Touching Tiny Lives in Lesotho

2011 Highlights and Annual Report

2012-01-26T22:29:00.000-08:00

We are already a month into 2012, but you can read about everything TTL accomplished last year in our 2011 Annual Report!

Here's a snapshot of some 2011 highlights:

1652 Visits made to children’s homes through the Outreach Program to provide nutritional and medical support, as well as training to caregivers

246 Visits by clients to clinics and hospitals, facilitated by TTL

401 Visits made to new and expectant HIV+ mothers to aid in the Prevention of Mother-to- Child Transmission (PMTCT)

36 Trainings/site visits to strengthen the Village Health Worker Network and identify children in need of support

125 HIV + mothers supported in their role as caregivers

178 New child clients served through the Outreach programs

156 Child clients who reached health and stability and successfully graduated from the Outreach Program

52 Children rehabilitated in the Safe-home

288 Total number of child clients supported in 2011

975 Total number of TTL child clients served to date

Going Home on a Horse

2012-01-25T05:37:00.000-08:00

Goodbyes at TTL are bittersweet. Mamello left the safe-home yesterday, which is really a cause for celebration – it is always great to see kids going back home, healthy and usually a bit chubby, to their families. It is a victory for TTL and the accomplishment of our mission. It is a little selfish of me then, to be disappointed when they go, knowing that I will no longer see their smiling faces pressed up against the playroom window when I walk down to the office and will receive no more of their high fives or hugs. But I admit, every time a child leaves from the safe-home I get a little sad.

Mamello was in the safe-home for about 2 months. She had been malnourished and suffering from symptoms of HIV a few months ago, but by the time she arrived at TTL she was well on her way to becoming healthy, already on ARVs and responding well to them. She came to TTL because her mother had just passed away and was living with her aunt and uncle who were expecting a new baby of their own and didn’t know if they could care for her adequately with a newborn baby (Mamello’s ARVs must be given on a strict schedule). So we were graced with her presence and from the beginning she was goofy, smiley, and energetic. You couldn’t go in the safe-home without her handing you a series of random toys – she didn’t expect them back, she just likes to share.

But alas, the temporary safe-home is indeed only temporary, and yesterday it was time for her to go home. It has been raining a lot recently and we weren’t sure if the roads to her village would be washed out so we arranged with her uncle to meet us at Malefiloane Health Center, about an hour away from TTL. We arrived at one o’clock and her uncle and his horse were there waiting for us, ready to bring Mamello back home. In the past I have only experienced taking kids directly back to their home, so I found it rather interesting/amusing, watching Mamello’s uncle stuff TTL’s food rations (powdered milk, lentils, canned fish and vegetables) and all of Mamello’s acquired possessions (clothes, lotion, soap) into his relatively small saddle bag. When he got it all packed in tight he strapped Mamello to his back with a couple of blankets, hopped on his horse and they rode off into the distance as we shouted our goodbyes. She handled the reunification pretty well – the hand over from us to her uncle – until the horse started actually moving and her cries became audible as they galloped away from us. She seems to be in good hands though and I’m sure will readjust to her new surroundings in no time. It seems that by the time Outreach visits our reunified safe-home kids a week after they leave us they are clinging to their caregivers. A few weeks later they have forgotten us completely. This is how it should be I guess.

Mamello will be missed and the playroom will be calmer with only one kid able to walk by himself and only one toddler who needs fed but we are ready to help the next baby who needs the constant care and support of the safe-home.

First Impressions

2012-01-18T02:02:00.000-08:00

The following post was written by volunteer Tucker Dunn who will be spending 6 weeks at TTL.

My arrival at TTL seemed like it was years in the making. Over the past several years, I have known several people who have taken the time to come down to Mokhotlong to help TTL further its mission, and now, I finally have the opportunity to do the same.

Since arriving, I have tried to immerse myself in the world of TTL as much as possible. Whether I am playing with the babies in the playroom, entering data on the computers, or going on outreach to check in on some of our child clients, I learn more and more about the problems facing many of the communities in Mokhotlong, and what TTL is doing to help alleviate some of these problems. Everyday has been an incredible learning experience.

One thing that has struck me is how committed everyone at TTL is to these children. While the bo’me shoulder most of the responsibility of caring for the children in the safe home, everyone here does their own part to ensure the wellbeing of the children. At various times throughout the day, you can see Nthabeleng going into the playroom to help the bo’me feed the children during lunch time, Tumisang the gardener making faces at the giggling faces pressed up against the playroom window, and Puleng the receptionist slipping into the playroom to partake in a highly spirited and hilarious game of chase with Khathatso and Mamello. Everybody here at TTL has their own role that is essential for TTL to be able to provide the services it does, and it is truly remarkable that everyone finds their own way to brighten the lives of these children on a daily basis.

a lot happens in 2 weeks

2012-01-17T02:02:00.000-08:00

With all the excitement of Christmas, followed by two weeks travelling in South Africa, it feels like it’s been awhile since I’ve sat at my desk in the fellows’ office.

Even though I've only been gone a few weeks, a lot has changed while I was away. The days are hotter and mountains greener, TTL's garden is thriving, and the back of the property has become a bit of a construction zone while we repair one of the buildings.

It’s endearing that all the toddlers haven’t forgotten me during my two weeks away – something that seems to happen so quickly once they leave the safe-home and return to their families. All the kids are looking a bit healthier, a bit chubbier, and that much closer to being ready to return home. Some of the babies, like Tsitso, are almost unrecognisable with how much they've changed, a positive sign that he is finally growing like he should. Pelaelo was also able to return home to his mother's care after a 6 week stay in the safe-home.

I was also welcomed back by the smiling face of our newest arrival: Tsebo.

Tsebo has come to the safe-home because he is malnourished and underweight for his 8 months (he currently weighs 5.2kg). He has also been exposed to HIV and we are still waiting on the results of his DNA-PCR test that will help to identify his HIV status. Luckily, his development does not seem to have been too negatively effected by his poor nutrition yet. Unlike our two other 8 months old in the safe-home, Tsebo is constantly grabbing at toys, has no problems sitting by himself and looks ready to start crawling any day now. Hopefully his HIV test will come back negative and with a bit of time on the nutritious safe-home diet of 5 meals a day, he'll be ready to return to his family in no time.

Christmas in Mokhotlong

2011-12-27T22:12:00.000-08:00

Being away from home over the holidays is always strange and that, coupled with my first December summer, made the approaching Christmas season feel a bit surreal. However, we started off our holiday weekend with the staff Christmas party on Thursday and all of the singing, dancing, gift-giving, and feasting infused me with ample Christmas cheer. Add a Christmas Eve bonfire, some holiday baking, and a wonderful Christmas meal at the Lephoto’s and it turned out to be a great holiday.

It is interesting to celebrate a major holiday in another country, and impossible to refrain from noting the similarities and differences to the customs and celebrations I am familiar with in the U.S. I’ll share with you some of my observations:

Differences:

- Since Electricity is still somewhat of a novelty in Mokhotlong, you do not find the streets lined with lit trees or colorful electric displays of Santa and reindeer in people’s front yards. In fact, the lead up to the holiday seems almost nonexistent (from my isolated foreigner's perspective, anyway). Though opulent Christmas displays do usually get one in the Christmas spirit, I think America might place more importance on all that Christmas hype than the day itself so in some ways it is refreshing to experience a refined holiday - Christmas just as Christmas.

- Christmas Dinner.

<-- In the United States

In Lesotho -->

Similarities:

- Basotho and Americans alike tend to leave Christmas shopping until the last minute. Rachel and I went to Pep (a store in Mokhotlong that sells… everything?) an hour before it closed on Christmas Eve to buy marshmallows for the aforementioned bonfire and had to stand in line for nearly a half an hour to get to the register! It was kind of a madhouse in there.

- Families in Lesotho love Christmas celebrations like the rest of us, and they splurge on Christmas also. They don’t have credit cards to max out at the mall though. Instead, they "dip into their savings" by using most of their food rations, namely maize meal, for Christmas celebrations. I have been told that this celebration makes January a particularly hungry month for many families here. TTL, thanks to generous donations made by local organizations, is giving families more food than is in their usual monthly package this December in hopes that giving food to use for Christmas celebrations will limit food shortages in January.

Like so much of my experience at TTL, the holiday reminded me yet again how fortunate we are in North America to have so much - so much family, so much food, so much of everything really.

Merry Christmas to all of our TTL supporters! Thank you for your generosity and attention to our cause. We are so blessed to have such a strong network of support. We wish you the happiest of holidays.

Cooking mutton for the staff Christmas braai.

Gift exchange at the Christmas party - involved a lot of singing and dancing.

Taxi Fare

2011-12-16T04:52:00.000-08:00

People who are just learning about TTL frequently ask about our role in the lives of children after they leave the safehome. All of our safehome babies become outreach clients when they are reunified with their families, meaning that TTL still supports them with monthly food packages and monitors them to make sure they are continuing to make strides in their growth and development. When we are confident that these children have the care and resources to continue progressing without TTL's assistance, they are "graduated" from these services. However, even when they no longer require our check-ups and nutritional support, TTL does its best to ensure that the health needs of these children are met.

To illustrate TTL's efforts to be an ongoing source of support to the children we reach, below are Leboneng and Nako.

Leboneng, now 6 years old, was in the safehome from 2006-2007. Nako, 3, stayed with us in 2009 and 2010. These boys are no longer part of our outreach program, but they stop by TTL once a month to get the taxi fair TTL gives them to come to Mokhotlong Hospital to pick up their ARVs. The boys live in the same area and arrive together with their caregivers, who cannot afford the cost of transportation. How much money does TTL spend on making sure Leboneng and Nako get these important drugs every month? Just over $2. The adage "a little goes a long way" comes to mind.

Although the availability of ARVs in Lesotho has vastly improved in the past couple of years, access to the clinics and hospitals that provide them can still be a challenge to those living in rural villages. I can't say for certain what would happen if TTL did not provide this assistance to Leboneng and Nako, but it is a real possibility that they would not get their ARVs, depriving them of the chance to live healthy lives in spite of HIV.

Karabo leaves, Khatatso arrives

2011-12-14T02:50:00.000-08:00

Today, Karabo was reunited with her mother and grandmother after a 3 month stay in the safehome. Referred to TTL by a rural health clinic, at 1 and ½ she weighed only 8 kg and was unable to stand without support. In her letter to TTL, the nurse reported that “the child was weaned too early having been advised to do so by a traditional doctor. Now the child is malnourished since the mother cannot sustain supplementary feeds.” During her time in the safehome, Karabo has made great progress with gaining weight (now at a healthy 9.15 kg), starting to say words and taking her first hesitant steps by herself. No doubt she will be running around all by herself soon enough and we're happy that she was healthy enough to return to her family in time for Christmas.

Last week, Khathatso arrived at the safehome after being referred through our Village Health Worker Network. He had recently been admitted to hospital for kwashiorkor, a form of acute malnutrition due to a lack of protein. Khathatso's mother passed away over a year ago due to TB and his aunt had taken on the role as caregiver. With 4 other children in the house under the age of 5 and no stable source of income, TTL was concerned that Khathatso's aunt might be stretched too thin to provide him with all the support he needs to recover and get his development back on track. At almost three years old, Khathatso has adapted to the safehome the fastest out of any of the children I have seen here so far. Most children, particularly the older ones, take a few days to adjust to the safehome sticking close to the Bo’me and avoiding the other kids. Khathatso on the other hand was laughing and playing by the end of day 1.

more visitors

2011-12-04T22:14:00.000-08:00

With three kids leaving the safehome and meetings and errands in Maseru, last week was busy. Friday capped it all of with three groups of visitors coming to TTL!

First, our partners at Sentebale arrived with their supporter Ein Herz Fur Kinder in a helicopter on TTL's front door step. It was an opportunity for Ein Herz Fur Kinder and Sentebale's UK staff to learn more about TTL and the types of challenges faced by OVCs in the mountains of Lesotho.

