the weekly reporting format and give that to their supervisors.
  • Monthly Reporting format:  The Supervisors collect all the CNEs’ weekly reporting formats and consolidate these into the monthly format.

Qualitative

  • CNE feedback form:  Filled out once a month by the CNEs to provide RMF management information about case studies, challenges, and success stories in the field.
  • CNE Needs form:  Filled out monthly by putting a simple tally in the boxes where they’ve had to give counseling.  Supposed to be a very easy way to assess the counseling needs in the field.

Process of verifying our data

We held our own internal audit of the first year of our reporting (May 2010 – March 2011).  Since our program is reporting big numbers and getting a lot of attention from government and NGOs, we wanted to be sure internally that our data was airtight and accurate.

Thanks to having a multi-layered MIS, we were able to go to the source of our reporting to get the accurate data.  By back-tracking of the data we were not only able to verify our data down to the individual child but also identify at which steps our MIS wasn’t working well.

Each CNE maintains a daily diary where she notes down information on the village she visited each day.  Then she copies all the information on children under 5 into a MUAC register, where she records the MUACs of children on each visit to the village over the months.  In this we have a full year record (or whenever the child was first identified) for each individual child.  This register is used by the CNE on a daily basis so that she can remember the history of each child she visits and so that she can see whether the child is improving or worsening on each visit to the village and can direct her counseling accordingly.  We believe that we have accurate MUAC registers for all CNEs, except for a few CNEs who we let go for poor performance.  For those villages we had the new CNEs we hired do fresh surveys and collect fresh data and compared that with the questionable data.

The CNEs use this register to fill out their weekly reporting format, which is submitted to their supervisor each week.  This format is where the problems with calculating and addition started.

The Coordinators then collect all the CNEs weekly formats and use those to create the district monthly aggregate report.  This is also where some errors occurred.

The weekly reporting formats and monthly reporting formats were filled out in hard copy by CNEs and District Coordinators, who did math by hand or using their cell phone calculators.  This many times led to human error which was not picked up until later when the data was entered into excel sheets by our data entry operator.  It was also a cumbersome process for the coordinators to consolidate all this data on a monthly basis and often took longer than RMF management would have liked.

Dr. Athar Qureshi, RMF’s Director of Programs, worked with the coordinators to create a new format, by village, where we reworked the totals for each village by month.  This gave us a more accurate number.  The Coordinators spent a weekend filling in all the data and checking the math.

Once the data was in an excel spreadsheet the team analyzed it and compared it to the original data submitted, the baseline data, and the NRC survey.  The NRC survey and baseline data are results we’re sure about because we can link those to the individual children, so those are good points to verify the data from.  We found that most of our data was reported accurately, with minor errors here and there, but that the process in which we collected our data was extremely time consuming and even more time consuming to go back and check.  This also made it difficult for the District Coordinators to apply the program data in the field and to do cross checking of reports which CNEs submitted.

During this review we also realized that there were many activities CNEs were conducting on a daily basis which were not reflected in our reporting formats.  CNEs recorded activities that were not reflected in the reporting formats as notes in their daily diaries, but each CNE recorded these activities in their own method.  During the data cross-checking these daily diaries proved to be very useful for checking numbers, names, and dates whenever there was a question in the reporting formats.  RMF realized the utility of having uniform reporting and a structure to these daily diaries while still allowing the CNEs some free area to write their personal notes.

We also faced some difficulties in the formatting of data from month to month as the overall compilation of the data was done by different people at different time intervals.  Before January of 2011, RMF did not have a data entry operator and instead all program data was entered by DCs or program managers.  Depending on how busy various individuals’ schedules were, one individual would enter the data for a few months and then another person would take over.

Lessons Learned

While this review of program data was tedious and painful at times, it was a tremendous learning experience for all staff members involved.  For the CNEs it was a process of reflection on the quantum of work they had done and also a time to formally point out questions they had and challenges they faced.  By spending so much time sorting through the program numbers, DCs gained an increased familiarity with what the numbers were actually capturing and became much more comfortable with data.  RMF’s program management also got to see where the gaps in reporting were and where we could support program staff better.

 

The following were some of the key lessons we learned and changes we’ve made to our reporting system:

  • The Daily Diaries and MUAC diaries are key, but structure is important
  • Someone needs to “own” the data
    • In November 2010 RMF realized this problem and requested our donors to provide us additional funding for a data entry operator and monitoring and evaluation officer who would “own” the data and make sure entry was uniform across all 5 districts.
  • Each piece of data should be clearly defined

Next steps

Following this review, the team created new, more intuitive daily reporting formats and a revamped MUAC diary to help address many of the problems we identified.  When introducing these new formats Dr. Athar and our Monitoring and Evaluation Manager, Julia Tewaag, held a two-day training for each district (10 CNEs and one DC) to introduce the formats, ensure everyone was clear on definitions and to walk CNEs and DCs through exercises which would help them better apply their data in the field.

