Zeina Makhoul, SPOON’s Nutrition Scientist, recently returned from Haiti where she trained orphanage staff on the implementation of a comprehensive Nutrition Screening System, developed by SPOON in partnership with Holt International Children’s Services. The Nutrition Screening System is designed to identify critical feeding and nutrition needs of children living in orphanages and foster care. Through the Nutrition Screening System, children with feeding and nutrition needs can be identified and treated before they become impacted by malnutrition.
My second trip to Holt Fontana Village in Haiti was absolutely amazing. I was heartbroken saying my goodbyes to the staff and especially to the children. I got to see the children celebrate their Kindergarten graduation J and International Day of the Child. I got to decorate the stage with Miss Rollande, their teacher, where they performed songs and dances to a big crowd of family, friends, and caregivers. I got to dance with them many times as they practiced to the beat of a popular song by a Haitian artist (Dekole by J-Perry. The song has beautiful lyrics and calls on Haiti and Haitians to rise up and take flight (to “dekole”). I bet you can’t help but dance too!). And I got to immerse myself in the culture and get to know the beautiful people of Haiti.
The rest of the time, I was with Supreme (the Village’s manager), Miss Gilles (the Village’s head nurse) and Nicole and Aselène (two nursing interns sponsored by Holt Fontana), in a small but, fortunately, air-conditioned room training on nutrition, the screening tools, feeding children with special needs, anemia, measuring weight, height, hemoglobin, food allergies, low birth weight, severe malnutrition, diarrhea, and more. Did I mention the training was in French?! While Supreme, the only participant who speaks English, did a big part of the translation, I was alone with the nurses for 3 days. Thanks to my French school education (and skills in Pictionary!), we were able to successfully go through the training and have interesting discussions on malnutrition.
After more than 30 hours of training over one week, we started screening the children at the village. The nurses worked efficiently together; while one took weight and height measurements, the second recorded the numbers on the screening form, and the third got ready for hemoglobin measurement. They switched every few children so they all get a turn to practice all procedures. It was nice to finally see the training put to work.
While most people would flinch at the thought of getting their finger pricked, the children at the Village were so excited, comparing their colored bandages. Not a single tear in the house. They’re the bravest kids I’ve met! The staff found that nearly half of the children were anemic. All the children are receiving a multivitamin and a protocol is now in place to supplement those who are anemic with iron and follow-up with future screenings.
The training was definitely well received. I can see the nurses’ confidence increase and their skills improve the more children they screened. Miss Gilles was so happy that she could finally record information on a form instead of a notebook. Also, the electronic database allows her to print a list of dates for routine screenings, future hemoglobin testing, dates of iron supplementation, doctor’s appointments, etc. for all the children with only few clicks. This will facilitate follow-up care.
As for Nicole and Aselène, they are probably the first two nursing students (due to graduate in August!) in Haiti to receive training on the unique nutrition needs of institutionalized children. They can hopefully apply the knowledge and skills they acquired in other child care institutions or in their practice, wherever that might be.
As the pilot phase continues, we will continue to work with the staff at the Village to refine and improve the nutrition screening system so no child has to needlessly endure any form of malnutrition, even if mild.
Until next time, I leave you with my favorite verses from Dekole:
Si-n vle peyi-n avanse If we want our country to advance
Fòk nou mache tèt kole We must walk together
Peyi sa twò rich pou-l pòv This country is too rich to be poor
Dads are part of the magic that makes the world go round for their kids, so this weekend we are celebrating all you dads out there – Happy Fathers’ Day!
On this day, we also can’t help but think of the tens of millions of children around the world without dads of their own.
When you support SPOON in nourishing babies and kids who are living without permanent families, it means the world – and opens a world of opportunities – to these children.
Will you help us to broaden the horizons of hope for little friends across the globe, by making a pledge of $25 per month to SPOON?
Your monthly gift helps us to sustain life-changing programs for the kids who need us most.
With thanks and in celebration,
Cindy and Mishelle
Dear Friends -This week, our very own Cindy Kaplan was elected into the prestigious Ashoka Fellowship for her systems-changing work to improve nutrition for orphaned and vulnerable children worldwide.”I share this incredible honor with my co-founder, Mishelle,” said Cindy, upon hearing the news, “and with the many people who have helped transform SPOON’s vision into reality for countless children.”
Cindy is too humble to ask, but the other members of the SPOON team invite you to whoop it up and celebrate this huge accomplishment with us – through a gift to SPOON in her honor.
While the Ashoka recognition brings SPOON strategic resources and a three-year financial commitment, we continue to rely on gifts from you and people like you to make the life-changing work of SPOON possible.
It has never been a more hopeful time for SPOON and for the children we are working to reach. Let us raise our glasses (and sippy cups) to a bright future!
