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India Malnutrition Program: Community Mapping Pilot

May 9, 2011 in Caitlin McQuilling, General, India, Providing Medical Support, Rebuilding Communities, Voices from the Field by Jonathan White | Comments closed

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

We can use any financial help you are able to provide on this project to continue our Education, Treatment and Outreach and help towards 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.

Voices from the field: We shall name her Anandini, Anandini is Joy!

April 20, 2011 in Helping Children, India, Naiara Tejados, Providing Medical Support, Rebuilding Communities, Voices from the Field by Jonathan White | Comments closed

Naiara with Anandini

By Naira Tejados

I still rememer vividly those days, long ago in terms of time, but mentally like it was yesterday.

After two days in shock, unable to sleep or eat after finding Gila (5 year old girl with tuberculosis meningitis and hydrocephalus) in her home on January 27th, I recieved a call from Caitlin informing me that the poor little girl had died despite all the efforts of the doctors in Ahmedabad.  Honestly I must admit that I felt a slight relief, as I believe if she had survived her quality of life would not have been what a little girl who had gone through so many traumas so young deserved.  The events around Gila’s death were reported in this blog by Caitlin McQuilling here.

Anandini's grandfather

It was obvious that someone in the family must have transmitted the deadly tuberculosis bacterium to Gila. So, after questioning and observing, it wasn’t difficult to identify the most critical patient in the family: the grandfather, the patriarch of the home, who had spent a long period bedridden, the last few days with fever and bleeding when spitting. My biggest fear was of the possible transmission of bacteria to the other 5 children in the home.

After two days immersed in the hospital we came to know that, while the grandfather clearly was suffering from tuberculosis, nearly all family members were anemic. With the help of our star native worker, Sumitra, I asked what their diet consisted of. It took me a few words to know that the conditions in which the family lived were deplorable: they had some land with dhal, a very typical lentil in India, had a few crops with peas and corn from which they made flour to cook roti, cakes of bread. They had nothing else. It was a great pleasure to provide the family food and other everyday items that they could not acquire. It was obvious that the family had spent all their savings in the treatment of Gila and was now ruined…

The second day, two hours after we dropped the family off at home, already very late at night, I got a call from Sumitra saying that Gila’s mother, who was in its final stages of pregnancy, had begun to feel the pains of childbirth. A new life was on the way! The next morning, impatient, I went to the hospital to see the new baby, when to my surprise, I learned that Dhana had not yet given birth. A nurse warned us that Dhana was very anemia Dhana and her life was in danger. I could not believe it! I thought again and again how unfair life was being with this family. Of course this hospital had no blood bank. Suddenly, a lot of ideas my mind was: what was the blood group of Dhana? Could I donate my blood? I begged the staff to analyze my blood type and they told me that it was not possible at the hospital. We had no choice but to go for help to a private hospital run by Catholics located in the same town, the same hospital that just 2 weeks before had stolen Gila’s life by not providing her the necessary drugs because of the family’s inability to pay. Maybe we could beg this hospital in this case to save the life of her mother and her brother/sister. We asked the midwife permission to take her to the other hospital, where we thought everything would be better under their supervision, but the midwife and the nurses told us that the baby would be born in the vehicle if we did. There was no time for anything, only wait.

Suddenly, from the hubbub of the hospital, we heard the cry of a newborn baby. It couldn’t be anyone else other than Gila’s new sibling. Taking advantage of a nurse on her way out of the delivery room, I rushed over to ask if the one crying was the one we were expecting. She nodded and let us know that everything had gone well, both the mother and daughter were fine, and there was no need for a blood transfusion to the mother. It was a girl! I could not contain my tears of joy. It was inevitable to think about reincarnation, so present in the lives of these people. Is that what you call it?


Anandini

To my surprise and joy, the next day, I learned that the Gila’s parents had asked us, the Real Medicine Foundation staff, to choose a name for the girl. What an honor! Thus, we chose the name Anandini for her, which means “joyful.” Anandini never cries. It was without a doubt, the best gift I received in India.

About a week after the birth, Caitlin, Jaimie and I went to the home for a visit. The family welcomed us with open arms. Concerned about their economic condition and their future, we asked how much their debt from Gila’s treatment totaled. They reported that to treat Gila they had borrowed € 1,000 to be returned with a 25% interest from a local lender, an insignificant amount in Western society, but which converts a family like this into a debtor for many years, perhaps also to the next generation.

I received a lot of money after writing a personal email the night Gila died to all my family and friends: It was an email asking them, each within their desires and possibilities, to donate money to use with the various groups I work with in India. Therefore, I immediately thought that I would love to help this family to get rid of this horrible debt. Thanks to the generosity of Jaimie, who was also present, and because she has raised a lot of money of her own (http://www.realmedicineblog.com/2011/03/18/voices-from-the-field- one-birthday-wish-granting-wishes-for-many-by-Jaimie-shaff) we decided that we would pay equally between the two of us. A few days later we returned to the home with the money, allowing the family to be free of at least of this burden. We did this knowing that this was something outside of our organization, because the organization focuses on providing medical resources but not providing cash. We saw the first smile yet on Dhana’s face. Many thanks to everyone who made this possible!

Anandini's father, Chhatra

We could not resist asking Anandini’s parents what work they would do from now on. Their response was unanimous: when she was a few weeks older the family would migrate along with other farmers having to abandon their homes, greatly increasing risk of several diseases in appalling conditions to which they have to submit, and leaving the older children in the care of grandparents. This response left us all broken hearted. Already familiar with the good work and infinite human quality of this family, Caitlin and Jaimie did not hesitate to offer a job to Anandini’s father, Chhatra, as a Community Nutrition Educator (CNE) with our organization. Chhatra, now works joyfully in his own village and neighboring ones, going from house to house, making sure that other children do not become victims of malnutrition and other medical conditions that are so easily preventable but that steal the lives of many in these villages.