 

With our M&E house in order, RMF is now ready to automate!  We have just launched an exciting pilot together with Dimagi and Microsoft Research India (MRI) to help us decide what is the best technology for our program to use.  With the help of Google and the Open Data Kit project, we’re also testing how Androids can be of use in our program.  More on those pilots in the next series of blog entries.

For more information about RMF’s Malnutrition Eradication Program in India, click here

We can use any financial help you are able to provide on this project to continue our Education,Treatment and Outreach and help toward our goal of Malnutrition Eradication in this region of India.

To contribute to this initiative, please click Donate button or visit our website at realmedicinefoundation.org


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by Jana Siu

Vicki the pharmacist described to me the neighborhood of Cleto Rojas in San Clemente as rustic. I found “rustic” to be an understatement. This area increased dramatically in size after the earthquake. Houses are constructed of wooden poles and mats of weaved reed stalks as roofs and walls. Plastic sheeting, some that have the emblem of medical relief organizations long gone, insulate these homes. It’s a very dusty, windy, dry part of town. We chose Cleto Rojas as the location to do our preventative health campaign.

Tumbling out of our cramped motos with our supplies and anticipation, we were slightly disappointed to see all of 5 people sitting outside. But knowing that information spreads pretty quickly through paper-thin walls (literally), we soon found ourselves in a crowd of 60.

One of the major problems found here is a significant parasite infection rate. There is no running water so the municipal district fills these above-ground concrete wells shared by groups of neighbors. Water gets contaminated quickly. Add in all the stray dogs, close bathroom quarters, and poor hygiene practices, people get sick.

Hand washing for hygience demonstration

First things first, each child was given an anti-parasitic. Next, our staff gave a presentation on proper hygiene, food preparation, and basic parasitology. We concluded with a hand-washing demonstration. Our audience was engaging, participatory, and it was a fun and interactive experience for everyone.

Luisa giving dental cleaning demonstration

Luisa, our volunteer dentist pulled out her dental model to everyone’s delight, and talked about dental hygiene. “What else do we brush besides our teeth?” Luisa asked. “Our tongues!!” chimed the kids in a loud chorus.  I have no doubt that her lesson stuck. The children squealed in delight over their new toothbrushes that we passed out and got a helping of fluoride, although they admitted to liking the taste of toothpaste much better, so we passed those out too.

Our lecture on women’s health created so much input from the women that we had to institute the “raise your hand before you speak” rule. This was one of the few times that I was happy that people couldn’t wait their turn to talk.

2 hours later, after questions were answered, teeth were made a little stronger, and free gifts were passed out, people trickled back home. I find that you can never over-do preventative health. And unless vaccinations are involved, everybody has a good time and learns something new. If we happen to lose a few clinic appointments due to proper hand-washing then…hooray!

Children with new toothbrushes

More information and reporting about our clinic in Peru can be found here.

Follow us on TwitterFacebook or become a fundraiser for us at Causes.com

To help us continue to purchase medicine, supplies and fund the staff at the clinic you can contribute to this initiative by clicking on the Donate button below or visit our website at www.realmedicinefoundation.org/donors.

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On behalf of all of us at Real Medicine Foundation, we would like thank everyone involved for the wonderful fundraising event at the Andrew Weiss Gallery on Sunday!

Your support, generosity and contributions will make a difference in the lives of countless children and their families we serve around the world.

Photos of the event below:

In recognition of today’s World Refugee Day, we would like to highlight our work with refugees in Uganda and the overall plight of more than 40 million uprooted people around the world.  With conflict and natural disasters escalating in many countries, finding new homes and allowing refugees to restart their lives is increasingly difficult.

Real Medicine Foundation (RMF) supplies the Kiryandongo Refugee Settlement in Uganda, a home to more than 26,000 Sudanese, Kenyan, Congolese and internally displaced Ugandans, with something rarely found at refugee camps; HOPE.  Providing this hope to Kiryandongo by supporting the healthcare, education and vocational support of its residents.  We have been working with Kiryandongo since 2008 through a grant from the World Children’s Fund and other individual donations and in collaboration with UNHCR and the Ugandan Office of the Prime Minister.  

 “Kiryandongo has become a permanent settlement,” says Real Medicine Foundation Founder and CEO Dr. Martina Fuchs. “The residents cannot return to their homes, and they deserve opportunities for a future beyond the camp.  Real Medicine’s programs want to supply not just concrete support, but a sense of hope that life can and will get better.”

