One Tiny Sock

The smallest child at the Touching Tiny Lives Safe Home, Kamoho, sits listlessly in my arms, his eyes half closed. He feels slightly feverish and is having respiratory problems. One of the caregivers inserts a thermometer into his armpit - 102 degrees Fahrenheit. I was drawn to Kamoho because he was still, curious, gentle, and their was love in his eyes. He couldn’t have been more than ten pounds at a few months old. His twin brother, Kamohelo, was much louder, a crier.. the nose boogey-dripping type. Whenever I got close his crying intensified so I kept my distance. In Lesotho my presence with infants often causes this reaction. I imagine I must look like a scary white-skinned, blonde-haired alien to them. The walls are decorated with child development posters, schedules and numbers for feeding times and other reports. 

It was obvious, the six children currently in the Touching Tiny Lives Safe Home suffered from malnourishment. This is the reason Touching Tiny Lives was created in 2004. Since then, when the Outreach Team discovers children too sick to remain at home they bring them to the temporary Safe Home, for an average of 3-4 months. The children receive development support with a team of extremely hard-working and spirited Bo-Me who truly love their jobs. Once the child recovers and maintains a healthy weight they are reunited with their families. TTL upholds to their holistic care services and frequently visits the homes to check on the children, drop of food packages and ensure the families are feeding the child. 

On the Human Development Report, Lesotho ranks as one of the lowest.  The HDR compares 187 countries in UN territories with their HDI (human development index). The index measures values such as, a long and healthy life, access to knowledge and a decent standard of living. The most notable indicators taken are life expectancy at birth, average years of schooling and gross national income per capita. The country’s HIV/AIDS prevalence and sub-sequential life expectancy at birth of 48 years old in development labels Lesotho as a country high on needs based aid and very impoverished. 

Another indicator that I believe is one of the most important and telling of extremely poor conditions is child mortality and the number of children suffering from malnutrition. Poverty causes malnutrition, and conversely, hunger contributes to poverty. It is a vicious cycle. Malnourishment has long lasting and sometimes fatal effects. It can begin as early as conception if a mother does not receive proper nutrition causing future developmental problems. A malnourished child can suffer neurological problems, stunting, have vitamin and mineral deficiencies, and/or compromise their immune system.  Where TTL focuses their work national statistics indicate that each year as many as 2,500 children suffer from malnutrition in Mokhotlong district, with 500 of those children becoming severely malnourished. In Thaba Tseka district, those numbers are 3,500 and 700, respectively (touchingtinylives.org)
 

Brandy and I drove with the Outreach Team far into the mountains of Mokhotlong, one of the highest districts in elevation in Lesotho. It is a long way from the capital, isolated from resources and services, and most of the population lives in rural areas. Someone once told me Lesotho was created separate from South Africa as the non-arable land, the Mountain Kingdom. It is the home and the pride of the Basotho, who are cut off from many resources, such as food, with only 7% of the land arable. Food insecurity has remained high in Lesotho for many years. The situation is about to be made worse by a bad harvest last year, caused by a dry rainy season followed by unexpected downpours or low temperatures during the wrong season.

Each village we passed was an hours walk from the last. There was no cell phone signal and the roads were a mess of rocks and steep slopes that no Combi taxi could ever climb up. The bed of the truck was packed with food packages full of Plumpy’Nut, Soya Mince, and bags of lentils. We visited five different villages. All of the children wailed loudly when they had to take off their clothing for weight and height measurements. The mothers of babies who have returned from the Safe Home took out their green medical booklets labeled “Health Book” where they document feeding times, observations, and the weight and height of their child. Sometimes the Outreach Coordinator pointed out an older brother, sister, neighbor or friend as a child that once received TTL services. To date, TTL has reached more than 1600 clients.