For more information about RMF’s Malnutrition Eradication Program in India, click here and for more on our HIV/AIDS 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 towards 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.


SmileTrain and CHL Apollo-Indore bring new smiles to MP!

March 22, 2011 in General, Helping Children, India, Jaimie Shaff, Voices from the Field by Jonathan White | Comments closed

by Jaimie Shaff

Shakuntala before surgery

We’ve all played the classic game “heads, shoulders, knees, and toes (knees and toes!)” Actually, I’ve been so wrapped up in adulthood, I had forgotten about it. One night when we visited the Bhil Academy, I saw Naiara playing the game with the smallest kids and remembered singing the song with my cousins and preschool students, back in the day. Part of the song goes “eyes and ears and nose and mouth…” and the children point to the respective parts of the face. Two eyes. Two ears. One nose. One mouth. Something so simple, most of us don’t even think about the meaning.

Shakuntala after surgery

For children born with cleft palates, the song is not so simple. The physical deformity is visually shocking, and can cause much stigma against the child throughout life. From what we have seen in rural India, when the child is first born, parents don’t know what to do or how to feed the baby, and some children end up severely malnourished. As the child grows up, he or she is often ostracized from his/her peers, leading to delinquency and absence from school. As an adult, the acceptance into society is reduced, and all social aspects of life are affected. For women in our region, a cleft palate is a serious burden to bear, increasing risks such as domestic violence and job discrimination.

Sharikia before surgery

Fortunately, a solution is simple. A procedure that takes only 30 minutes can change the entire future for a child. Unfortunately, the knowledge of available services and access to such is not widespread in rural areas, and the burden of a curable birth “defect” adds weight to an already difficult life.

20 February 2011, SmileTrain and CHL-Apollo-Indore Hospital held a health screening in Meghnagar for cleft palates, heart conditions, thyroid issues, and other ailments not screened for at rural health centers. Our nutrition team arranged for three children from three districts to be screened for cleft palate operations, and the team at CHL-Apollo offered to operate on any children we brought with us to pre-op.

Sharika after surgery

On Wednesday, Naiara, Edith, Pushpa, Manisha, and myself brought four children from the districts of Jhabua, Khargone, and Barwani to CHL-Apollo for pre-op (three children were sick and had to be postponed).

17 March 2011, all four children received successful operations for their cleft palates.  Thanks to the incredible support and efforts by SmileTrain and the team of CHL-Apollo, the lives of Shakuntala, Sharika, Pepita, and Pipu will be forever changed.

Pepita before surgery

I was absolutely overwhelmed with the quality of care and attention provided by CHL-Apollo, and am so grateful to see the generosity and compassion that exists in the world.  Out of all of the experiences I’ve had working here, this was certainly one of the best.

Pepita after surgery

Three of the children will be receiving a second surgery in June, and three more children are in line for their first.  We can’t wait to see their new smiles!

A special thanks goes to Mr. Rajul Bhargava, Dr. Jaideep Chauhan, the team at CHL-Apollo, and the staff of Hotel Infiniti for all that you did to make this possible.

SmileTrain’s website can be found here: http://www.smiletrain.org and CHL-Apollo-Indore Hospital can be found here: http://www.chlhospitals.com

For more information about RMF’s Malnutrition Eradication Program in India, click here and the Bhil Academy click here

To contribute to this initiative, click on the Donate button below or visit our website atwww.realmedicinefoundation.org

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Voices from the field: “One Birthday Wish granting wishes” for many by Jaimie Shaff

March 18, 2011 in Helping Children, India, Jaimie Shaff, Voices from the Field by Jonathan White | 1 comment

by Jaimie Shaff

For the friends and family who know me best, it goes without saying that my date of birth is a sore spot for me. Last year, I actually skipped town and went on an AcroYoga retreat out of state!

This year, I’m unbelievably grateful to report I had the best birthday ever, and it’s all because of you (and Causes, of course). I began with a goal of raising $1,000 for some of the sweetest kids, and ended up with an astonishing $7,025. The money raised gave us the opportunity to follow up with kids from my “love” list, and saved three lives in the first two weeks. Just like that.

Here’s a little update of what we’ve done so far:

-Gave toys and coloring materials to kids to promote their psychosocial development (and to let them be kids!) on Chinese New Year.

Pankaj and toys

-Found Suriya and Amansingh close to death, and gave them a fighting chance to live. We’ve since uncovered a larger issue, in that the family is using these poor little children to exploit the system, but that’s for another blog.

Amansingh after 2 weeks at the Nutritional Rehab Center

-Provided emergency transportation and support to Rahul, a 2 year old with Tubercular Meningitis, to a prestigious public hospital in Ahmadabad, where he received a life saving shunt to drain fluid from his brain. He’s just returning from his first follow up appointment, and things are looking good, but his condition is far from stable. However, it does look like his sight might be coming back!

-Provided Basanti an operation for her clubfoot through the organization A Leg to Stand On (http://www.altso.org), at Civil Hospital. She’s recovering beautifully from her first operation, with a second operation scheduled for June.

Jaimie and Naiara signing Basanti's cast

-Transported Ayush (the happiest little guy in the world!) to Ahmadabad to follow up on his brain-shunt and evaluate his physical disabilities.