This was followed in the afternoon with a meeting with TTL's Board so that the TTL could staff meet the new members and provide them with a brief orientation. It was great to hear how committed everyone is to supporting vulnerable children in Mokhotlong and we're looking forward to working together in the new year.

And then at the end of the day, TTL received a visit from the local branch of Standard Lesotho Bank. They have generously donated maize meal that TTL will be able to distribute to our clients to improve families' food stability while they are waiting for the crops to come in. With the continuing drought this year, the crops are already very far behind and so this food is badly needed by families in the region.

Thank you to Standard Lesotho Bank for their generous donation!!

1 in 4

2011-12-01T07:04:00.000-08:00

1 in 4 people in Lesotho are infected with HIV/AIDS. This is the third highest rate of HIV/AIDS infection in the world and the consequences of this epidemic are apparent across the entirety of this small nation.

1 in 4 children in Lesotho are orphaned. This means that over 130,000 children – and roughly 9% of the total population of Lesotho – is missing one or both parents.

These statistics cannot be seen as unrelated. It is estimated that 65% of Basotho children have been orphaned because of AIDS and no family, or child, in Lesotho is immune from the devastating impacts HIV/AIDS has had –and continues to have -on this small mountain kingdom.

Today, December 1, is World Aids Day. TTL has been able to commemorate this day in the best way possible: a graduation from the safehome.

Lerato and I arrived at TTL at about the same time and her story has always stuck in my mind as the exact reason TTL is needed in the area. Here’s her story:

Lerato arrived at the safehome in mid-August. She was malnourished, showed poor developmental growth, and had tested positive for HIV just weeks before. Her mother had passed away from HIV related causes and she was being cared for by her aunt who suffers from the after-effects of a stroke. Immediately after arriving at the safehome Lerato started to show signs of improvement. She was started on ARVs and went from being very lethargic and barely able to walk to walking, dancing and even running around the playroom. She also loved to have her picture taken and would put on a very serious face until a second after the flash when she would dissolve into a fit of giggles.

However, while Lerato’s nutrition and health has greatly improved, she is still developmentally delayed. She celebrated her 4^th birthday in October but her behaviour has often been hard to distinguish from children in the safehome who are 1-2 years younger. The safehome caregivers have worked hard with her, encouraging her to say words and feed herself, but it’s difficult to assess how much of an impact her HIV status – and long bouts of malnourishment and illness – has had on her development. But Lerato has also always seemed to be very influenced by the other children around her. During her stay at the safehome, when there were older children who were walking and feeding themselves, she was often more motivated to do these things as well.

When we took Lerato home to her aunt today, her brother and cousin were there to greet her. There were also about a dozen other children who had gathered to see what was happening. Hopefully with the influence of older siblings and playmates around, Lerato will continue to make improvements in her development – wanting to talk, and feed herself, and do all the other things the older children (and sometimes children of the same age) are doing. Combined with the nutritional and medical support that the Outreach team will continue to provide, hopefully for once the odds will be stacked in Lerato’s favour.

My one wish for this World Aids Day is that next year at this time, when Lerato will have turned 5 and the school year about to start again in January, she will be healthy, successfully taking her ARVs, and ready to start primary school with all the other children.

christmas comes early

2011-11-27T23:19:00.000-08:00

On Friday, TTL got a great start to the Christmas season thanks to the generosity of the Lesotho Institute of Accounts (LIA), working in partnership with the Lesotho Revenue Authority and STANLIB. TTL was thrilled to host the event organised by the LIA and share the generous donations from these three institutions with local women's support groups in the region.

Thank you to Lesotho Institute of Accounts, Lesotho Revenue Authority and STANLIB! Their kind gifts of blankets, clothing, and especially food items, will be of great benefit to TTL’s babies and all the families we support.

With the sun shining brightly and lots of singing and ululating it was a great way to the end the week.

Full House

2011-11-23T22:55:00.001-08:00

The TTL safehome is staying busy and crowded! Two babies leave, four more arrive. We now have 13! Let me introduce you to the new babies in the playroom.

MAMELLO – Mamello has been at the safehome for almost two weeks. Her mother passed away and her grandmother, who is now her primary caregiver, is paralyzed and unable to care for her right now. Mamello is HIV+ and on antiretroviral therapy. She is a happy kid, eating well and walking on her own.

PUSO – Puso was brought to the TTL safehome at the end of last week. He is five months old and small for his age. He tested positive for HIV and will begin antiretroviral therapy this week. He is a curious baby, constantly checking out any action going on around him.

PELAELO - Pelaelo is our newest safehome member, arriving just in time for dinner last night. He was brought to the outreach workers who were picking up Thatohatsi's mother to bring her to the hospital yesterday. Pelaelo lives in a neighboring village to Thatohatsi (a 3 1/2 hour drive from Mokhotlong). 3 years old, Pelaelo is malnourished and has been sick much of his short life. He tested positive for HIV this month and TTL will help him get started on ART as soon as possible.

THATOHATSI – Thatohatsi is the baby girl who Rachel wrote about picking up in her last post. She spent one night in the safehome before she was admitted to the hospital because of her cough, fever, and respiratory problems. She was also vomiting after eating. She is a tiny 3 month-old, weighing only 2.1 kg (about 4.6 lbs.). Sadly, Thatohatsi’s twin was also sick and died last week. Thatohatsi's mother joined her at the hospital last night where she is receiving IV antibiotics and being closely monitored. When she is discharged from the hospital she will return to the safehome.

Happy Thanksgiving to everyone in the States! Being at TTL makes me realize just how much I have to be grateful for, and how often I take it all for granted. Thank you for all of your support and have a wonderful holiday.

building a legacy

2011-11-22T07:07:00.000-08:00

On Monday, the two TTLF fellows – myself and Meghan – and two members of the TTL Outreach Team – Kokonyana and Nthabeleng Lehela – went off to see a set of baby twins that TTL had heard about through our Village Health Worker Network. Both babies were underweight and the mother had been struggling with breastfeeding and so we were off to see how TTL might be able to assist the family. I knew that the twins lived far away but it was Monday and I had been distracted in the morning answering emails so when Kokonyana came to tell me it was time to go at 8:30am, I quickly ran to the kitchen to grab an apple and hopped in the truck. I had no idea that we wouldn’t be returning to TTL until 7pm. Although, I’m not sure anyone in the truck realised it was going to be such a long day.

We left Mokhotlong and drove further and further out into the mountains –and as per usual, the further we went, the worst the road got. About three hours into the drive, we started to periodically stop along the way asking whatever Mosotho we could find if we were still on the right track. Each time there was a quick exchange in Sesotho and a hand that gestured off to the mountains in the distance – we had to just keep going. Across a river and over a few more precarious mountain sides, we arrived in another small village and what looked like the end of the road. The Outreach Staff asked a man sitting outside his rondavel about the family we were searching for and again there was a hand pointing off to the mountains in the distance. We weren’t there just yet but this was as far as the truck would be going – we would be walking the rest of the way. Along with directions, the villager also gave us some bad news: one of the babies had passed away earlier in the week.

So off we went by foot, even more uncertain about what we would find at the end of the road. Twenty minutes later, we arrived at a set of four rondavels on the side of the mountain but after a few calls of ‘Ko Ko’ it didn’t seem like anyone was home. Eventually, we spotted a woman off in the fields and called her over – it turns out she was the sister in-law of the mother of the twins. She confirmed that one of the babies had died and the mother had taken the other baby to the local traditional healer. She suggested that we speak to her mother in-law and brought us over to the fourth rondavel where we found three more family members. The grandmother was thrilled at the sight of Meghan and I, exclaiming that we were the first white people to be in her home. I honestly wasn’t surprised, her home felt like it was in the middle of nowhere. After the Outreach Workers explained to the family about TTL we were off with the sister-in law as our guide to find the mother of the twins.

Down and up another mountainside, we arrived at another cluster of houses and managed to find the father of the twins. We were one step closer to finding the mother and baby. But while the father agreed to find the mother for us, he seemed reluctant to accept TTL’s support. So while he went off to get his wife and baby, we set out to find the chief, hoping that he might persuade the father to accept TTL’s support.

By the time we were meeting with the village chief it was already after 3pm. After a long conversation with him, and another discussion with the father, it was agreed the baby would come with us to the safehome. I think what really helped convince the father was his sister-in law. Before her marriage she had lived in a different village, one where TTL had been, and she explained to him that she knew of babies that we had helped and the difference TTL could make.

As we headed back across the fields and mountainsides towards the TTL truck, this time mother and baby in tow, I was relieved that the baby would be coming back to the safehome with us – particularly because this village seemed so far away from any type of help. Driving the long 4 hour trip back to TTL, I held on tightly to this tiny baby who was supposed to be 3 months old, but looked much much younger, trying to protect her as much as possible from the bumps on the road. As I thought about the day everything was a mix of emotions. I was hungry and tired, happy and hopeful that we would be able to help this little girl, sad and frustrated that TTL hadn’t been able to get there sooner to help her twin, and comforted by the fact that the sister-in law stepped in on TTL’s behalf and knew who we were. It is a sign that TTL is truly building a legacy for itself across the region, and the more people who know of TTL means the more vulnerable babies TTL will be able to help.

-Rachel

a day on outreach

2011-11-15T05:58:00.000-08:00

Yesterday we planned to visit 4 clients in the Mapholeneng area (about 35 km from TTL) to do monthly outreach health assessments and to distribute food and formula. The clients all lived in different villages so we traversed many hills and bumpy roads meet them.

Our first visit was to Boikarabelo, a small baby girl we found bundled in her rondavel with her dad and sister – her mother had gone down to the river to get water. Aside from a little diaper rash, she looked healthy and is growing well. The mother has been unable to breastfeed so TTL has supplied the family with formula to ensure that Boikarabelo does not become malnourished – a big risk to babies in Lesotho whose mothers cannot breastfeed and whose families cannot afford formula. Before we left we weighed and measured Boikarabelo and replenished the family’s formula supply.

The rest of our day did not go as smoothly. We found our next two clients at home, but their caregivers were absent. Their mothers and grandmothers had gone to Malaphaneng town to receive rations from the World Food Program. We weighed and measured the kids – Tsepiso and Moleleki, and then left to try to track their caregivers down. We arrived at the Red Cross in Mapholeneng, where the WFP was distributing food and found hundreds of people and an assembly of donkeys, waiting to receive food support. We asked around but could not find Tsepiso’s mom or Moleleki’s grandmother in the crowd. We will have to return to their households to discuss their children’s health and development – especially Moleleki, whose malnourishment does not appear to be improving even with TTL’s food support.

No one was around at the last home we visited. A lot of driving to accomplish nothing. The outreach staff tells me that this is unusual – families are usually at home when we visit, but the inability to communicate easily with our clients’ families is one of the obstacles TTL has to work around. It is also one of the reasons why TTL’s work is so important in this region of Lesotho because we are supporting families who are isolated and hard to reach, living far away from access to most aid services. Failing to meet with these clients and caregivers was disappointing, but it was good to see first hand some of the challenges the TTL faces in its outreach to rural mountain villages.

-Meghan

a new arrival of a different kind

2011-11-08T07:28:00.000-08:00

TTL is happy to introduce the newest addition to its team in Mokhotlong: Meghan Harrington.

Over the next four months, Meghan and I will share this blog space and try to keep everyone updated on all the happy and sad, fun and mundane, events that make up life at TTL. And with that, I'll let Meghan continue her introduction herself...

Hello from Touching Tiny Lives! I’m Meghan Harrington, a new TTLF Fellow,here in Mokhotlong for just four months. My time here is flying by – I arrivedabout three weeks ago and thanks to the friendly hospitality that everyone atTTL has shown me, I am feeling right at home. Having heard so many wonderfulthings about TTL from Bridget, Reid, and Kevin’s time here (my sister,brother-in-law, and brother-in-law’s brother respectively), I’m happy to reportthat my experience thus far has exceeded even the high expectations I hadcoming over. Lesotho is a beautiful country, full of friendly people, and I amhumbled to be working for an organization that is successfully tackling some ofthe biggest challenges facing this country.