- The SPOON Team
Zeina Makhoul, SPOON’s Nutritionist, is currently in Bangalore, India, training orphanage staff on the implementation of a comprehensive Nutrition Screening System, developed by SPOON in partnership with Holt International Children’s Services. Zeina sent in this blog post about the initiation of the training at VCT, or Vathsalya Charitable Trust, a 22-year old organization that provides care for orphaned children, places them with foster families, and matches them with domestic and international adoptive families.
Every morning, my ride pulls up to the front of the hotel. VCT’s driver and three little boys, 4, 7 and 9, pick me up. It’s only a 5 minute drive to VCT but we always manage to sing a couple of songs, play a game and make goofy faces.
It’s a different story inside the nutrition screening training room! It’s almost the end of the training and it’s been intense. Thirty-two hours of training in 4 days and counting. I’m so impressed with Team VCT’s endurance and dedication. Except for the occasional tea and lime juice break, Sylvia, Vineetha, nurse Hema and nurse Deepam did not leave the training room. Neither did I.
So far, we have discussed special health care needs (cleft lip/palate, cerebral palsy, Down syndrome, fetal alcohol syndrome, congenital heart disease, low birth weight, severe malnutrition), fever, diarrhea, constipation, vomiting, iron deficiency anemia and growth. We practiced measuring hemoglobin using the HemoCue machine by pricking each other’s fingers, measuring weight, length, height, head circumference, and plotting and interpreting measurements on growth charts. Growth screening was definitely the most challenging section. But after lots of practice and long discussion, I can say with confidence that Team VCT is now a champion of WHO growth charts!
After each day, I asked the team to tell me one new thing they learned and were surprised by. And all of them said, “upright positioning” when feeding children with special needs like CP and cleft palate. The next ones on the list were “small frequent feedings” if an infant is volume sensitive, has reflux or poor appetite and “limiting feeding to 30 minutes or less”.
The nurses, Hema and Deepam, and I stayed one hour longer today and completed the nutrition screening on three little girls who stay at VCT over night. It was exciting to see the first nutrition screening form being officially completed and filed into the child’s medical chart. Tomorrow, we measure the other 30 kids!
It’s Valentines Day! Finding the perfect gift for a loved one can be tricky. You could celebrate with flowers and chocolates and another dinner out – or you could show your love with a heartfelt gift to SPOON in your Valentine’s honor. (Or both!)
A gift to SPOON ensures that orphaned, fostered and adopted children around the globe will get the nutrition they need to grow and thrive.
When you make a gift of $25, $50, $100 or more in honor of your Valentine, we’ll send a personalized message of love and hope.
Thank you for your love and support for children living without families across the globe.
Happy Valentine’s Day to you and yours from all of us at SPOON!
by Mary Hearst, PhD
After 39 hours of travel, John and I arrived in Dushanbe, Tajikistan. On the way, Raushan met us in Almaty and to our great joy, we saw Kate in the airport heading home from the training in Astana and her time in Karaganda! Sounds like the time in Kazakhstan was successful. In Dushanbe, Raushan, John and I were greeted at the airport by our Open Society partners (OSI) and whisked to our hotel for a quick nap. Our first meeting was that afternoon with the OSI team of Nigora, Zarina and Jamshed.
Smart, articulate, dedicated professionals committed to improving the lives of children. Our agenda was arranged by the OSI team and included meetings with Ministry of Health leaders, city officials, visiting all four baby houses and time with national experts to discuss the results of the desk review – a review of all available data on children in Tajikistan.
To our great pleasure, the well-being of children is a high priority nationally. The Ministry of Health official was well aware of the nutritional deficits present in all children in the country and was aware of the additional burden among children living at the babyhouses and in other institutional care situations. Nationwide, the Ministry of Health official told us that 30% of the children are stunted, 30% are anemic, 40% have Vitamin D deficiency and 50% have iodine deficiency. The status of the children in babyhouses was uncertain – better? Worse? It is important to find out. The Ministry of Health official gave his approval for us to visit the babyhouses and gave us his verbal support for carrying out the work of the SPOON Foundation.
There are two babyhouses in Dushanbe. They are administered at the city level and because of their proximity, the babyhouse directors meet regularly with other city health-related organizations also administered by the city. This is important for two main reasons. First, there is regular communication and support that exists for the babyhouse directors. And second, the assessment and intervention efforts of the SPOON Foundation will be ‘easier’ and likely similar.