Naiara and Ayush

-Paid off the loan shark used to pay for Gila’s (rest in peace, little one) expensive private medical procedures, allowing the family to be free from debt in order to raise their new daughter, Anandani, to be healthy and safe. This story deserves justice, a blog to come.

Anandani

-Hired Anandani’s father as our first male CNE to help him avoid migrating for work and leaving his family struggling to survive.

Anandani's father

-Brought 4 children from the fields to Indore for cleft-palate operations at CHL Apollo through the organization Smile Train. (http://www.smiletrain.org).

Shakuntala before her cleft-palate operation

See Jaimie’s Birthday Wish Causes page here: http://wishes.causes.com/wishes/203560

Special thanks to “A Leg to Stand on” and “Smile Train” for helping make the operations possible.

Thank you everyone for allowing us to do this. The lives of these children will be forever changed thanks to your kindness, compassion, and support. You should just see the smiles.

For more information about RMF’s Programs in India, click here and here

We can use any help you are able to provide on this project to continue our Education, Treatment and Outreach in the Madhya Pradesh region of India.

To contribute to this initiative, click on the Donate button below or visit our website at www.realmedicinefoundation.org

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Voices from the field: Returning to Khandwa

March 4, 2011 in Caitlin McQuilling, Helping Children, India, Providing Medical Support, Rebuilding Communities, Voices from the Field, Whole Health by Jonathan White | Comments closed

by Caitlin McQuilling

RMF Community Nutrition Educator, Samoti, and a child recovering from SAM. Photo Credit: Ximena Prugue

In March 2009, when I was conducting the initial field visits to develop RMF’s Malnutrition Eradication Program I visited a village called Shali Dana, in Kalwa block of Khandwa district in Madhya Pradesh.  I remember being shocked and overwhelmed by the amount of children with severe acute malnutrition I saw in this village and the complete apathy and absence of government services in this village.  We saw dozens of glassy eyed children with thinning hair, bulging stomachs, and protruding ribs, empty anganwadi centers, and children who had been tortured by traditional healers in the name of recovery because of the absence of government health services.  Seeing this village convinced me that RMF had no choice but to do something drastic about this problem.

Samoti visiting Shali Dana

Fast forward to March 2, 2011.  Today I spent the day with our Community Nutrition Educator Samoti in Shali Dana.  She’s been working in this village for exactly one year and has made over 25 visits to this village, every 2 weeks.  Samoti has spent this last year developing a strong relationship with the community, visiting each house with malnourished kids on a bi-monthly visit, and has supported and encouraged government anganwadi workers.  Also over the last year, our friends at Spandan, a wonderful local NGO, have worked closely with the government anganwadi center to upgrade the center using community resources and have been working with the anganwadi worker to improve the quality of preschool education and other services offered to the community.  They have also done a lot of work to promote education in this village in both Hindi and Korku, the local tribal language which is in danger of dying out.

I almost started crying today as I sat in a beautifully painted anganwadi center listening to excited, energetic kids singing nursery rhymes in their native Korku when I remembered that this was the same village which shocked me so 2 years ago.  While being serenaded by the children Samoti showed me her register and went over the details of all the children with severe acute malnutrition in the village.  When she did her baseline survey in March 2010, this village had 14 children with severe acute malnutrition, roughly 15% of all children under 5 in the village, an alarming rate of SAM.

Photo credit: Ximena Prugue

Now the village has 0 SAM children.  We visited the households of 10 kids today who were formerly SAM.  Some of these kids were positively fat, while others were now moderately malnourished.  Watching Samoti made me proud.  As she walked through the village, she was greeted by each family walking by.  She scooped up children as she walked, joked with elderly women, and walked straight into people’s homes announced to pinch babies on the cheek.  If I didn’t know Samoti to be one of the warmest and most compelling women I’ve met, I would think this was all staged.  But having terrified 100s of kids by measuring their mid-upper arm circumference to assess their level of malnutrition I know that you cannot just come to a village once or twice and have kids walk up to you with their arms out, waiting for their MUAC reading.  And that’s exactly what a few of the toddlers in this village did!

If you’ve read the annual report from the Eradicate Malnutrition Program its easy to be overwhelmed by the numbers:

  • 65 staff across 600 villages
  • 37,141 families and 56,194 children reached during the baseline survey
  • 6,857 village nutritional training sessions conducted, training over 68,410 people
  • Counseled 91,034 individuals on malnutrition prevention and treatment
  • Successfully referred 895 children to NRCs
  • Achieved a 25% reduction in childhood malnutrition across intervention villages, 17,994 children who directly improved because of this intervention

They’re unbelievable numbers when you add them up, even for those of us who saw the progress in the field and did the adding.  I’m one of the members of the RMF team who spent hours and hours analyzing our program data.  Eyes bleary from staring at excel sheets and going absolutely crazy over the errors while cleaning data, we sacrificed our sanity and eyesight to make sure our data is as accurate as possible.  Even though I personally verified forms and conducted spot checks in the field to ensure the accuracy of reporting, I have a hard time believing that we reached over 80,000 children!

Young mothers and their children in Shali Dana

But today watching a new mother glow as she was breastfeeding her chubby infant and watching Samoti joke with mothers in the formerly tragic Shali Dana, I saw beyond the numbers and graphs to what RMF’s best at.  Here’s an invitation to every RMF supporter: come out and see for yourself the reality behind our numbers.  There’s nothing like it.