The impact TTL has on tiny lives in Lesothois evident the moment you arrive on TTL’s campus. Eleven little ones greetedme, most already on their way to becoming healthy, growing kids thanks to thenutrition and medical support provided in the safe home. One 2 ½ year oldlittle boy, Ralithakang, had arrived at TTL a few days before me, severelymalnourished, HIV+, and infected with tuberculosis. While the other childrenplayed, he preferred to lie down, too sick to smile or move around. WitnessingRalithakang’s progress in the last 3 weeks has been the most inspiring part ofmy time at TTL. He is laughing at everything, trying to talk, and walking withsupport. Seeing his transformation confirms how important this work is – TTL is giving these kids the opportunity tosurvive.

Yesterday Tsepang and Retsepile, two of thekids in the safe home, were picked up by their moms and taken home. I was sadto see their familiar faces leave us, but it was also a reminder of the greatfunction that TTL’s safe home serves when these now healthy, happy babies arereunited with their families.

So grateful for the opportunity to be here,witnessing all of the wonderful things happening at Touching Tiny Lives.

new arrival

2011-10-17T05:25:00.000-07:00

It's lunchtime at TTL and I poked my head into the safehome to find only two babies sitting on the mat ready for lunch. Everyone else was curled up fast asleep, including our newest arrival: Lebohang.

Lebohang is 6 weeks old and his parent's first child. His mother has just passed away due to complications during childbirth that were most likely negatively impacted by her positive HIV status. As his chubby cheeks show, Lebohang's current health is pretty good compared to most of the children who come to the safehome. However, the misdiagnosis of his mother's HIV status during pregnancy means that Lebohang was exposed to HIV. Doctors at the hospital thought it would be best for Lebohang to come to TTL so that he can receive all the care he needs while his family deals with the loss of his mother. This will also allow us to test Lebohang's HIV status so that a proper care plan can be identified as early as possible.

treading the forgotten sky

2011-10-11T08:54:00.000-07:00

Touching Tiny Lives is very grateful to Theresa Adams and everyone working for, and supporting, Treading the Forgotten Sky.

Theresa embarked on an amazing journey across Lesotho to raise funds and awareness about the HIV/AIDS epidemic that impacts every corner of this small, beautiful nation.

From all the families we work with and TTL staff, thank you so much including us in this amazing project. Treading the Forgotten Sky's generous donation will have a significant impact on TTL's efforts to mitigate the effects of HIV/AIDS on Lesotho's children.

Some of TTL's babies also wanted to say thanks! All these children are part of TTL's Outreach program and will benefit from the amazing efforts and generosity of Theresa and all those involved with Treading the Forgotten Sky.

october 1st

2011-10-03T06:04:00.001-07:00

Saturday, October 1^st marked the International Day of Older People. While sometimes it feels like there are so many days of ‘international recognition’, this one is pretty poignant for TTL and its clients. Like so many countries deeply impacted by the HIV epidemic, grandparents in Lesotho are raising their children’s children.

I spent Saturday with TTL’s Outreach team, driving to a village about 3 hours outside of Mokhotlong to visit a ‘grandmother-headed household’. Tlotlo had been referred to us through TTL’s village health worker network. Tlotlo's mother passed away a few weeks after her birth, leaving Tlotlo and 4 siblings to be cared for by their 71 year old grandmother. At just 1 month old, and with so many children in the house, the outreach staff was concerned about the family's ability to access and purchase formula to feed Tlotlo. After talking with the grandmother, it was decided that it would be best for Tlotlo to come and stay at the safehome for awhile where he can have access to all the food and support he needs during this period of critical early growth.

Tlotlo is now at TTL, bringing the number of babies in the safehome up to 7 – twice as many as we had only a week ago.

lesotho sun

2011-09-26T07:12:00.000-07:00

There are days when the constant sun/wind combination in Lesotho starts to feel like too much.

This weekend I travelled with Nthabeleng just south of Maseru to Roma: the home of the National University of Lesotho. It was the annual graduation day at the university, and while I skipped both of my own university graduations, I was pretty excited to attend this one. A close friend of Nthabeleng’s was graduating and plus it was all anyone on the radio was talking about so it seemed safe to assume it was going to be a pretty big event. And it’s really no wonder - in a country where attendance rates in secondary school are only 16% for men and 27% for women, the fact that 2,700 people would be receiving university diplomas was a big deal.

We arrived at around 9:30 and the day progressed with lots of speeches, processions of graduates and the never-ending dancing and ululating of all the proud family members and friends in the crowd. It was great to see everyone dressed up in their finest for the celebration - which amongst the women was a mix of ‘western’ clothes, dresses made from traditional fabrics, and a smattering of classic bridesmaid dresses. The speeches all talked about the important opportunity these graduates have to support the development of their country, be entrepreneurs, and create job opportunities that will help bring their fellow Basotho out of poverty. While I have no idea how many graduates stay in Lesotho, and how many may choose to try their luck in South Africa or elsewhere, I am sure none of them lose their ties with their home. It is exciting to think that this group just might be the generation that will help to bring about some of the country’s much needed change, and at the very least they are a sign of progress.

But by about 2pm my excitement with the day was starting to wear thin. My water was long gone, I was covered with a thin layer of dust from spending the day in the middle of a field, and the hot sun was feeling pretty relentless. Luckily, the graduation came to an end about an hour later, but as we waited in the long-line of cars leaving the graduation, the sun continuing to beat down on the car, I had had about enough of the sun for the day.

And then there are days like today – when I remember at 4pm that I thought it would be a good idea to do a load of laundry over lunch time. And as I quickly pin up my washing on the line at the back of TTL’s property I know that even the last few hours of Lesotho sun accompanied by the wind off the mountains will be enough to give me clean dry sheets tonight. And that’s pretty amazing.

tgif

2011-09-16T05:29:00.000-07:00

The three little ladies in the safehome have been having a pretty good day..

first there were cookies...

then some dancing..

lunch!

and everyone was having a great time until I made them line up for a photo

Reitumetse

2011-09-15T07:17:00.001-07:00

Yesterday I spent most of the day travelling to and from Thaba-Tseka with Nthabaleng and one of TTL's board members. The purpose of the trip was to meet with the District Administrator in Thaba-Tseka as part of TTL’s ongoing efforts to purchase a piece of land where a new Thaba-Tseka outreach office can be built. TTL began working in Thaba-Tseka in 2007 after we started receiving referrals from some of the clinics in the area that borders the Mokhotlong district. Since then, Outreach has been working actively across the Mashai district in Thaba-Tseka and TTL has been hoping to expand across the entire region. To do this, TTL needs to build a new outreach office in Thaba Tseka.

So off we went to Thaba Tseka to plead our case and see what could be done. After a quick 20 minute meeting, we were on the road again heading back to Mokhotlong. The three of us laughed at the fact that we would drive for over 6 hours today -all for a 20 minute meeting- but we all knew there really was no other way. Infrastructure in Lesotho, particularly in the highlands, remains poor. The government office in Thaba Tseka does not have email/internet, and based on the long line-up at the DA’s door, I don’t think he is spending a lot of time on the phone. Besides face-to-face is almost always more persuasive. All-in-all the meeting was positive, but no concrete results yet.

As we drove home bumping along the dirt road, the sky slowly darkened and I found myself watching the clock. My mind wandered between my grumbling stomach and what I could possible eat for dinner tonight; debating whether there would be enough time this evening to put a few hours into the funding proposal I’ve been working on; and most importantly, when would we finally hit the paved road – the first sign that we were almost back at the town of Mokhotlong.

Just before 7pm, my mind was brought back to attention by the ring of Nthabeleng’s phone. Assuming it was her family calling to find out when she would be home, I was not expecting what would come next. A few quick sentences later, Nthabeleng hung up and turned to me to say that Reitumetse had died. I found my mind racing, wanting to ask why, what could have possibly happened since we had left that morning. But the truth was I knew there was no real answer and there was really nothing else left to be done. The reality of the situation was that Reitumetse was born premature, exposed to HIV, and had not been receiving adequate nutrition for the first two months of her life. She had simply come to TTL too late. Preemies face a lot of challenges regardless of where they are born and rural Lesotho is not the most forgiving environment. And so beside some sighs and ‘ach’s we continued to drive in silence, bumping along the dirt path on the way back home.

Since then I’ve been thinking a lot about what Nthabeleng said during the meeting in Thaba-Tseka: none of us can say the children in Thaba-Tseka don’t require, and deserve, the same type of critical support TTL provides children in Mokhotlong. However, it is logistically impossible for TTL to serve all of Thaba-Tseka and establish itself within the region without have a base there.

Reitumetse was one of our clients from Thaba-Tseka. I can’t help but think that if she had been born to a mother in Mokhotlong, there is a chance TTL may have reached her earlier. Maybe we would have been put in touch with her mother when she was pregnant and we could have minimised Reitumetse’s exposure to HIV. Maybe Reitumetse would have been referred immediately after being born premature and TTL could have provided nutritional support to the family, rather than the water and sugar solution that she lived off of for the first two months of her life. The truth is, I know the same scenarios can and do occur in Mokhotlong. Even if Reitumetse had been a TTL client earlier, her fate may have been the same - sometimes nothing else can be done.

But despite all the ifs and maybes, I can only hope that things start to come together so TTL can build a centre in Thaba-Tseka. By expanding its reach and establishing TTL’s presence in the district it would make a difference. Reitumetse’s life was far too short and I can’t help but feel that she deserved a better chance. There are so many vulnerable children in Lesotho who deserve a better chance at healthy and happy futures -and at least I know that TTL does make some of those chances possible.

Reitumetse, 09/07/2011 - 14/09/2011

Born premature to an HIV + mother, Reitumetse arrived at TTL’s safehome on August 29, 2011 at almost two months old. Her mother has passed away due to HIV-related causes and her father’s whereabouts are unknown. On September 14, Reitumetse started to develop difficulties breathing and was admitted to hospital where she passed away that evening.

first goodbyes

2011-09-06T08:00:00.000-07:00

With so many new and exciting things that happen when you move somewhere different or start a new project, this week seems surprisingly to be marked by a lot of things ending. Some of them good (I have finally gotten over my first bout of head cold/sickness in Lesotho) and some of them sad (the lovely team of volunteer nurses –Eric, Mary and Marshall- that have been keeping me company will be leaving at the end of the week). It’s been great having them around the past few weeks. I think Khutliso our one boy in the safehome has enjoyed having some male playmates for a while and it’s been wonderful to have people around who can help explain some of the more in-depth medical issues to me. Some of you may have seen Marshall's blog about their experiences in Mokhotlong here: http://traveltoafricawithme.com/blog/

Also by the end of this week, all but one of the kids who were in the safehome when I first arrived will be gone. Relekane – one of the most relaxed and sweet-natured toddlers I have ever met - returned to her family on Friday. Khutliso and Retsipile Lekhooa are also both due to be leaving by the end of the week. The departure of children from the safehome is a funny thing. I can’t help but a feel a bit (selfishly) sad that the babies will be leaving and I won’t be able to come and visit them in the playroom anymore. The medical volunteers and I also can’t help but speculate on how the other safehome kids must feel when one of their playmates leave. Lerato arrived at TTL only a week before me and so these three were also her first friends here. Lerato and Khutliso seem to have become particularly close, chasing each other around the playroom and sitting side by side at meal time. Acting like the big sister, Lerato has more than once returned a toy to Khutliso that one of the other kids had stolen (almost always that other kid being Retsipile). We all wonder how she will adjust once the others are gone.