 Education is currently supported by directly paying for school fees, uniforms and supplies for 638 children, roughly half the students at the settlement schools. The kids range from nursery through high school age. RMF also provides a Vocational Training Center at the settlement for young adults, employing local instructors to teach marketable skills such as hairdressing and tailoring. 

 RMF also supports the “Panyandoli” health clinic at Kiryandongo which services more than 40,000 people in the camps and surrounding areas and treats as many as 4,400 patients a month. The majority of patients are women, many of them suffering from malaria or pneumonia.  RMF provides the clinic with medicine, medical supplies, cleaning staff, repairs, renovation and a solar powered water system.

In addition, RMF provides support and training for treatment of post-traumatic stress among the students and orphans at the Mama Kevina School in Tororo, Uganda where many of the children have been affected by war, AIDS, floods and deep poverty. Several of the students were also forced to be child soldiers and are currently recovering from those horrors.

We are highlighting the plight of refugees under our care and to advocate on their behalf for the help they need and ask you to contribute in whatever way you can to helping them rebuild their lives.

To contribute to this initiative, please click Donate button or visit our website at realmedicinefoundation.org.

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by Sarah Stern

Annual Report for RMF Outreach program at the Florence Western Medical Clinic

Real Medicine’s partnership with Whole Foods Market, Venice, California is continuing successfully. In the last 12 months, 1,728 patients were provided with bags of nutritious groceries. Patients sign up at the Florence Western Medical Center’s front desk to be considered to receive food. We are looking into additional partnerships with organizations and grocery stores that would be able to meet the growing dietary needs within this community.

Our children’s Health & Fitness program is held the 1st and 3rd Saturdays of the month, from 10am-2pm. Fitness instructor Roz Baker provides nutritional education and goals along with a fitness “boot camp” that provides children with fun, yet challenging exercises and a cardiovascular workout. Our yoga instructors provide the children with stress relieving breathing techniques and poses that they can take into their daily lives. 144 children were provided Health & Fitness instruction along with yoga and nutritional classes last year. The physical condition of most of the children participating in the program starts out as poor.

Many have very little cardiovascular fitness, are weak and some are obese. Our experience shows that after a few classes the kids understand the importance of being healthy and how it is in their own power to get healthy and fit. Regular attendees now request us to create exercises for them to take home and several children have started to lose weight. The majority of the kids live in areas where parks are dangerous, and few and far between. This program gives them the knowledge and confidence to take control of their health. Our goal is that it will transfer to all aspects of their lives.

Real Medicine Foundation believes in focusing on the “whole” child. In Sri Lanka, following the Tsunami of December 2004, we found the use of art therapy extremely beneficial in helping children to deal with the tremendous trauma they had experienced, to relieve post-traumatic stress and to open the door to communication.

The children of South Los Angeles face many emotional challenges, such as gang violence in the streets where they live, homelessness, unemployment and despair of their parents or caregivers on a daily basis, and our goal is to provide them with a safe atmosphere to be able to express themselves. Thus, we provide art, reading and specialized workshops as these services are unavailable within their community. Real Medicine will continue to expand this program by providing summer programs as well, i.e. a “Back to School” drive which will provide all children with new backpacks, school supplies as well as vouchers that can be used for clothing and shoes.

132 adults attended our “Healthy Living” workshops provided by our partner Health Net. Workshops educate the patients about the importance of a healthy lifestyle and how to incorporate it in their daily lives. Dietary suggestions as well as low-impact exercises are presented, along with encouragement to quit smoking and limit alcohol use. 80% of all patients who participate are suffering ailments due to obesity, poor dietary and lifestyle choices.

Our annual holiday party was held on December 18th, 2010 where 65 children received over $2,000 worth of toys, books and sports equipment donated by Northrop Grumman Corporation. We are looking forward to this year’s holiday and expect it to provide even more items and gifts for the families.

Four times a month, Real Medicine provides physical therapy sessions with a licensed Physical Therapist, Charmayne Cahn. In the past year over 25 patients (with a 50% return rate) received physical therapy sessions. The majority of patients are seeking treatment for injuries due to strokes, arthritis, falls and automobile accidents.

Our program continues to grow each year, and with the possibility of additional funding promises to provide even more services for patients including a registered dietician, Lifestyle counseling, field trips to cultural activities centers for the children and transportation to music programs, grief counseling and other free community services provided within Los Angeles. Depending on funding, we also aim to resume our Psychological Trauma Support Program since it is desperately needed in the community we are serving.

To contribute to this initiative, please click Donate button or visit our website at realmedicinefoundation.org/donors.