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

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

To contribute to this initiative, click on the Donate button below or visit our website at www.realmedicinefoundation.org

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India: Supporting Renewable Energy at our BHIL Academy project

February 17, 2011 in Helping Children, India, Naiara Tejados, Providing Medical Support, Rebuilding Communities, Voices from the Field by Jonathan White | Comments closed

by Naiara Tejados

Jhabua, India, 16th of February 2011

RENEWABLE ENERGY AT BHIL ACADEMY

It has really been a pleasure for me to see how, little by little, renewable green energies have become a part of our lovely school, the Bhil Academy (www.realmedicinefoundation.org/initiative/bhil-academy-jhabua-district-madhya-pradesh-india or search Bhil Kids on Facebook). Because of the hard work and dedication of donors, volunteers, and partners, the Bhil Academy is becoming more and more ¨green¨ every day!

eV Renewables´s staff members working at the Bhil Academy

Solar Electricity from eV Renewables and Loop Solutions

In Jhabua, electricity is scarce and typically only available for a few hours a day. After the sun went down, the children could do little but go to sleep: our children could not study at night or even walk to the toilets because of the darkness.

On 26 January 2011, eV Renewables enterprise from Hyderabad (evrenewables.com/) installed solar panels at the Bhil Academy. Thanks to the generous donations from Mr. Alok Brara and India Infrastructure and the incredible generosity, time, and energy of the team of eV Renewables, our students finally have light at night.

The solar panels are able to provide the entire school with at least 6 hours of steady electricity.  In addition to the solar panels, Loop Solutions (www.loop-india.com/) also supplied the school with portable lanterns. These lanterns not only light up the girls hostel, but also provide essential portable lights for the children to walk between buildings or in case of an emergency.

eV Renewables´s engineer Saaketh Preetham and Fabian Toegel

After a brief introduction of how to maintain the panels by the staff of eV Renewables, the 9th class children have been tasked with the responsibility of maintaining the solar panels and the supply of solar electricity to the school.

The solar panels were inaugurated the 28th of January by the kind honorable Kalavati Bhuria. I loved to see our children welcoming her with traditional Indian dances and songs! Thanks to everybody to make it possible!

More from Project REV

Also in the news of renewable energy, thanks to the work and steady donations from Project REV and our local volunteers, we have finished the construction of a kitchen-garden.  We will soon be able to grow our own crops in the school and provide a valuable learning activity for all of the children! We have now levelled a plot of land and surrounded it with a new fence to keep all animals (mainly cows, goats and dogs) out of the area, bought some nutrient-rich soil for cultivation, supplied the plot with watering-pipes, and purchased some seeds to plant. Our gardener, Mansouk, has purchased seeds for vegetables such as lentils, pumpkins, eggplants, spinach, cucumbers, tomatoes, radishes, cabbages, and lady-fingers, and will plant as the seasons require.

Kitchen-garden after preparing it to start seeding veggies

Also from Project REV, we have our fantastic compost bins!  Every day the school feeds 320 children from Kindergarten to 9th Class, and every day some food is left. In order to help the children learn conservationism and the usefulness of waste, organic waste will be collected in the compost drums and, after decomposing, used to enrich the soil of the garden. What an incredible way to enhance the education of the students of the Bhil Academy!

Decomposing drums to collect compost

Thanks to all donors, partners, and volunteers that have made all this possible! We will keep thinking of more renewable energies that could help in daily life at Bhil Academy, and welcome your suggestions. The next big venture will be the harvesting of rainwater. We already have a big big hole!

Hole to harvest the rainwater

Naiara Tejados

Volunteer of Real Medicine Foundation

Follow us on Twitter, Facebook or become a fundraiser for us at Causes.com

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

Voices from the field: An angel, from Justdail.com

February 15, 2011 in Caitlin McQuilling, General, Helping Children, India, Providing Medical Support, Voices from the Field by Jonathan White | Comments closed

An angel, from JustDial.com by Caitlin Mcquilling

I’m often asked what keeps me going in the face of the hardships and emotionally taxing situations we face working on issues such as childhood malnutrition and HIV/AIDS day in and day out.  My answer is simple: it’s all about finding inspiration in the most unexpected of places and circumstances.

Caitlin, and the mothers and children at the Malnutrition clinic

On Tuesday while out on a village visit we came across a little girl, Gila, who was extremely sick and dangerously malnourished.  She and her family had just returned from a month long stay at a private hospital in Dahod, Gujarat where Gila was properly diagnosed with tubercular meningitis, but unfortunately was not given the proper treatment.  Over the month she was there the family spent their entire savings and then some only to see Gila rapidly deteriorating.  After a month when the family could no longer afford “treatment” they were sent home.  This is when we found the family in the village, desperate for us to help in any way we could.  As soon as I saw Gila I knew she needed expert medical care not available in the state of MP.  We told the family that we would have to bring the little girl to the hospital immediately and they eagerly agreed without a second thought.

Along with Gila’s father, Suroj, we consulted a doctor in Jhabua to get his opinion on whether or not the girl could travel.  With the doctor’s immediate advice to go straight to Ahmedabad Civil Hospital and BJ Medical College,  I set out along with Sumitra, our CNE who first met the family, our wonderful and uncomplaining driver Mesul, and the little girl’s father and cousin on the 8 hour car ride.

As soon as we reached BJ Medical College, one of the best government health facilities in the country, we were rushed straight to the pediatric ICU.  The wonderful team of doctors there immediately put the little girl on oxygen and started treatment immediately.  They told us that the little girl’s condition was extremely serious and her chances of survival weren’t good, but promised to do everything they could to save her.  I spent the day in the hospital with the family on Wednesday, understanding the next steps with the doctors, getting all the lab tests they needed expedited, and making sure that they were comfortable.   We set the family up with a network of kind local volunteers who promised to look after the family on a daily basis since RMF couldn’t station one of our team members at the hospital for the 3-4 weeks the family would need to be there.