However, above all else, these departures from the safehome are a time for celebration. The fact that another child – or in this case three- have become healthy and strong enough to return to their family are the critical achievements that make TTL such a successful model. Once home, they will continue to be supported by TTL’s Outreach team with frequent health checks as well as the provision of food and medical supplies. It’s by returning children to their families that TTL’s model remains a sustainable one. TTL brings resources out to communities, supporting families to raise healthy children while also providing that essential safety net, the safehome, for the most critical cases. And with each healthy child that leaves the safehome and later graduates from the Outreach program, TTL is able to shift resources in order to help that next child in a critical health situation. Because as Nthabeleng has been telling me from day one, we all know there are many more children out there that just haven’t been identified yet.

introductions and new developments

2011-08-25T00:59:00.000-07:00

First of all, let me introduce myself -my name is Rachel and I am the new fellow at TTL. Having only arrived in Lesotho a week ago I am still feeling a bit green and am quickly trying to learn some useful phrases in Sesotho and find my way around Mokhotlong (I know it’s small but anyone who knows me will tell you that I have a hopeless sense of direction).

But meanwhile, there has been a lot happening at the TTL campus that I would love to update you about.

Also new on the TTL campus is Lerato. She came to the safehome on August 11 following discharge from hospital. She is suffering from malnutrition and is HIV + but has recently been started on ARVs. Lerato is a very sweet and easy-going toddler and has started to show some improvements and gained weight since arriving at the safehome. Both Lerato’s parents have passed away but the hope is that once her health status improves and stabilises, she will go home to live with her aunt.

Tsekiso, whose friendly face you’ll recognise from his birthday celebration with TTL staff and volunteers in July, went home to live with his grandmother on August 7. Tsekiso was brought to TTL by his father after being treated and discharged at the hospital for severe dehydration and malnutrition. His mother passed away in 2009 and his caregiver situation has been unstable, contributing to his malnutrition. While at the safehome, Tsekiso was identified as HIV + and started ART. Now that his health has been stabilised he has been able to return to his grandmother’s care. TTL will continue to support Tsekiso and his brother, another TTL client, through the work of the Outreach team.

On August 12, TTL welcomed soldiers from the local military base to the TTL campus. Under the leadership of Second Lieutenant Lekanyane and Captain Ndlelene, a group of Mokhotlong based soldiers visited with the children and generously donated clothing to the safehome. This was the third time local army personnel have come to visit and donate items to TTL and it has been great to receive this ongoing support from TTL’s local community in Mokhotlong.

Changes have also been happening to the buildings at TTL. Thanks to the generosity of the Town of Gummersbach, TTL now has three functioning solar panels that supply solar heated water for the TTL campus.

We are looking forward to the completion of the second phase of the project: the installation of a complete photovoltaic system. This system will produce between 2000-3000 kWh of electricity each year – roughly half of the energy consumed in the safehome and kitchen.

Essentially all the water on site will be solar heated and half of our electrical needs for the safehome and kitchen will come from the sun. Many thanks to the town of Gummersbach for making sustainable changes at TTL possible!

That’s everything for now. I look forward to keeping you all updated with my thoughts and experiences and all the comings and goings and stories and successes at TTL over the next year.

Lasting Impressions

2011-07-23T12:31:00.000-07:00

Duke University engineering student Catherine Joseph volunteered with TTL seven months ago and recently returned for another short visit.

I had forgotten how brightly the stars shine here. The last time I was here in Mokhotlong, the season was summer. Each night, I would spot Orion, my favorite constellation, as he began his walk across the African sky, and I would track his progress during the late evening hours.

That was six months ago. Now, Orion is no longer visible during the daytime hours, and each time I look up, I struggle to find a recognizable constellation.

I imagine the experience of a child in the safe home is similar to that of me and the stars. While the loving bo’me are constantly caring for and loving the children, every few weeks, the babies look up into a sky of new volunteer faces. Searching unsuccessfully for a recognizable face, it seems likely the children would forget past volunteers as new faces and personalities flow through the safe home. Studies indicate that many of our long-term memories don’t begin until well after our first year of life. Since many of the children in the safe home are behind developmentally due to malnourishment and illness, I assumed that the one child that I met during my previous visit would have no recollection of me. I expected to be earning his trust as I knew I would have to earn the other children’s. But Khutliso surprised me.

The first step I took into the safe home playroom drew either curious looks or trembling lips from the children as I greeted the bo’me with the few Sesotho phrases I remember. My eyes were immediately drawn to Khutliso, recognizable by his distinct puppy-dog eyes peering out of his now chubby and healthy-looking face. His look of surprise instantly melted into a smile as he turned around, reached his hands out for mine and began to walk me around the playroom, showing off how much he has improved since I had last been there. Each day, as I enter the playroom, Khutliso finds me and we establish a little walking track around the playroom. We either walk for a long time, pausing only to dance or stomp our feet, or we sit and play with the other toddlers.

I still haven’t figured out if Khutliso actually remembers me, or if he just recognizes me as another person who will help him walk and make him laugh. And I’ll probably never be able to know with certainty. But these events have made me wonder how much the safe home babies will remember of their experiences here. Some children stay only a short time, so it seems likely that their memory of TTL will quickly fade into remembrances of outreach visits. But others, like Khutliso, spend many months recovering from malnutrition and illness, becoming accustomed to their surroundings and to the love and affection of the bo’me. And the older children, like Tsekiso, a three-year-old in the safe home, are likely able to observe and absorb more of their surroundings, making the safe home familiar and comfortable.

But how long do these memories last? Just the other day, one of the babies, Shai, was reunited with her family. As the bo’me said goodbye to her and she was carried from the safe home to the outreach car, she screamed with recognition that she was leaving home. But her objections upon arrival to her family’s home were far less vocal. Did she actually remember her home? And how long will it be before she forgets that the safe home was once her home?

These are all questions that I’ll likely never be able to answer. Only time will tell how much the babies will remember of the pain they once suffered and the joy that the caregivers at TTL were able to replace it with.

--
Catherine R. Joseph

Party in the Playroom

2011-07-18T11:23:00.000-07:00

This post was authored by Morgan Benson, a Notre Dame student and Hesburgh-Yusko Scholar volunteering with TTL for two months this summer.

At my first birthday party, I stuck my face in the cake. It’s not a memory I have myself but one from my parents who held this party for me, even though I wasn’t going to remember a thing from it.

At first it seems sort of silly that they would even have the party. But after some thought, I realized that it was to celebrate the fact that, for the past year, I had grown and been loved. Birthdays are a day to recognize that fact and celebrate it with the people that care about you.

This is why there was a birthday party in the TTL safehome recently. Tsekiso turned three years old that last Friday, and Khutliso turned two on Saturday. Tsekiso and Khutliso are two of the oldest in the safehome with two of the biggest personalities, so when Chelsea and I heard they were turning a year older, we knew we had to celebrate.

Birthday sign made, cake baked, and accompanied by every bo’me and outreach worker we could invite to the party, we sang happy birthday to Tsekiso and Khutliso.

Frankly none of the kids knew what was going on. But everyone who had a hand in taking care of these boys for many months now gathered and celebrated the birthdays of two boys who got a second chance.

Neither of the boys stuck his face in the cake, but I think they enjoyed the party. Seeing them happy and smiling was a privilege TTL works for every day. They were surrounded by 20 of the people that have cared for them since they were so critically ill TTL had to intervene.

I was just a guest at the party; the bo’me and outreach workers are part of Khutliso and Tsekiso’s TTL family who loves them and got together to celebrate their lives. And so there was a party in the playroom.

Searching for Solutions

2011-07-04T05:14:00.000-07:00

TTL is proud to be hosting two undergraduate students from Notre Dame who are here as part of the Hesburgh-Yusko Scholars Program (http://hesburgh-yusko.org). In this post, Chelsea Lehman shares some of her first impressions of Lesotho and the challenges of addressing poverty and poor health in a country with virtually no economy.

SEARCHING FOR SOLUTIONS (By Chelsea Lehman)

You were my strength when I was weak
You were my voice when I couldn't speak
You were my eyes when I couldn't see
You saw the best there was in me
Lifted me up when I couldn't reach
You gave me faith 'cuz you believed
I'm everything I am
Because you loved me.

Celine Dion’s words blare into the main street of town out of the speakers of a grocery and household goods store we like to call “Big China.” I’m not sure which is more striking, the reality that nearly every store in town is owned and operated by the Chinese, or the music, an old U.S. hit sung by a Canadian. Dion adds to the slow bustle of domestic animals, the occasional car, and the Basotho lining the street, selling their small collections of imported goods: fruit, warm hats and socks, bargain jewelry, miscellaneous kitchen items. The origins of these items range from South Africa to London. Nowhere can a homemade craft or open air market be found, which most people consider the trademark of an African country. I admit I did…until I arrived three weeks ago, a Notre Dame student volunteering with TTL for two months. Even the Sesotho blankets, the signature item of Lesotho worn by nearly every Basotho, are imported from South Africa.

Why is this important? Surely it is trivial in the face of HIV, which is crippling Lesotho. After all, of the 1.9 million people of Lesotho, 25% are living with HIV, a disease that consequently has left 90% of those infected to also battle TB and has stolen the parents of an estimated 100,000 children. The government of Lesotho is attempting an aggressive fight against HIV through its provision of free testing and antiretroviral therapy to anyone who can access it. The issue, though, is that access continues to limit the reach of this program in a mountainous country populated predominantly by rural villages connected by dangerous roads that become ever more precarious with any kind of weather conditions.

I bring up the import situation because it illustrates a phenomenon: Lesotho effectively has no economy. Last week I spent an afternoon with Dr. Chris, a native of Zimbabwe and Baylor pediatric doctor who drives from Maseru for a week at the end of each month to provide care and ARVs (the drugs taken by HIV positive patients) to the people of Mokhotlong. It was an “ARV day,” which essentially involves driving out to a rural clinic in one of the villages of Mokhotlong, seeing dozens of patients, and outfitting each with a couple months’ worth of pills.

After explaining the system to me: what the government does, the HIV testing and bloodwork process, and how he decides which of the many ARVs on the market to prescribe to each person he sees, he looked at me. A sadness transformed his typically energetic and jocular demeanor. In response to a question I raised about the ability of malnourished people to respond effectively to ARVs, he said, “it’s not a problem. The drugs will still work. But the children are still going to be sick. They’re hungry. What we have to end is poverty.”

This is what I’ve spent my past couple weeks, and especially the last few days, thinking about. Paul Farmer cites a relevant Haitian proverb to make a comparison that illustrates precisely the point Dr. Chris raises: “Giving people medicine for TB and not giving them food is like washing your hands and drying them in the dirt.” A sustainable solution to disease commands the provision of the basic rights we take for granted: food, clean water, education, and healthcare.

But while a temporary good, simply giving people food every month is not sustainable. However, Lesotho’s economy, in its current state, gives aid organizations little choice. I’ve been wracking my brain for ways to revolutionize the local economy to provide the Basotho with heartier, more reliable incomes, but the fact of the matter is that no outsider can give Lesotho an economy. The Basotho people have been living off of imports and the dozens of various aid organizations for years. Subsistence living is their way of life, and now with imports and foreign aid they seem trapped amidst two very different systems driven by two often opposing ideologies.

Raised in a capitalistic society, I, like most Westerners, don’t understand their lack of innovation or motivation to make simple changes to improve their situation. But then I examine their traditional ways of doing things, as well as the ways in which aid has been given in the past, and I begin to see why they perceive their situation differently.

Every time I throw on my running shoes and pick up the road that leads out of town, I am reminded of what aid seems to mean to them. Without fail, after I attempt a “hello” or “how are you” in Sesotho, children ask me for “sweets” or “chin-chin” (money, in Sesotho) and herdsmen for my watch or gloves or shoes. This is what white people have done in the past, and over time it has become the rule. The Basotho expect it, but they cannot live on handouts forever.

The Saga of Poof

2011-06-30T03:16:00.000-07:00

TTL is proud to be hosting two undergraduate students from Notre Dame who are here as part of the Hesburgh-Yusko Scholars Program (http://hesburgh-yusko.org).

We're thrilled that Morgan and Chelsea are with us for two months, and rather than keep all of their contributions and insights to ourselves we've asked them to share parts of their experience here on the TTLF blog. To start things off, here's Morgan's account of her relationship with a baby boy who recently passed through the safehome:

THE SAGA OF POOF (by Morgan Benson)
This morning, Phoofu left for Queen II Hospital in Maseru. TTL brought his mother and the mother of another TTL safehome client, Nthabiseng, here for the night before both babies and mothers joined a group going into Maseru from Mokhotlong hospital.