I learned that it is not rare that the child does not continue to gain weight. Like all aspects of poverty, child malnutrition is not one-sided. It is not simply solved and involves a large amount of factors and circumstances that lead to a malnourished child. I saw a pain in the eyes of the mother. There is no guarantee when TTL drops off the food boxes that the baby’s weight will be maintained, especially as it was in the Safe Home. I can’t imagine the feeling created by the inability to feed your child or from having to choose between feeding her older child who can help in the fields or her young newborn, or to feed herself and have enough milk to give, or her husband who works from dawn until dusk every day. There are so many choices that have to be made each day, between food or a roof over their heads, between a trip to the camp-town for food or waiting for the crops to grow. 

We arrived back at the offices at 5pm. TTL was quickly proving to me it has worked hard to embody the sustainable and holistic practices that make a successful NGO through “nutritional packages and education; medical support; assistance with transportation to clinics and hospitals; and child developmental support. Their philosophy remains that the family and the child must be helped together, “reinforcing a family bond and helps prevent the establishment of permanent care facilities, such as orphanages," (Touchingtinylives.org)

 

http://www.who.int/childgrowth/standards/chts_wflh_boys_z/en

http://www.who.int/childgrowth/standards/chts_wflh_boys_z/en

How TTL determines how far the child is from a healthy weight

The children who face additional complicating factors often require significantly longer stays or intense treatment and care at the Mokhotlong Hospital with the help of Baylor Clinic doctors. There, we found tiny Puseletso. Only a few days after Puseletso was brought to the Safe Home he began vomiting and refused any of the food. Brandy explained that some of the children have infections and although they are fed they cannot absorb the nutrients. Vomiting and coughing, along with respiratory problems are signs something is not right. Because of an infection the doctors could not see Puseletso was not absorbing the nutrients in his food. When we visited him at the hospital his stomach was expanded nearly eight inches out, blown up like a balloon, his ribs look comparatively skeletal and his face magnified because he had no fat.. anywhere. 

http://touchingtinylives.tumblr.com

A more detailed excerpt of the story of Puseletso from the Touching Tiny Lives Blog (follow along! Writings are done by my awesome friend Brandy).

“Today we’ll share a story of a boy. He was 10-months old, 4.2kg(9lbs) and 61cm(24in) when he arrived in the Safe Home. Several hours later he started to vomit, signaling a need for care we aren’t equipped with, and was admitted to the hospital. That was right before Easter. After the weekend we checked on him: weight 3.9kg(8lbs) and running a high fever. We thought, “He lost more weight in the hospital? Maybe he’s just got an infection. With antibiotics he’ll be good in no time.” 10 days later he hadn’t received antibiotics and was 3.2kg(7lbs). Coughing and dehydrated he was a living image of skin and bones. In two weeks he had lost an entire kilogram of weight and was way more than -3SD from the median weight of 6kg(13lbs). For already severely malnourished children, it’s a deadly place to be. They become immunocompromised and general functioning becomes more difficult. With the hospital staff and Safe Home staff doing what they could to make him as comfortable and healthy as possible, it was a dismal waiting game.

It’s been 21 days since he was admitted and we are so grateful to say that this amazing little boy has gained back almost all the weight he’d lost. He was finally put on antibiotics to fight whatever infection that was causing him to lose weight. Although his battle with malnutrition continues until he reaches the median weight, things are looking up; a much needed outlook when it was down for so long. He is expected to be discharged and back in the Safe Home under TTL care by the weekend!”

One of the reasons I joined the Peace Corps was to understand poverty better. How, I am still not sure, but my experience with TTL has shown me that poverty is more easily told through the eyes of a child. As I was packing up my things I found a small tiny sock mixed with Brandy and I’s load of laundry. I returned it to the Safe Home and said goodbye to little Kamoho and the smiling, bubbly toddler Retsilisitsoe I had fed the four mornings I spent there. Retse continued to throw the sock around like it was a ticking bomb, grabbing it quickly, laughing hysterically and then throwing it to another side of the room and sometimes hitting me with it. Each year, millions of children die from malnutrition. The child is an innocent and vulnerable being. They have no control over their situation and can do very little to change it. They do not understand the severity of their position or why they are having these pains of hunger in their stomach and they do not know how to stop it.