At 5am on Thursday while I was rushing to get my things together for the airport, I got a phone call from Suroj.  Between sobs, Gila’s father told me that she had passed away a half hour before and he didn’t know what to do.  He wanted to go home as soon as possible to cremate Gila, but didn’t know how he would get her body the 10 hours home.  He begged me to help the family find a way home as soon as possible.  When I got into the taxi a few minutes later I knew my options were severely limited.  I had to be on a flight in an hour to go to an important meeting in Bhopal, but I also couldn’t leave this family stranded.  I’m not very familiar with Ahmedabad, especially to find an emergency hearse at 5am capable of making an 8 hour trip across state boundaries.  But as I greeted the taxi driver, that my friend found from JustDial.com, I immediately had a good feeling about him.  I had 20 minutes to convince Nitin, the driver, to drive 10 hours with a sobbing father and a dead body.

I laid it on thick.  In my remedial Hindi I told him about the work RMF does in Jhabua, about the malnourished kids, about this caring family who tried to do everything for their daughter but who were failed by the medical system.  I wasn’t ashamed to beg this man to do us this favor.  By the end of the taxi ride this driver had no choice but to agree to my outrageous request to go directly from the airport to the district hospital to find a family who didn’t speak his language (Bhili v. Gujarati) and to take them and child’s body 8 hours to a tribal area which many individuals in Ahmedabad have prejudice about.   The driver was hesitant to take on this responsibility but conceded to take the family as far as Jhabua (not their village) as long as there was a death certificate.  While the taxi driver seemed honest, I could only wish for the best as I handed him money and ran into the airport to catch my flight.

While going through airport security I arrange an expedited death certificate from the hospital and connected Nitin with Suroj and Suminta.  As I boarded the flight Nitin was lost on the hospital campus.  On my layover in Indore I confirmed that Nitin had in fact picked up the family and that they were safely on the way to Jhabua.  Phew.  Job done.  I could now concentrate on PowerPoints and process indicators.

Thursday evening I got a call from Sumitra, our CNE who met the family in Jhabua when they arrived.  After she filled me in on how the family was doing, how the cremation went, and so on, she also had a message for me.

Not only had Nitin driven the family the 10 hours to Jhabua as agreed, he also insisted on driving them all the way to their remote village himself.  Not only did he go out of his way to drive them to the village, he attended Gila’s cremation as a member of the family.  The next morning he called Sumitra, not to complain, as many people would, but to thank her.  He told Sumitra that he was grateful that RMF asked him to do this.  He said it made him feel so good that he was able to be there for this wonderful family during their time of need and was just happy to be part of all of this.

Thank you Nitin.  Its individuals like you who keep us going and remind us that even in the most terrible of circumstances, humanity can be found from the most unexpected places.

For more information about RMF’s Malnutrition Eradication Program in India, click here and for more on our HIV/AIDS 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 towards 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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Goong Hay Fat Choy, Day 2: How your donations saved two lives

February 9, 2011 in Helping Children, India, Jaimie Shaff, Providing Medical Support, Rebuilding Communities, Voices from the Field by Jonathan White | Comments closed

Continuing with our series from Jaimie Shaff in the field in India, here is Part 2!

by Jaimie Shaff

Naiara joined me on the second day and we began the day with a quick trip to the toy store. Luckily, the toy storeowners had just gone to Indore and had some more toys for us! We picked up a couple of our CNEs and headed back out to the villages, this time starting with some of the kids living in villages outside of our program’s reach.

Day Two:

Manoj

Manoj lives in a village that we do not cover in our program. It took us a little over 2 hours to get to the village, and then another half hour to find Manoj. Manoj was the victim of an inept doctor’s IV rampage, and had over 16 needles stuck in him in just two weeks. By the time we got another doctor to give him appropriate treatment Manoj was traumatized. His mother and I shared tears of frustration, but worked hard to get him better. And then he came for follow up in the middle of a measles outbreak and was promptly stuck with a measles vaccination! Poor kid. But, I’m happy to report he’s super healthy, afraid of me, but very happy with his new toys!

Vijay

Vijay was the first serious case at the NRC in June 2010. I didn’t know him, but the CNEs did. It turns out he lives right next door to Manoj! He and his twin brother are happy and healthy, and received some toys to share.

Neha is finally starting to gain some muscle in her legs, but is still in serious need of psychosocial support. She makes an attempt to walk and doesn’t hide as much, but is still needs a lot of TLC. Her father just grew a kitchen garden filled with green leafy veggies, so we shall see how she progresses in the coming weeks.

Amansingh before

Amansingh from house

On Day Two, we had a whole list of children to see. However, there was one child we absolutely had to see. Amansingh had come to the NRC in October, when our nurses Jana and Rachel were here. He was severely malnourished, filthy, covered in a fungal skin infection, and absolutely miserable. After a month in the NRC, he came back for follow up with a severe case of the measles, complicated by bronchial pneumonia and conjunctivitis. At this follow up, we were introduced to his little sister Suriya, 6 months at the time and ineligible for a vaccination. She was a beautiful baby girl, smiling all the time, and we hoped the mother’s breast milk would protect her.

Amansingh

Amansingh’s village is extremely far away and not covered by our program. I had never been out to his home, but quickly realized why his case was so severe. Their home is a 15-minute drive from the Anganwadi center, and does not have a water pump within a reasonable distance. There is no crop around the house right now, and the parents do not have any other form of income or access to markets.