Phoofu was the first new baby to arrive at the safehome since I did three weeks ago. I am an undergraduate student from Notre Dame spending eight weeks at TTL this summer (…or winter here). After I spent a week settling in and getting used to all the faces in the safehome, a new one arrived. Phoofu did not have the weeks or even months of TTL’s care that the other babies did. He was tiny with frighteningly bloodshot eyes from living inside a smoky rondaval. And there was something else about his eyes.

They shook. They didn’t follow anyone or anything. They simply moved quickly from side to side wandering around the room. I asked one of the bo’me what this new baby’s name was. “Poof!” was what I conceived her response to be, so I said it back. After the laughter subsided, she handed me his bukana and I realized it was Phoofu (Pofe-oo). Well from then on he was Poof to me.

I held him when I accompanied Me’Mamosa to the hospital soon after he arrived. She explained to the doctor that he was referred to TTL because he was “abnormal.” He also had a very large soft spot on the back of his head that she wanted to check out. The doctor told her to avoid traumas to the head, but other than that, he was fine. But as Phoofu spent more time at TTL eating well and being cared for, it was clear there was something else different about him.

We looked forward to when Dr. Chris from BIPAI (Baylor International Pediatric AIDS Initiative) would come in the next couple weeks to get his opinion. During that time, Poof and I bonded. He began to make more noise and smile more- one of the cutest smiles I’ve ever seen, almost always preceded by a look of deep confusion or frustration that erupts into pure goofy joy. But during that time we also began to notice more issues with Phoofu.
At 10 months old, he couldn’t sit up by himself and wouldn’t hold his head up properly. When Dr. Chris finally came to TTL to check up on some of the little ones, I again got to hold Phoofu as he confirmed our suspicions that Phoofu has Down syndrome, in addition to hypotonia (low muscle mass) and severe eye problems. Though it was comforting to see him spending time on Phoofu, examining his eyes, legs, torso, and head, even noting to us the high arch in his mouth consistent with Down syndrome, I knew this was bad news.

I tried to figure out what this really means in a country I don’t know and a culture I am still so unfamiliar with, but I didn’t find anything encouraging. One report described the chances of a child with Down syndrome in rural areas of Lesotho reaching adolescence as “slight.” However, this was largely because of the medical care available. This is when TTL is so vitally important.
When Phoofu’s caregivers noticed something wrong, they were able to contact TTL. Now Phoofu is on a 5-hour drive into Maseru to see a disabilities specialist with his mother. I don’t know what they will be able to do for Phoofu and his family, but TTL is ensuring that he is going to the best place he can and will continue to provide Phoofu and his family support.

I’m not sure if I will get to say goodbye to Poof in the safehome before he returns to his village with his family. I’m not sure what his future will look like, living with a condition that can cause so many health problems. And I’m not sure if his family is in a position to provide him with the care he will need. But I do know that TTL’s committed outreach team will do everything they can for Phoofu, and for that, I am proud to be spending my summer learning from them.

Four Families Together Again

2011-05-10T07:35:00.000-07:00

Four of our kids were reunited with their families in the past week, meaning that TTL was able to dramatically and positively alter the future of four kids who were either acutely ill or abandoned and in need of a caregiver (or both).

Mpontseng, a sweet four year old girl who was extremely sick and malnourished when she came to us almost two months ago, returned home to two healthy grandparents and an extended family that was beyond excited to have her back.

Kabelo, an orphaned baby boy who came to TTL when he was a few weeks old and stayed with us for the next six months, was taken in by a female relative that our outreach team worked for months to find.

Lipuo, whose mother died recently and whose father is unable to care for her, was reunited with her grandmother and older brother.

Tlholohelo, a hilarious baby girl who was initially in need of serious medical attention and nutritional support, returned home to her mother.

As with all the kids who transition out of the safehome back to their villages, we’ll keep a close eye on their progress with regular outreach visits. And new babies in need of support will inevitably fill in the spots vacated by the four who left.

In fact, when we dropped off Kabelo, it was with his grandfather and the grandfather’s young wife who were caring for at least eight other children of extended family members ranging from toddlers to pre-teens (they’ll be taking Kabelo to be cared for permanently by another family member in an even more remote village).

Among the group of kids living there was Kabelo’s three year old sister, whom we immediately noticed was malnourished and in need of medical attention. While it was undeniably disheartening and somewhat alarming to drop off one healthy baby in a household where another is clearly not thriving, it was also a relief to know that we could now help another child in need.

She’ll likely be coming to the safehome temporarily within the next few days. We’ll do what we can to boost her weight and overall health before returning her to her family, better off not only because of an enhanced health state but also because the long term outreach support from TTL will hopefully allow her to continue thriving. That’s the ideal outcome, at least, and the one we’ll do our best to achieve.

Death Before Dawn

2011-04-26T03:05:00.000-07:00

This morning a baby girl died in my arms. Her last breath was abrupt and unsatisfying, the way an incomplete sentence hangs on the page: taunting, defiant, unnecessary.

We picked up Boikano on one of my first outreach trips. It was a memorable outing that involved driving well beyond the end of what should be considered a road, working with a village chief to assign a man on horseback to continue the journey, and then somehow intercepting a petite grandmother traversing a rocky mountain while carrying the malnourished and dehydrated three month old baby who we’d soon nurse back towards health at the safehome.

Once she arrived at TTL, Boikano gained weight quickly. She struggled with chronic sinus and respiratory infections, though she’d been relatively asymptomatic in the past couple weeks. She was also recently confirmed as HIV positive and was started on ARVs about 10 days ago. Her health was actually on the upswing. Until, of course, it wasn’t.

Yesterday afternoon she started looking listless, and by 5pm was running a high fever and had vomited once. We gave her medication to help bring down her temperature and tried to replenish her fluids, just as we’ve done dozens of time when similar scenarios arose with other babies. When I went to bed around 1am, the bo’me hadn’t come looking for me or Eric, indicating that Boikano was perhaps not better but likely not worse.

A few hours later, I awoke to a man’s voice, speaking softly in the dark outside my rondavel door. The words were English--otherwise I think my brain would have dismissed the voice as a passing shepherd guiding his herd down the road past TTL.

It had to be Eric, my co-fellow, in conversation with one of the bo’me from the safehome. After a minute of fumbling around to find a hoodie, I opened my door to the cold autumn darkness to see what was going on.

(Fall has just arrived in Mokhotlong--crisp, fragrant, and blustery-- and it is rapidly ushering away the the vibrant green foiliage and previously ubiquitous purple flowers, gradually polarizing the colors of the daytime landscape into two distinct camps: the assertive bright blue of the sky or the soft golden brown of the mountains).

I’d been the last to check on Boikano and since I often gravitate towards the medical side of our work anyway, I encouraged Eric to go back to bed while I went down to the safehome. Being awoken by the bo’me didn’t necessarily mean something critical was happening, but perhaps more importantly both of us knew there was little we could do in a crisis other than take her to the hospital where there would likely be no responsive medical staff and certainly no doctor on duty for hours.

Boikano was on the bedroom floor next to one of the bo’me, wrapped in a plastic sheet and a plush blue blanket. Even without a medical degree, I was pretty sure that she wouldn’t be long for this world and would in fact probably be dead within minutes. Her eyes were open but not tracking; in addition to being unconscious, her breathing was significantly more rapid and shallow than when I’d observed her respirations the previous evening, her hands and feet were icy, and there was moisture beading on her upper lip. I sat for a minute, trying to remember how to treat a a baby for shock or ARV-related toxicity or any other possible cause of her condition, knowing there wasn’t really anything I could do but not yet wanting to admit it.

I don’t have any experience with how death is supposed to be handled here but I have enough experience as a human to know that a baby deserves to die with as much comfort and love as possible in its last moments. I lifted her limp body and cradled her tiny body tightly, whispering things to her that I don’t even remember, watching life drain out of her until the last exhale.

The morgue is essentially within sight of TTL so it doesn’t take long to get there. And thanks to one of my predecessor’s blog posts about a similar experience, I was somewhat prepared. Not that getting down on hands and knees and leaning into a dark coffin-like chamber containing a dead adult male whose rigid cheek was only separated from my own by a thin sheet while I positioned Boikano on his chest was any more pleasant with the memory of Kevin’s blog post in my mind, but it helped to know certain practicalities like that it is standard to jam multiple bodies into one small, cold space and that I needed to leave a handwritten note on the door with the name, gender, time, and contact info before leaving.

When I returned to TTL the sun was still just a suggestion from beyond the horizon. I cried for the second time since being here (the first was last week, when Neo and Molefi left TTL for an orphanage--perhaps not an ideal outcome but at least their departure confirmed their health and the success of TTL’s initial intervention). Eric--who despite worshipping his sleep was not actually in bed when I returned--came over and managed to make me laugh, and the miracle of Skype meant that I could share the events with my boyfriend back in Seattle, all before dawn. Experienced, processed, released and done. Or something like that.

Now as I sit in my office next to the playroom, back to work as usual, I hope the rest of my day continues to be filled by the happy chortling of the babies and the comings and goings of the bo’me. And I also hope it’s a very long time before another early wake up call from the safehome.

The Smallest Superheroes

2011-03-30T23:46:00.000-07:00

Any kind of meaningful experience should shift your perception of things, so perhaps that's why I am worse than I've ever been at guessing a child's age. When kids come to the TTL safehome, it's usually (ok, never) because their home situation and health status are great--quite the opposite, hence TTL's entire purpose. So even while we have an amazing success rate in terms of transforming tiny sick babies into chubby happy ones, the pre-TTL time of suffering still leaves a mark on rates of physical development.

Even though I know each safehome child's name, nickname, medications, favorite toys, alarming versus normal fussy cries, and signature spastic movements or other idiosyncrasies, I'm constantly re-checking our med charts to remind myself how old each one is; it's the one detail that my brain cannot seem to accept into the permanent archives, perhaps because every time I check a kid's age it seems like a surprise (we have a four month old who is stronger and almost as big as a two year old, for example). In almost all cases, our kids are much smaller than, say, their American counterparts.

It's no exaggeration to say that at first glance many of our kids or any of the many, many malnourished children in the rural areas surrounding TTL look months or even years younger than what my previous experiences with healthy, well-fed children would lead me to assume. One of my best friends at home has a baby around maybe five months old who is developing normally according to US standards but when I see pictures and videos she looks to me now through my TTL lens like a freakishly large and incredibly cognitively-gifted mini superhero.

Just last week we admitted two new children to the safehome, both our oldest here currently. Even though they are the most shy and withdrawn of our kids--not at all surprising since they are old enough to perceive the dramatic changes in their circumstances at a deeper level than the infants and thus more likely to struggle with fear and disorientation until they feel secure--we're confident they'll grow into their roles as the new king and queen of the TTL playroom. While initially reported as both being four years old, more research revealed that one is just under three and the other is four and a half. Yet before paperwork surfaced to confirm dates of birth, we were prepared to take initial reports at face value because in there is no reliable norm for kids who are that sick and malnourished.

Thankfully, TTL's focus on kids age 0-5 allows us to target kids in the most vulnerable early developmental stages and give them the best shot at making up lost ground. Between the safehome and our vast outreach network, we are able to reach hundreds of kids facing nutritional challenges, usually on top of other health conditions such as HIV or respiratory infections. Our safehome kids eat five times a day--three meals, two snacks or, for infants, as much bottle feeding as needed--and the frequency, quantity, and variety of foods they get is in no way the norm in Lesotho. On outreach, we commonly supply staples (such as corn meal and sorghum) as well as lots and lots of formula for babies whose mothers cannot breastfeed for a variety of reasons (sickness, death, disappearance, and the mother's own nutritional deficiencies are the most common).