 Follow us on TwitterFacebook or become a fundraiser for us at Causes.com

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by Caitlin McQuilling

Community Mapping

The month of April was RMF’s Community Mapping Month in Barwani district as part of our Community Mobilization Pilot with the Department of Women and Child Development.  The team started this community mobilization activity by having a two day training on the method for Community Nutrition Educators (CNEs).  This was to ensure that all CNEs used similar, participatory methods in doing the mappings.

 The first day was at the office in conjunction with the weekly team meeting where mapping techniques, use of symbols, and methods to involve community stakeholders were discussed.  The second day of training, Anjana split the CNEs into two groups and took them out to a village near Barwani to do a practical mapping exercise as a group.  This hands-on mapping training turned out to be the most effective, with the feedback from many CNEs saying that this gave them the most clarity and confidence.

CNEs started the mapping exercise by meeting with the village Patwari wherever possible to discuss the village layout, ensure his/her participation in the mapping exercise and to obtain a village map.  They made an appointment with key community stakeholders, including anganwadis, Sarpanches, patwaris, and active mothers, to do the community mapping exercise on their next visit.

In each village, we ask the community to lead this exercise, with the CNEs prompting the community members to dive deeper and deeper into the mapping exercise.  CNEs were instructed to ask community members to map out both the things there were proud of in their communities and the things they thought were bad for health.  Good things included schools, new latrines, and village meeting places.  Bad places included liquor shops and open defecation sites.  In each instance, CNEs were instructed not to pass any judgment or not to make any suggestions, but to let communities do this analysis on their own.

Community mapping covers:

-          Households in the community (some villages got down to the level of detail of the names of the family members in each house, other just mapped out the homes)

-          Location of SAM kids

-          Water sources, streams, rivers, damns, ponds

-          Hand-pumps

-          Public buildings: AWCs, schools, panchayats, PDS shops, AWW homes, temples

-          Shops (general stores, PDS shops, liquor stores)

-          Local doctors, health centers, medicine men

One of the best examples of this method leading to community realization and behavior change was in Badgaon with CNE Saroj.  At the beginning of her mapping session, a handful of women sat around the poster paper, with their heads and faces covered and didn’t say much.  As the anganwadi and ASHA led the mapping and did most of the work the women started to contribute more and more, peeking out from behind their veils and laughing and arguing as they discussed various aspects of the community.  In the beginning, a few men stood around the outside of the circle, attempting to look as disinterested as possible.  As the mapping progressed, they too couldn’t help themselves with participating more and more.

During her mapping exercise she asked community members to map out the positive and negative things in their village.  The women listed newly constructed latrines (under TSC) as positive things in their village.  Then Saroj asked them if they were being used.  The community members laughed nervously and admitted that no one used these newly constructed latrines and still continued to defecate out in the open.  Saroj asked where the open defecation sites were.  The anganwadi worker plotted these right next to a stream.  Without passing any judgment Saroj asked the community what they used the water for.  They all said bathing.  Then as Saroj remained silent, women in the group all started to giggle at the same time.  They were making the connection between the open defecation and the proximity to the stream they used as a water source.  And in this moment, this simple mapping activity may have had the largest Behavior Change result of any of the activities RMF has undertaken in this village thus far.  Community members started to chatter amongst themselves and comment that they should start using the new latrines right away and started speculating that this contaminated water may be why children are getting sick.  It’s too early to see if this has made a true change in the community, but this kind of self-realization is bound to be much stronger than any lecture or training session.

This was the most dramatic example of the effects of community mapping observed so far by RMF Managers (Caitlin was present during this session), but the community mapping seems to be a very effective and well-received activity.  It’s a chance for local communities to show off their knowledge for a change and makes them feel proud of their knowledge.  RMF CNEs have reported enthusiastic participation of community members in each session.  Anganwadi workers have told us that this is “a very simple activity” and fun. 

The key to making these mapping exercises work is to make sure the CNE understands that this is not just about drawing a map, but that it’s a community mobilization activity.  CNEs can facilitate the map making process, being the illustrator or scribe, but the actual process must be conducted by community members. 

We found that the mapping exercise is better with a small group of 5-10 individuals, otherwise it gets too crowded and confusing and leads to less participation.  To be able to include more individuals in the process, CNEs did the mapping in 2-4 sections per village, depending on the village size and number of anganwadis.  One map was made for each village, but the CNE drew the map in various stages depending on how many anganwadi centers there were in the village, so that each section of the community could participate meaningfully.  The final complete village map was then copied and given to each anganwadi center to hang on the wall so that each anganwadi center has a full map.  Another important pointer the CNEs found was to begin the mapping process by drawing the village boundaries instead of just diving into mapping locations.  This was scale could be developed.

To date mapping has been completed in 114 villages in Barwani district.  Given the success of this activity it will be scaled up to all RMF villages in the 4 other districts this quarter.

For more information about RMF’s Malnutrition Eradication Program in India, click here

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