Suriya how we found her

We arrived at the home to our worst nightmare. Amansingh’s little sister was lying on the ground outside naked, covered in flies, filthy, and crying. She was severely malnourished, and covered in the black marks indicating a recent case of the measles. She was also covered in scars. Her mother was sitting about 10 feet away rocking back and forth, laughing. Her mother is mad.

Amansingh emerged from the house with his father naked, filthy, and miserable. His skin infection had returned with his edema, and he was once again presenting with SAM. With a few words, we whisked the family into our car and began the trip to the Jhabua District Hospital, 2 hours away.

Amansingh and Suriya at hospital

In the car, I felt a little hungry (it was 3pm at this point and none of us had eaten since breakfast). I brought out a couple of snacks, including some dried fruit and a Luna bar. I offered around the car, and back to Amansingh’s family. To my absolute horror, I watched as Amansingh began to practically inhale the food. He hadn’t eaten in days. Needless to say, my hunger quickly disappeared.

We got to the hospital and our favorite doctor came to meet us, sad but not surprised that Amansingh was back. In good hands, we left the hospital and headed back home.

The problem is, this is not going to have an easy solution. The two little children’s lives have just been saved, but the problems are far from gone. The mother is psychologically disabled. The father is in his late 50s/60s. The house still has no access to water, food, or health services. The mother abuses the children during her fits.

Currently, there are no services available for children like this. Their rights as human beings do not exist, as there are no support structures in place to safeguard these elusive “rights.” They are safe, now, in a hospital, but they will no longer be protected when they return home. We cannot remove them from their homes.  We can barely stop ourselves from whisking these children away to a better life.

The sunny side is that without this toy-giving extravaganza, these children may not have had a chance. While we make every effort to follow up with our kids, sometimes it takes just a bit longer. For these two, we came just in time. Suriya still has innocence in her eyes, and it is beautiful.

Your donations and your generosity to my Facebook Cause saved the lives of Amansingh and Suriya. They changed the lives of many others and will keep on changing lives. It’s incredible how a little bit goes such a long way out here. Thank you, from the bottom of my heart. I can’t wait to continue giving.

For Amansingh and Suriya, we can give our attention and our awareness. We cannot do more than offer services and provide access to basic human necessities. We can only do our best. Our best, right now, is to spread the word, increase awareness, and incite change. Through change, be it policy or a magical group that knows how to help these kids, we are doing our best.  We can change the lives of so many future children by starting now.

Follow us on Twitter, Facebook or become a fundraiser for us at Causes.com

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 towards 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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Goong Hay Fat Choy! Your donations bringing Chinese New Year to India

February 7, 2011 in Helping Children, India, Jaimie Shaff, Providing Medical Support, Rebuilding Communities, Voices from the Field, Whole Health by Jonathan White | 1 comment

by Jaimie Shaff

We have lost seven children since I arrived. For these seven children, our best was not enough. They were too sick, adequate medical care too scarce, and their bodies too weak. We have treated hundreds of children at the NRC since I came here late July, but some of these cases were so terrible and challenging that our “best” was all that we could promise.  Most of them made it, their resiliency evident by the smiles we finally saw, but a few we just couldn’t save.

In honor of these children, I decided to stop ignoring my birthday and use it to grant the wishes of a couple of kids via the “Causes” application on Facebook. In just three days, I had surpassed my target of $1,000. I was absolutely overwhelmed by the giving nature of my friends and family who all pulled together to grant the wishes of these children.  I also figured that if we could grant the wishes of two children in three days, we could grant more wishes before my actual birthday—so I upped the goal!

February 3rd marked the beginning of Chinese New Year, and the year of the Rabbit. With all of the donations that had already come in, I decided to do a little Goong Hay Fat Choy celebration for our most serious cases. We made a list of the kids who touched our hearts—the most complicated cases of malnutrition—that could use a little bit of psychosocial stimulation. For about $100, Anjana and I purchased every non-motorized toy in the local toyshop and went out to the field with some of our Community Nutrition Educator’s (CNE’s.

Oh yea, and keep in mind that the last time most of these kids saw me, I was having someone stick them with a blood test, IV antibiotics, malaria rapid test, or measles vaccination. They definitely do not associate me with toys….

Day One:

“C”, our little HIV+ baby boy, got a truck and a coloring book. I also saw his mother smile for the first time ever. He just started ART (after months of battling the system) and is finally in the green of the MUAC tape! (Photo used with permission)

Lalita, a little girl we’ve been supplying with in-village therapeutic food, has chubby little cheeks and received a tea set, ball, and coloring book.

Sangeeta and Pannu, our post-measles SAM cases, got dolls, walkers, coloring books, and balls. Pannu, whose eyes are scarred from his bout with measles, needs to have a corneal transplant, an operation not covered by the government schemes for children below the poverty line. This will cost over 2.5 lakh rupees (approximately $5,500) and will require a donor and significant amount of hospital time. Even if we get the donation and the donor, it is unsure whether the parents are able to take that much time away from the fields. For now, we’re happy with the two little one’s being nice and chubby.

Salem, a measles/SAM/malaria/anemia case, received in-village TF and heavy-duty malaria treatment. He was very confused when we handed him a truck and ball instead of a malaria rapid prick and yucky yellow medicine.

Mamta, a little girl who had suffered with severe post-measles bronchial pneumonia, received a tea set and push toy. We also met her new little baby brother!