While food security isn't necessarily at the heart of TTL's work, it's definitely a critical component of our work. Every mouthful helps these kids get one step closer to being back on track, and in their own way they are all turning out to be mini-superheroes.

Two Steps Forward...

2011-03-16T05:38:00.000-07:00

Here we are in the middle of March and I’ve yet to update our loyal readers on the happening here in Mokhotlong--my apologies!

One of the problems with letting almost a month go by without a blog post is that so much happens, it’s hard to pick out just one incident to highlight. On the staff and volunteer side of things, the past few weeks have seen six volunteers come and go. Among this crowd was a four person medical team (led by TTLF Medical Director Dr. Amy Hutton from Chelan, WA) that spent two weeks interacting with babies in the safehome, assisting on outreach, and conducting some staff trainings on topics that our safehome coordinator identified as things that our caregivers encounter on a regular basis (these included hand-washing, vomiting, diarrhea, oral thrush, cough, TB, and rescue breathing). Then, this past weekend we welcomed two fourth year medical students from Cornell who are spending their last six weeks of med school doing an elective at the Mokhotlong Hospital located adjacent to the TTL campus just as my co-fellow departed for two weeks, giving me (and my boss) the chance to see how capable I really am here on my own.

The safehome has remained relatively full at eleven babies as of today. We bid farewell to one baby and one toddler at the end of February (some of you may have already seen pictures of baby boy Neo returning home to his mother and Nthabiseng’s last morning here on the TTLF Facebook page). Nthabiseng was the biggest and oldest child in the safehome while she was here, and she had a correspondingly large personality. Seeing her go was definitely bittersweet since so many of the staff had grown attached to her but transitioning a child back home is always a happy occasion as it marks incredible, undeniable improvement.

The outreach team will continue to provide her and her family with support and track her progress--something I have to remind myself of every time I think of the last hospital check-up I took Nthabiseng to for her final assessment with us, during which the nurses quite directly ordered me to adopt her because letting her go home meant letting her return to the same situation in which she became so sick to begin with.

Given the number of sick and malnourished babies that come through those hospital doors on a daily basis, I could definitely sympathize with the nurses’ skepticism. What I didn’t have time to add to the conversation was the fact that TTL clients have the unique advantage of long-term support through our dedicated outreach team. Caring for our clients is multi-stage process that goes beyond the most acute treatment phase; it involves a partnership between TTL and each child’s caregivers, who receive both supplies and education to help ensure the child’s health continues to improve.

For the most part, this model works, but it can’t guarantee 100% success. While Dr. Hutton’s medical team was here and working at the hospital, a mother came in with a baby who was suffering from advanced malnourishment. It’s not clear whether anything could have been done for the baby given the severity of his condition by the time he got to the hospital, but even after he arrived it took many hours for him to be seen by a doctor. The next day, he passed away lying next to his mother on a gurney in the pediatric ward. Adding to the tragedy is the fact that this child was a former TTL client who had graduated, meaning that his health was so stable for so long after we’d initially encountered him that he no longer needed the regular support of our outreach team. How a child can go from being so healthy to so very sick without intervention is not only perplexing but heartbreaking. Even though this kind of incident is rare, and even though it’s nearly impossible to pin down the exact place where things started to go wrong, it’s not acceptable. Thankfully there is no indication that Nthabiseng or any of our other clients are at risk for this kind of situation, but the reality is that things can go very wrong very quickly.

“One child at a time” is a fitting motto for TTL in so many ways, and if TTL wasn’t here there’s a good chance no one would be. Yet sometimes it’s still difficult to swallow the fact that no one can be there for every child every time.

Memories Beyond Mountains

2011-02-23T02:52:00.000-08:00

In his final post about a week ago, Kevin recalled many of his first impressions of this place: endless mountains, wandering sheep, warm bundles of babies, and much more.

While in many ways it feels like I just arrived, my calendar insists that I’m already almost a month into my year-long fellowship. And even though I’m certain many of my initial impressions will remain fresh in my mind, I can already perceive how the crisp edges of each new experience have worn ever so slightly soft as they settle neatly into the folds of my long-term memory (or to the place where socks go when they disappear from the dryer, never to be found again).

Largely because I couldn’t even begin to fool myself about my absolutely miserable track record of journaling, maintaining a personal blog, or officially cataloging my life in any way whatsoever, I committed to writing out a list of my first impressions after my first week in Lesotho.

Similarly to Kevin’s recollections, the mountains are featured prominently on my list, as are the amazing variety of clouds that cast shadows on the slopes. And of course the sheep, donkeys, and horses meandering through both tamed and untamed spaces. Landing in what may indeed be the Wild West of Africa is just one of the many reasons I feel so lucky to be here; I’m originally from New Mexico and while I’m no cowgirl, I find undeniable comfort in open spaces, men (or women) on horseback, and mercurial mountain air that is in one moment a chilly, wind-whipped burst scented with dust and rain and then suddenly penetratingly hot and thirsty.

For the most part, these observations aren’t necessarily directly related to TTL. Yet at the same time, one of the most salient characteristics of TTL is its Basotho-ness. TTL is supported by a global community of generous advocates but is at its heart an organization that is run and managed locally, responding to local needs and local possibilities. That may sound almost trite, but it’s hard to over-emphasize the importance of this detail. Internal ownership of any solution--whether for health, poverty, education, sanitation, or another issue--is an essential ingredient to sustainable success. Though I’ve just arrived, I’m already as impressed by TTL’s success in this area as I am passionately protective of it.

TTL’s work and the geographic, economic, and cultural context in which it takes place are inseparable. Take the mountains, for example. They are indeed staggeringly beautiful, but if you are one of the thousands of Basotho living in rural mountain villages, the mountain terrain is also isolating--especially when roads are limited and extreme weather predominates (the climatic pendulum swings between torrential rains or drought-inducing aridity; currently, many parts of Lesotho are experiencing massive flooding and subsequent crop damage, the extent of which won’t be revealed until harvest season). TTL’s outreach team is, in many cases, the only connection such villagers have to health care and nutritional support.

There is no denying the complexity of the challenges involved in serving the population of orphaned and vulnerable children we target. There is also no denying the positive impact that TTL is having in Lesotho. As the coming year stretches out in front of me, I look forward to sharing stories of successes and setbacks with you, and will do my best to integrate as much of the texture of this very special place in the process.

Well, That's That

2011-02-14T01:13:00.000-08:00

And here it suddenly is: my last day on the job. One year sits behind me.

Tomorrow I leave Mokhotlong for Maseru, and the following day I fly back to the United States. My year-long fellowship at TTL is complete.

I still vividly remember the day I arrived here, and the stream of thoughts that shot through my head: Crazy roads. Amazing villages. Cute babies. Wild mountains. Rapid language. Lots of sheep. Strange world. So different. Here I am. Lesotho. Africa. Rural as hell. Wow… Here I am, and I have a whole year ahead of me.

I remember unpacking in my rondaval, finishing, laying down on the bed and looking up at the thatched roofing. I was a little overwhelmed, felt the physical distance between my loved ones and me, but I was also excited. Really excited. I told myself to just take it one day at a time.

The next 364 days went by much faster than I thought they would. And here I am at the end.

It feels abrupt, awkward, sad, unreal, and, again, exciting. I'm leaping forward into the next chapter in my life -- just like I was on my first day in Mokhotlong.

As for what the next chapter will entail, I'm still unsure. I have a lot to figure out. What's my next adventure? No clue.

I'll miss my coworkers. I'll miss the boss. I'll miss the pace of life, the slow weekends here, the simplicity of town and the basic, every-day sense of adventure that comes to me on waking up in a foreign, remote and vastly-different country than my own.

I'll miss the smell of a clean baby in my arms, little hands wrapped around one of my fingers, and the privilege of playing every day with an ever-revolving crew of toddlers who I get to become close with.

I'll miss seeing those toddlers go through the transformations that occur here at TTL all the time, from malnourished and sick to happy, healthy and rambunctious.

As for TTL itself, I know it will continue to thrive and grow without me.

And as for this blog, it will also continue on.

I'm happy now to introduce the newest TTLF Fellow, my replacement at TTL, and the newest author for this blog: Meghan Werner.

I'll let her introduce herself, but urge all of you to keep checking in with her for all the latest updates from TTL. I know she'll keep you posted!

Meghan: It's all yours. Enjoy it while it lasts. It will go by quickly.

A Healthy Five Month Start

2011-02-11T02:40:00.000-08:00

Today, the trend of babies arriving at the safe-home finally reversed, as one of them instead went home.

Our little, chunky, bright-eyed Retsepile, who arrived at TTL a few days after her birth at the beginning of September and has been here ever since, has gone home to her father.

Back in September, Matello found Retsepile at the hospital with her father, who said Retsepile's mother had passed away shortly after the delivery. Retsepile was 2.6 kg, or about 5.7 pounds, and was in a relatively healthy condition. Still, the couple had already lost two other babies, now the mother had died, and the father was scared Retsepile would also pass away without the support of her mother and because of the lack of resources at his disposal for feeding Retsepile.

TTL agreed to help the father by having Retsepile come to the safe-home, where we could provide her with formula and get her through the critical first months of her life.

Now, five months later, Retsepile is healthy and happy. And her father, who regularly visited her here and seems like an involved, caring parent, is ready to take care of her.

If it weren't for TTL's services and care, would Retsepile have made it? Luckily, we'll never have to know.

A Dichotomy I Won't Forget

2011-02-08T23:53:00.000-08:00

It isn't new, and it's always around, but it never gets old or seems normal or becomes more easily understandable. Never. Not even a little bit.

It is the heavy, intimate pounding of reality here, as it takes form simultaneously in its two most polar extremes: the drastic recovery of a child into health and smiles and a radiating personality, and the rapid decline of a child into heavy breathing, distress, and tragic death.

Of course, we fight for the former and against the latter. Still, though, and especially when there are lots of babies in the safe-home, sometimes we are fighting both battles on two different fronts. Sometimes, we have to take victory with defeat, practically at the same time, and in one's own mental space, the gymnastics of understanding such clashing results can become a twisted, tiring tumble through disconcerting thoughts and lots of "what if" questions.

Mothofeela-folomane, the little boy I just wrote about in my last post, died yesterday at the hospital. He had been too small, too ill, and we'd found him too late. Life isn't fair -- wasn't fair for him. I wonder what would have happened if we had found him just one day earlier. What if his house hadn't been so damp and cold and dilapidated because of the rain? I cringe at the thought of what his daily life was like toward the end -- HIV ravaging him, and malnutrition settings its teeth ever deeper. We lost the battle for his life after entering it too late, and it's sad.

But in another on-going battle, we have swung back hard and knocked down the many dangerous threats that were on the verge of overcoming another small boy.

Molefi, who came to the safe-home two weeks ago after Matello and I found him covered in flies and his own feces in the nearby village of Checha, has suddenly hit his stride toward recovery.

For the first week or so he was here, he was extremely lethargic and looked miserable as a result of his diarrhea, vomiting and overall struggle against dehydration. But since Dr. Chris from Baylor came to TTL last week and gave Molefi a full check-up and some new prescriptions, Molefi has been recovering at a remarkable rate.

He is now chowing down his bowls of plumpy nut and porridge, the same bowls that, before his turn-around, he would look at solemnly and turn his head away from. He is all smiles and giggles now, after being stoic and silent and melancholy before.

As I continue preparing to leave TTL next week -- when my year-long fellowship comes to an end -- I can't help thinking of all the kids I've seen during this year, and in both categories: those who have struggled and died and those who have made miraculous recoveries.

I know that in pursuing a mission like TTL's, there will inevitably be both realities to contend with. And it's tempting, in a way, to think that I will remember only the good outcomes, the success stories.

But, of course, that would be foolish and fake.

It is precisely the dichotomy between the tragic loses and the triumphant victories, and their combined and disobliging tendency to occur simultaneously, that has struck me the deepest, and which I know will remain etched in my head forever.

Responding to Destruction

2011-02-07T23:55:00.000-08:00

Disaster isn't a reality you can ignore -- a fact that is becoming more and more obvious as we continue to see the effects of the flooding and rain on our clients, their crops, their family food security, and their overall well-being.