Babyhouse #2 has 100 children between the ages of 0-4 years. As you will see in the photos, the physical environment is wonderful. If fact, the staff have taken it upon themselves to decorate and augment the environment. Children are grouped by ages and live in a sort of suite – they have their beds in one room which is attached to a play room and a dining room. Each suite has the same staff that work in those rooms. The staff of the suites are in a competition to see who can do the most elaborate decorations – paper mache, painting, activities for the children. We were impressed by the artistic abilities of the staff! There are no children with disabilities at this babyhouse. We got to hold babies, play with children, observe mealtime. It again reminds me of how important this work is – all of those beautiful children. We also learned that a very high proportion of children are considered ‘social orphans’. They have parents, many of whom visit, but because of poverty of a spouse who migrated for work, the family could not afford to keep the child at home. Those children are not available for adoption. Unfortunately, it also does not mean they eventually go home to their parents.
Babyhouse #1 has 103 children, including children with disabilities and has the Kishti Center attached. Oh, the beautiful children! Again, the environment was pleasant, although not nearly as decorated as Babyhouse #1. The children wanted to be held (we were all willing!). Our friend Ricardo was there to describe the needs of children with disabilities, show the great work of the Kishti Center, and provide support for the SPOON Foundation’s involvement. As we know, the staff work hard to care for the children, but living in an institution is stressful. The children with disabilities are unable to get all the care they need and there is limited to no equipment available. Despite good intentions on everyone’s part, the growth, developmental and social/emotional needs were apparent for children of all abilities.
The next day, we boarded an old Soviet-era plane and flew north over the mountains to Khudjand. The Khudjand Babyhouse is in town, but the Istravshan Babyhouse was 1 1/2 hours south of Khudjand, by car. The situation was different in Khudjand. The babyhouse had 50 children and the physical conditions were not as good. There were more economic challenges present, a greater need to rely on donations from supporters, the building was colder (no central heat), less staff. But the children were no less precious.
Istravshan had several advantages. First, they had a cow who just had a calf! Great for fresh milk! They have fruit trees and grape vines from which they dry the fruit and make compote for the children year round. They also have a vegetable garden that they built for the children to learn and engage as opposed to the Khudjand Babyhouse who needed the garden to supplement their diet. Yet, the 22 children wore hats to stay warm while inside. Many of the younger children had no facial expression or engagement with me, as you would expect from infants or small children.
When we landed back in Dushanbe, we met again with OSI. It is clear, and everyone agrees, that SPOON has an important role to play. There needs to be an assessment of the children’s growth, cognitive and physical development, micro nutrient deficiencies. There needs to be an assessment of staff training needs. There needs to be an assessment of the physical environment and equipment needs. SPOON experts can then provide key recommendations, interventions, training and seek equipment to improve the growth, development and life chances of these 275 gorgeous children.
by Kate Nelson Ward
Carrie and I visited the Karaganda Bota Goz Baby House three of the five days I was in Karaganda. Upon arriving the first day, children from several groups were outside playing in the pleasant weather. They were so precious all bundled-up and running around, playing in the snow with toy shovels. On this day, we brought with us hats, mittens, cloth diapers and clothing that my friends and family from the US had donated. We, unfortunately, were told we couldn’t take pictures this day, but it was a sight to see. The children rushed and gathered around the bag of “goodies,” like we were Santa opening his sack of toys. One of the doctors came in and discussed with the caregivers whether Carrie and I could take some of the children outside. The caregivers told us that unfortunately, they did not have winter boots for the children in their group so they would have to remain inside.
The next day, Carrie and I braved blizzard-like conditions to visit again. Carrie termed it, “Extreme Orphanaging”! This time we brought winter coats from the US and snow suits and boots we found at a local second-hand store. I spoke with the director, whom I met at the Astana training, and also with the chief pediatrician, Dr. Ludmilla. They invited me to come the next day to conduct a brief feeding training with their doctors. How could I pass-up this opportunity?! Carrie and I trudged home through the snow and wind, where I spent the rest of the day preparing my key words (po-Rooski) for the training. Thankfully, my friend Stas volunteered to join us at the baby house to help translate the training.
We arrived promptly at 10am on Thursday and were ushered to the special needs room. Surprisingly, the children in this room had relatively mild special needs, but culturally/linguistically, children with special needs are typically referred to as deytey-invalidov (invalids). I spent the next hour and a half going over techniques for positioning and feeding with four doctors and two caregivers; working with an infant with Down syndrome and a child with cerebral palsy – both sweet little girls! The doctors were very receptive, but I honestly think the caregivers got more out of the training. After we were done, the doctors left, but we stayed in the room talking with the caregivers and playing with the children. We finished our time at the baby house by going upstairs and playing with another group of children. I then boarded the train to begin my long journey back to the US.
Leaving Kazakhstan is always bittersweet for me. I am sad to leave my friends, colleagues and all the beautiful children. However, this trip was incredibly productive and successful, and I have high hopes for SPOON’s work there in the future.