Kavita is a little girl who left the NRC without finishing her malaria treatment. She was severely malnourished and sick, but the family just couldn’t stay. We weren’t able to bring her malaria treatment in village, as she suffered from a type of malaria that did not have a simple form of medication, and it was too dangerous to allow the family to self-medicate. When we saw her in the village, we were all amazed! Her grandmother had taken our counseling and used it to start feeding her properly. Fortunately, the partial medication had worked on the malaria, and Kavita is now a healthy little girl!

Basanti, our intense case of full body edema and anemia, was woken up from her nap when we arrived. Her mother first introduced us to her new little brother, and then showed Basanti what we had brought her! We asked the mother if her husband would come with Basanti to Amedabad to have an operation to fix her foot, and her mother was so excited she ran into her fields and came back with a bundle of corn! It’s incredible how giving people are, even when they have nothing.

Pankaj and Maria are the epitome of inspiration. After all of the attention we’ve paid them (and plethora of field visits), the Anganwadi worker decided to bring them into her home for the past couple of months until we can all find a more sustainable solution. In just one month, Pankaj began walking, talking, laughing, and playing. Maria has started school. They’re both just incredible lights of my life, and what a joy it was to see the Anganwadi worker so active with them!

Vishal saw us coming and ran up with his arms wide open and cheeky little grin on his face. He immediately grabbed a little pull-toy duck and started pulling it over the dirt living space. He also reached for the MUAC tape to show off how much weight he had gained! We got to meet his new little sister and all left with huge smiles on our faces. What a wonderful day.


By the end of the first day, we had visited 12 villages and completely run out of toys. We had a whole list of children left, and decided to regroup the next day. Little did we know that Day Two would turn our lives upside down. Little did you know that your donations honestly would save two little lives.

Stay tuned for the Day Two story from Jaimie and further updates from the field!

Follow us on Twitter, Facebook or become a fundraiser for us at Causes.com

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 towards 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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Voces del Voluntarias: Naiara Tejados en India

January 31, 2011 in India, Naiara Tejados, Voices from the Field by Jonathan White | Comments closed

Jhabua, 24 de enero de 2011

Pienso en cada momento cuán feliz me hace saber que he tomado la decisión correcta. Desde que tengo uso de razón he querido vivir una experiencia así: recuerdo, cómo el primer año después de haber comenzado mi Tesis Doctoral intenté contactar con algunas ONG-s para durante mis vacaciones estivales ofrecer lo mejor de mí en algún país en vías de desarrollo. Tal y como me dijeron entonces, pocas ONG-s aceptarían mi ayuda de ser sólo para un mes. Fue entonces cuando decidí definitivamente posponer la experiencia hasta completar mi Tesis.

Me siento realmente afortunada aún en estos días pues en el año 2006 en Gobierno Vasco me concedió una beca para ir a Minneapolis (EEUU) para realizar un curso de identificación, aislamiento, caracterización y expansión de un tipo de célula de la médula ósea de ratones; fue allí cuando primeramente contacté con esta India maravillosa aún sin tocarla. Preferí convivir con una familia local en vez de hospedarme en un hotel. Así es como tuve la ocasión de conocer a la persona más interesante que he conocido en mi vida: Nancy Ramer, una señora mayor muy religiosa de origen escocés. Ya al día siguiente de llegar recuerdo cómo me empezó a contar que tras haber estudiado enfermería, atendió a muchos heridos en la Segunda Guerra Mundial en Inglaterra, y después recibió una “llamada de Dios” requiriendo de su ayuda: su ayuda era necesitada en un país lejano. Ella pensó que sería destinada a Manchuria, pero finalmente, y muy a su pesar, fue destinada a Sangli, cerca de Pune, Maharashtra, India. Estaba convencida de que la odiarían pues India recientemente había conseguido la independencia de Inglaterra. Fijó sus condiciones remarcando que bajo ningún concepto residiría más de dos años en India.

Pero Nancy –más conocida como Adji que significa “abuela” en Marathi- había también prometido algo más: nunca se casaría. Sin embargo, al poco de tomar el primer contacto con el país, conoció al hombre de su vida con el que pocos años después contraería matrimonio: un ingeniero americano también destinado a India. Así, además de romper su promesa de mantenerse soltera, también ignoró sus condiciones iniciales de que no residiría en este país por más de dos años, pues ella residió 37 años en este país dando a luz a cuatro criaturas. Ha sido ella quien me ha traído aquí con sus cuentos relatados hace casi 5 años llenos de magia.

En el año 2010, viendo ya el final de mi Tesis Doctoral, comencé a ponerme en contacto con distintas organizaciones que ejercen su trabajo en India a través de mis amigos de Minneapolis. Primeramente me puse en contacto con una ONG recién nacida denominada Help Kids India ubicada en la ciudad de Kodaikanal, Tamil Nadu. Sin embargo, estando yo completamente adentrada en mi Tesis que cada día se retrasaba más, estos contactos iniciales no dieron su fruto. Un poco después contacté con una fundación española denominada Asha-Kiran y me presté a moverme a su casa de acogida para niños semi-huérfanos o huérfanos ubicada en Pune, Maharashtra. Sin embargo, debido al retraso de la defensa de mi Tesis, perdí la oportunidad de venir a trabajar con ellos pues ya no encajaba en sus planes.  Mis esperanzas se desvanecían a una semana de defender la Tesis.