In addressing this reality, and in an attempt to prepare ourselves for the coming fight against its effects, TTL has officially begun efforts to start quantifying the destruction.

We have given our outreach teams a new "Water Damage Survey" that they will fill out for each client, detailing the condition of the road to the client's village, the condition of the home, the outlook for the upcoming harvest and a variety of other associated factors.

During the next few weeks, we will compile the information from these forms into weekly reports of conditions here on the ground, as we are seeing them first-hand. We will then use those reports to shape our physical response to the emergency -- whether that be in the form of bulked-up food packages, home repairs, or something else -- when the time comes for such a response. That time, as we see it, will likely begin with what will inevitably be a devastating and insufficient harvest season, in late March.

Not that the problems haven't already begun.

Just yesterday, one of our outreach teams returned with a client whose home in St. Martin is crumbling around his poor family. The rondavel's walls are dripping with moisture, and large patterns of mold have formed in off-white blotches and blackened spots. The heavy rains are literally washing the home away. Mothofeela-Folomane is 15-months-old and just 5.4 kg, or just under 12 pounds.

He is now at the hospital, and after his stay there, he will come to the safe-home for a stint of recovery. But after that, we're not sure whether his family will have a home for him to return to. This is one of the realities we will be trying to address with our water-damage forms and our associated response to what they tell us.

The next few months are going to be quite busy for TTL. Hopefully, we can put a dent in the destruction.

Disaster Flooding Emergency

2011-02-03T02:46:00.000-08:00

Part of the reason for such a large influx of babies into the safe-home in the past couple weeks is that flooding throughout the country has had a devastating affect on rural communities and their access to outside aid, crop production, and overall home stability.

Entire communities have been completely cut off because of destroyed roads, and many international aid organizations are beginning to ramp up emergency response efforts in the country, as more rain is expected.

For some context, I have pasted below information about the flooding in Lesotho from the most recent weekly report on the issue out of the United Nations Office for the Coordination of Humanitarian Affairs:

In Lesotho, heavy rains have claimed the lives of 30 people and 4,000 livestock. More than 30 houses have collapsed in the affected villages, and almost 50 % of the roads have been destroyed, rendering health centres and schools inaccessible.

The main pump distributing water in Maseru has also been damaged, which has interrupted water supply. At least 500 cases of diarrhea have been reported.

More than 60% of the fields planted with mainly maize, beans, sorghum and potatoes and 40% of garden crops have been destroyed by hailstorms and heavy rains.

Rapid assessments are being conducted throughout the country to inform the government on the immediate interventions to be implemented. The National Red Cross Society is assisting those affected with temporary shelter.

WFP's operations have also been hampered by the heavy rains. A total of 101 out of 429 schools in its school feeding program could not be reached, affecting 13,920 students. Four health centers in Thaba Tseka are inaccessible leaving 1,123 patients (pregnant mothers and children under 2 years) without their food rations. The country office is working on alternative measures to reach these beneficiaries.

Since reading this, I have reached out to the UN OCHA office, offering TTL's assistance in distributing food and/or other resources to the remote communities we serve.

For a country already in need of so much help, I fear an emergency like this is going to be devastating.

When it Rains it Pours

2011-02-01T06:50:00.000-08:00

It seems that when it rains here, it pours -- and I'm not just talking about the massively wet weather we have been having, which is causing flooding, washing out roads, destroying crop fields, ruining some rural homes, and making life muddy in general.

I'm also talking about the fact that, suddenly, we have 11 babies here in the safe-home: Nthabiseng, Retsepile (#1), Khutliso, Molefi, Retsepile (#2), Kabelo, the twins Thabelo and Ithabeleng, Neo, Nthabeleng and Retsepile (#3).

Nthabeleng, who shares a name with the big boss here, just arrived yesterday, while Retsepile (#3) just arrived today.

As 'Me Nthabeleng, who left last week for Maseru when we only had 7 babies here, said to me upon her return this afternoon, "With the safe-home, you never know what you'll get from day to day."

It's definitely a full-house. This afternoon, Eric and I joined Meghan -- the new TTLF fellow, and my replacement, who arrived last week -- in holding and playing with the babies along with the bo'me.

The toddlers are always fun to play with, but little Kabelo has also become one of my favorites. He's adorable and very calm, taking everything in and rarely crying.

Having this many babies at this point means something special for me: Through the end of my stay, which is in just two weeks, there will be plenty of opportunities to help out the bo'me, to give a bottle, or just to hold a baby for a while.

I'm glad that is the case. Once I'm home, I think I'll miss the babies the most.

Waking Up to Death

2011-01-29T06:09:00.000-08:00

My emotions are running high. I am still processing everything that happened. Writing is always cathartic for me, and so I've turned to write here:

I was woken up this morning with the all too familiar phrase, "Ntate Kevin, we need your help."

I jumped up, got dressed, and went down to the safe-home. There, in the changing room, was an 8-month-old TTL client named Thabiso. He looked the proper weight, looked relatively healthy, but his face was blank. I waved my hand in front of his eyes, to no response.

I followed Shamena, one of our safe-home caregivers, to the front of the office, to where the boy's parents were. The mother was crying, the father looked stricken. I asked what the problem was with the child, and was told that he was vomiting and had diarrhea and had been suffering from a high fever for about two days. I knew the combination of these symptoms to be an extremely serious one in young kids, and told the parents that they needed to take the boy to the hospital immediately.

Shamena and I went back to the changing room to get the boy, and knew immediately the awful truth: he was dead. We went through a few standard checks to confirm the grim reality that we already knew to be true. Shamena then tried to close little Thabiso's eyes, but they wouldn't remain shut. We were both uneasy. There were the parents in the other room. They had come to us for help, but it had been too late.

I scooped the tiny body into my arms and carried the bundle back to the parents. Few words were exchanged. I offered my condolences, and the mother wailed, and the father still seemed stricken.

I called Matello, our outreach coordinator, and went and picked her up from town and brought her back to TTL. She spoke with the parents briefly, and it was determined that we would take them and their lost child back to their village.

We all got in the car and started the long drive out to St. Martin, where they are from. About an hour into the trip, Thabiso's father had us stop in a village where a large number of people had gathered to welcome back a group of boys who had just gone through circumcision initiation. There he had a man on the street go and fetch his two brothers, Thabiso's two young uncles, who he knew to be there.

Again, the scene was hugely emotional, and the mother wailed, and the uncles shook in disbelief at seeing their brother and his wife obviously going through unbearable pain.

We continued on. When we got to their village, we all got out. Again the mother began wailing, which announced the horrible news to the village as we entered it. Neighbors and family members began pouring out of rondavals and coming to the grieving couple and the two uncles. The women went to the side of the mother, the men to the sides of the father and uncles.

We went into a large rondaval. One of the uncles collapsed against the wall and slid into a pile on the floor, weeping. Women formed a circle on the floor around Thabiso's mother, and collectively they moaned and rocked in anguish.

Village elders began arriving. I felt awful for the family, awkward and strange for being in this tight circle of grief as an outsider. One of the elders began praying, and we all dropped our heads in silence.

On the long drive home, Matello told me that Thabiso was the seventh of seven children of the young couple to die. The first six had all died in the first few months of their lives. Thabiso, at 8-months-old, had been their great hope. He had been healthy until the sudden fever and onslaught of diarrhea and vomiting.

Now back at TTL, I am still trying to process my morning. I feel so bad for the young couple. Why have they been given such a disproportionate amount of grief?

Is there an answer?

Right on Our Doorstep

2011-01-27T08:10:00.000-08:00

This afternoon, Matello, our outreach coordinator, came to me with a pressing concern.

One of our safe-home caregivers had arrived at work with information about a young boy, in a village not five minutes from TTL named Checha, who appeared to be severely malnourished and in an unstable home situation.

The mother of 16-month-old Molefi had arrived with him at her own grandfather's house a few days before Christmas, ostensibly on a holiday visit. A few days later, she had vanished, leaving Molefi behind with his 75-year-old, half-blind and hard-of-hearing great grandfather.

The current location of Molefi's mother, and of his own grandparents, is unknown.

At times, TTL is reluctant to bring children to the safe-home who may never be able to be reunited with family once healthy. As TTL is not an orphanage, such situations can present a maze of problems, and it is sometimes better to refer the child directly to the Department of Social Welfare. At the same time, however, it is often a moral imperative that we intervene immediately -- as I felt was the case in this situation.

Matello and I made the decision to go to the village right away to assess the situation, and if necessary, talk to the village chief about bringing the child to the safe-home -- for reintegration concerns to be hashed out later.

When we arrived at the home, the stone front of which was crumbling, we talked to the great grandfather, who ushered us inside. There we found Molefi, and an older female cousin, sitting on the ground eating small bowls of papa and potatoes. The girl's mother, Molefi's aunt, was also in the home, behind a curtain, nursing her own baby.

Molefi was filthy and covered in flies, which I tried to swat away in vain. The great grandfather, obviously very caring, showed his concern and asked for our help. To stand Molefi up and show us the boy's malnourished condition, the old man tried to take the bowl of papa away from Molefi, who cried and clung to the bowl with what seemed a sad desperation for the scant calories it held.

I picked him up and carried him outside so we could weigh and measure him. As I began removing his clothes, I realized the bottom edge of his shirt, at the back, was caked in his own dried feces.

It didn't take long for us to determine that we would take Molefi with us. With that in mind, we loaded him and his great grandfather into our car and drove over to the home of the chief.

After a long discussion in Sesotho, the chief agreed to write a letter acknowledging his knowledge of the great grandfather's arrangement with TTL, and we were soon driving back to the safe-home, Matello holding Molefi in the passenger seat.

Since then, the bo'me here have given him a bath and dressed him in clean clothes. He is now sitting in the playroom, drawing the interest of the other toddlers in our care.

For me, the entire episode was a reminder of the massive need here in Mokhotlong -- not just in the surrounding villages, but practically on TTL's doorstep.

I wish I knew the reason why his mother felt she needed to leave him behind. But without that knowledge, I only feel the relief of knowing that he is now here, as safe and cared for as a child can be.

Stopped in My Tracks

2011-01-20T23:18:00.000-08:00

It's funny how sometimes, when a tough, out-of-the-ordinary task becomes routine, it takes just one, unexpected failure among regular successes to stop you in your tracks, to have you once again realize the enormity and impressiveness of the act.

Such was the case yesterday, when I was reminded once more of just how amazing TTL's outreach efforts are.

I was in the office, catching up on a number of things after being away, when I saw most of our outreach team through the front window, mulling around and loading up one of the cars. I opened the window to say hello to Matello, our outreach coordinator.

"Can you come with us?" she said.

At this point in my year here, I still go on outreach occasionally, but not when I'm swimming in office work, and I was a bit surprised at the request.

"Maybe," I said. "Why?"

"The Land Cruiser -- it's stuck."

Apparently, the day before, unbeknownst to me, one of our outreach teams had gotten TTL's gigantic and extremely powerful Toyota Land Cruiser -- a gift from UNICEF -- stuck in the mud past Malefiloane Clinic.

This shocked me.

I've been stuck in the mud in TTL's other cars, but never in the Cruiser. In the Cruiser, I've crossed through rivers; I've driven over boulders; I've off-roaded on mountain slopes; I've driven at inclines I never knew possible. In other words, in the Cruiser, mud is nothing.

"The Cruiser is stuck?"

"Yes," Matello said, "and you should come."

She explained that she and the other three Mokhotlong outreach workers, including our two male drivers, were all going in another TTL truck to try to pull the Cruiser out of the mud, but that they needed another driver so that one of the men could push from the outside while the two others drove. That other driver was me.

We set off through the mountains and I smiled as I took in their seasonal beauty. A crisscrossing pattern of peaks and valleys, turned green in the summer sun, shepherded mist clouds through their cracks.

"Is the Cruiser blocking the road?" I asked, suddenly curious as to whether there would be a line of angry people stuck on one side of the Cruiser or the other.