El día de la defensa de la Tesis Doctoral, el 7 de octubre del 2010, un miembro del tribunal de la misma, Luis Rodríguez-Borlado, tras haberle expuesto lo sucedido, me hizo saber que una amiga suya estaba trabajando en India con una organización, y si deseaba, me podía poner en contacto con ella. Pensé que no sería necesario, pues prefería contactar con alguna organización vasca o española simplemente por tener la ocasión de conocerla mejor antes de adentrarme en esta experiencia. Sin embargo, tras contactar con muchas personas de distinta índole y diversas profesiones, me dí cuenta que mis esfuerzos estaban siendo banales. A punto de tirar la toalla, y con pocas esperanzas, contacté con Luis para preguntarle si podía ponerme en contacto con su amiga en India. Dudaba de si podría estar forzando la fuerza del sino que no me quería en India, y si por ello mi experiencia podría no ser positiva.

Aun así, el 9 de noviembre, escribí mi primer e-mail con pocas esperanzas de que nada fuese a salir bien. Aunque la conozca muy poco, puedo asegurar que Valeria de Azcoitia es una persona excepcional con muy buena voluntad y sensible, pues enseguida se puso en mi lugar y destinó toda su voluntad a ayudarme a cumplir uno se los sueños más grandes de mi vida. Ubicada en Mysore, me habló de su posibilidad de entregar mi Curriculum Vitae a una persona que trabajaba para Real Medicine Foundation (RMF). Siendo conocedora que los procesos en este país toman mucho tiempo, y habiéndose disminuido mis esperanzas por completo, para mi sorpresa y felicidad, en seguida Dheepa Rajan, la coordinadora de proyectos de RMF se puso en contacto conmigo mostrando su interés en tenerme en Jhabua, Madhya Pradesh. ¡Qué felicidad!

Desde entonces he de decir que todo ha ido sobre ruedas. En seguida percibí la profesionalidad de la organización, y sinceramente ahora que la conozco de más cerca, he de decir que no estaba equivocada.

Tras obtener el visado que me permite estar en el país 6 meses, el día 12 de enero del 2011 tomé el avión que me llevaría a Bruselas para después allí tomar otro que aterrizaría en Delhi. Aunque un poco inquieta, he de reconocer que el viaje lo realicé muy tranquila. Llegué a Delhi como a las 22:30 de la noche, y allí esperé a Jaimie Shaff, una chica de corta edad pero madura, que desempeña un puesto de Gerente de Programas de Salud y Nutrición en la fundación.

Al día siguiente, tras pocas horas de sueño y aún cansada y después de encontrarnos encontrado con Caitlin McQuilling, la Directora de Programas de RMF en India, nos pusimos camino a una reunión. Era la primera vez que veía los alrededores de India de día. Camino a la reunión, recuerdo cómo me fijaba en todo, pero en el camino de ida puedo decir que nada llamó especialmente mi atención excepto unas cuantas vacas comiendo basura y mucha gente caminando aparentemente sin rumbo. Pero fue a la vuelta de la reunión cuando viví uno de los peores momentos, si no el peor, de los vividos hasta ahora: de repente dos golpes secos sonaron en una de las ventanas traseras. Cuando miré se me encogió el corazón: eran dos niños, dos angelitos, uno de unos 6 años, el otro de alrededor de año y medio, pidiendo; el más pequeño estaba desnudo de cintura para abajo, y ambos estaban mugrientos, Caitling abrió la ventana y extendiendo su brazo, les dio chikee que compramos antes de la reunión. Con sus tiernas sonrisas se retiraron mirando una y otra vez lo que les habíamos ofrecido. Puedo decir que este fue el peor momento de los que he vivido en India. Supongo que el cansancio, el nerviosismo… todo tendría que ver, pero no pudiendo contener mis lágrimas les indiqué a Caitling y Jaimie que no se preocuparan por verme llorar, que ese había sido mi primer shock en India. Entonces dudé de mi misma, dudé de mi capacidad para residir en este país, apasionante pero duro al mismo tiempo. Pensé incluso en la posibilidad de tener que abandonarlo antes de lo previsto.

Han pasado ya casi 15 días desde entonces, y puedo decir que ni en un único momento he deseado regresar a mi país aunque he de reconocer que hay varias cosas que echo de menos. Este país creo que me está enamorando poco a poco. Si he de elegir una única cosa, elegiría a su GENTE. He estado en contacto con gente nativa tribal, paupérrima a nivel económico, pero la más rica del mundo a otros muchos niveles. Estoy viviendo algo que no era capaz de imaginar antes de pisar estas tierras. Ellos son la gente más entrañable que jamás he conocido, niños, adultos, y ancianos, los cuales sin tener nada te brindan todo.

He tenido también la suerte de conocer una escuela de cerca. Me encanta sentarme allí y observar, ¡ y es que es todo tan diferente de nuestra cultura occidental! Sus estudiantes, sobre todo los menores, me han robado el corazón. Qué ternura! En este remoto lugar de la Tierra no he conocido envidias, perezas, celos, no hasta hoy al menos. ¡Estas gentes son todo un ejemplo a seguir!

Estoy deseando empezar a trabajar duro, pues debido a que el tiempo que tengo es escaso, no me gustaría abandonar el país sin haber contribuido a la mejora de algo o alguien, por leve e insignificante que sea. He venido aquí a dar lo mejor de mí, a mi manera o a la suya, cueste lo que cueste, pues ellos lo merecen. Y sinceramente creo que, sin bien no puedo ofrecer un testimonio fehaciente aún, la organización para la que trabajo hará todo lo posible para que este sueño tan añejo se haga realidad, pues el entusiasmo, el buen hacer y el ímpetu de sus miembros son infinitos.

Naiara Tejados

Voluntaria de Real Medicine Foundation

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