Silly me. I should have known better, really.

One of the outreach workers, Nthabeleng, who was sitting next to me, smiled, quickly showing in the expression that my question was irrelevant.

"No one drives there," she said.

About an hour after leaving TTL, we reached a particularly muddy stretch of the road, and there ahead I saw the Cruiser -- or, that is, I saw most of it. I laughed out loud.

We stopped and got out. The Cruiser looked as if it had been driving along the road when its front left wheel suddenly sunk a solid foot-and-a-half into the ground, its back left wheel sunk more than a foot, and its right wheels both sunk about half-a-foot.

The front left wheel was barely visible -- and these are big wheels. The Cruiser's major clearance was gone, mud up to the bottom of the car, with pools of muddy water collecting all around it, making the situation seem even more hopeless. When something like this can happen to a vehicle like the Land Cruiser, I thought, no wonder the old, battered taxi vans and the ancient trucks people drive don't come out here.

Just then, TTL's formidable presence in the surrounding mountains -- dotted with villages I know we have visited before and will visit again -- struck me on a deep level. We literally go where others can't and won't.

After a long process of tying the back of the Cruiser and the front of our other truck to a large, 4- or 5-foot metal tow bar, we all took our positions. I climbed through the mud into the driver's seat of the Cruiser. I felt there like I was in a boat, with the bottom half of my vessel submerged.

Both cars were started, and to my surprise, with the combination of both cars reversing -- the Cruiser's massive power still apparent despite being half sunk -- we got the Cruiser out of the mud. The herd boys milling around -- whose cows I thought we were going to have to recruit -- seemed impressed.

The drive back seemed quick. I spent it behind the wheel of the Cruiser, and as I drove up steep inclines, over rocks and through streams, I marveled once again at TTL's outreach program.

In my mind, it is only at the ends of the earth that the Cruiser would get stuck.

There we were. And there we will go again.

Fat Faces Greet Me Home

2011-01-18T05:25:00.000-08:00

I haven't posted in a while because I just returned to TTL today after spending two weeks on vacation, traveling through South Africa and Lesotho with two of my brothers, Conor and Casey.

Throughout our trip, our rapid transitions between Third World conditions and First World conditions -- between Lesotho and South Africa, but also within South Africa itself -- stood out, as did the quite obvious, physical separations we noted between the neatly lined official towns in South Africa and the dilapidated shanty towns on their outskirts.

We also enjoyed our time immensely -- among other things, we did the "World's Highest Bungee Jump" off Bloukrans Bridge -- and I was glad to be able to show my brothers Mokhotlong and TTL.

When I got back to TTL today, I was surprised -- just as I was in September, when I returned from a short trip to the states -- at how the babies in our care seem to have changed and recovered greatly in just two weeks.

When you see them every day, their recoveries seem far more gradual. Skipping two weeks, they seem as rapid as they are -- the kids fatter and more lively. Retsepile in particular seems a chunkier, happier baby overall.

We also have a new pair of twins here who were born at the beginning of the month: Thabelo and Ithabeleng. They are the first new clients in the safe-home in 2011, and are tiny, tiny, tiny. Thabelo is just over 5 pounds, while Ithabeleng is just under 5 pounds.

It feels good to be back after so much traveling. I'm at home again, and the fact that TTL has become that for me is now more apparent than ever.

It's hard to believe that I now have less than a month to go in my year-long fellowship, that I'll be moving back to my other "home" soon. I'm sure that fact is going to cause some conflicting emotions as the deadline looms closer.

For now, though, I'm just happy to see those fat faces. In the next month, I think I'll be sneaking into the playroom more than ever.

My New Year's Resolution

2010-12-31T04:50:00.001-08:00

Today is New Year's Eve, and so my time in Mokhotlong is winding down. I return home in just a month and a half -- a place that still seems distant, but a place I thought of today in terms of my future and my "resolution" for 2011.

This year has been so transformative for me, I at first questioned whether I could think of a resolution befitting that transformation, befitting how I want that transformation to affect my life moving forward.

For me, New Year's Eve always brings to mind fond memories of my maternal grandfather, who my siblings, cousins and I all called "Captain Joe."

He was an amazing man: a former captain of a nuclear submarine in the U.S. Navy who was raised by Irish immigrant parents and who raised nine kids of his own with my grandmother. All his Irish character made him the grandfather I remember -- forthright and proud and wonderfully communicative with his young, admiring grandchildren.

Each New Year's Eve, my siblings and I stayed with him and my grandmother. We picked a movie -- usually a grandiose film influenced by his suggestions, like King Kong -- and we each got to select a box of candy to celebrate with. We'd inevitably fall asleep before midnight, but come midnight, or just before, he would wake all of us up to go out into the front yard and bang on pots and pans -- neighbors be damned.

In years to come, New Year's Eve became something else -- a time when wild ideas about what the future would hold filled my imagination. I remember thinking about flying cars and transportation devices, often with the impression that such fantastic inventions had a real chance of being around, come some futuristic sounding year, like, say, 2011.

It's strange now to be with those memories here, where for many people, cars in general aren't even a reality they have access to, much less flying cars.

Back when I was a kid in the late 1980s and early 1990s, imagining fantastic things, what were young rural Basotho imagining? I wonder.

This year, in many ways, my thoughts of the future are less about what my own life will hold than about what Mokhotlong will be like then. Will things have drastically changed? What will TTL be like? Will our network of supporters still be strong?

Will there be a cure for HIV? And like cars today, if there is a cure, will the poorest of the poor have access to it?

I've decided that my New Year's resolution this year is to keep asking questions like that, to keep wondering what the future will hold, not just for myself, but for others -- and whether I can affect that future in a positive way.

Will I be able to improve my life this year? Well, it's already pretty good.

More important: Will I be able to improve someone else's life this year? And if so, how?

To that, another amazing man and my paternal grandfather, who I called Poppy, comes to mind. He used to say that a key strength in a person was the ability to be "unobtrusively aggressive," and I think that's just right.

Sometimes, banging on pots and pans is just the thing to do.

An X-ray Dustpan

2010-12-28T00:39:00.000-08:00

Today, as I sat in the entrance to the Mokhotlong Government Hospital waiting to meet with the District Medical Officer about some TTL business, I watched as a cleaning woman swept the floor with two items: the common bundle of thatch people in Lesotho use for a broom, and a child's chest X-ray for a dustpan.

The X-ray sheet must have been discarded at some point, or left behind in a place that gave the woman the impression that it could be refitted as a cleaning tool. Still, I have experienced too many instances at the hospital of lost or misplaced X-rays delaying the treatment of a child for the sight to register anything in me but vexation.

Nthabiseng, for one, is back in the safe-home now after having spent a good amount of time in the hospital. When we first took her there two weeks ago for her trouble breathing, the doctor who saw her suggested the problem might be either TB or that she had swallowed a foreign object, and scheduled a chest X-ray for the following day.

But in all my follow ups, I was unable to determine just what the doctor had observed when looking at the X-ray, or even where the X-ray was. Was there TB? Was there a foreign object? Apparently there was neither, as we would have heard about it if there was. But there was no X-ray to be found, either.

From looking through her bukana, or health booklet, I learned Nthabiseng was diagnosed instead as having "AZT-induced PCP," or a form of pneumonia commonly found in malnourished children and people with weak immune systems, and which had been induced in Nthabiseng by her new regimen of antiretroviral HIV medication.

Today, back at TTL, she is still wheezing a bit, but seems better and will hopefully conquer her illness -- just as Retsepile seems to have conquered his.

Since having received the correct diagnosis of TB, and starting the proper medications for it, the tiny, emaciated little boy who not long ago was too weak to sit up, and who was so ill the doctor said he "probably won't make it," is now gaining weight rapidly and turning into the happy little boy he's always had the potential to be. It's been a heartwarming transformation to watch.

Nthabiseng and Retsepile are two of only five babies in the safe-home now, as the other, younger Nthabiseng -- who had been here since birth -- and rambunctious little Kokonyana both went home last week.

The other three remaining babies are: Khutliso, who is recovering well and is no longer vomiting his prescribed daily intake of plumpy nut; the younger Retsepile, now a chunky little girl; and Kabelo, whose arrival I recently wrote about.

We haven't lost any children for some time here, which means our low numbers in the safe-home are indicative only of a string of TTL successes -- a great reality to consider.

It's a reality, for one reason or another, that stands in contrast in my mind with the sight of an X-ray being used as a dustpan at the hospital. We are swimming upstream here, but we are winning.

Mpho Goes Home

2010-12-19T23:01:00.000-08:00

Today marked another departure from the safe-home. Mpho went home.

He first came here shortly after being born on June 6, weighing less than 4 pounds. He was born a twin, but his twin died. He's been here ever since, the bo'me caring for him through many stages of his development. From less than 4 pounds, he is now more than 13 pounds.

We've all grown fond of Mpho, who looks on everything with big, curious eyes and who, more recently, has been quick with a smile for you if you say his name or tickle him a bit.

He still has the chronic skin rash that has frustrated the bo'me and local doctors alike since his coming to TTL. But we are hoping it will clear up back home, with less soaps and less baths.

I'll miss Mpho, a friendly, familiar little face in the play room. I'll even miss his cry, which I had learned to distinguish from the other babies' cries and which he had a particular talent for making known throughout the safe-home.

But he is healthy, and strong, and is now going home stable after a harrowing birth and an uncertain beginning to life. And that's what it's all about.

"a headache for three days"

2010-12-15T01:46:00.000-08:00

Another baby boy arrived at TTL yesterday, another child orphaned shortly after birth. Born on November 7, his mother died on December 8, likely from complications of HIV/AIDS.

Like many people in Mokhotlong, she died amidst a sad and troublesome dearth of information, after seeming healthy and then having "a headache for three days."

From a Western perspective, it seems ridiculous when death is explained away as the result of a sudden ailment as seemingly innocuous as a "headache," or "chest pain," but here it happens all the time.

In Mokhotlong, those reasons seem more common than anything else in explaining death. Among our clients who have lost one parent or both, undiagnosed ailments are at the top of the list of killers, while "cancer" and "heart attack" are almost unheard of.

Kabelo, the little boy now in TTL's care, was brought here by his maternal grandfather, an old man who is already taking care of two other children with the help of his sister. They are another example of the elderly taking care of the young, with the middle generation wiped out by AIDS.

While Kabelo's grandfather and great aunt seem to love him, they don't have the resources or energy to provide the constant care a newborn needs -- especially with two older children to look after.

Thankfully, Kabelo seems pretty healthy, and a temporary stint at the safe-home will serve him well as his grandfather figures out the best care situation for him. He's a cute little guy, born heavy for Basotho children at more than 7 pounds, and is eating well.

The only sad part about his health is that, in a way, it is yet another indication of how tragic his mother's death was, as it is proof that she was breastfeeding him just fine until the sudden onslaught of her "headache."

Her death adds Kabelo to the already staggeringly high number of orphans in Lesotho. TTL will do what it can to help, but we can't replace Kabelo's mother.

With death, it's always hard not to ask why. It's harder still when the only available answer is "a headache for three days."

A Holiday Message

2010-12-13T23:39:00.000-08:00

Dear family and friends,

I am writing to you for a reason.

Of course, I wish you all Happy Holidays, a great 2011, warmth and joy and all the things that make the holidays in the U.S. so special. But really, that's not the reason I'm writing.

I'm writing because I know your hearts, because you're the people I count on, because I know you can help the community I have gotten to know this year. I am writing on behalf of children I've gotten close to, who don't have their own network of family and friends to rely on but who need support this holiday season more than anyone in the world.

I'll be spending this Christmas and New Year's in Mokhotlong, Lesotho, where I have been working since February with Touching Tiny Lives, a local charitable trust that provides life-saving support to children under five in this poor and HIV/AIDS-ravaged country in southern Africa.

What I have seen this past year has been both profoundly unnerving and profoundly uplifting -- horrible illness and unspeakable malnutrition, but also a locally-run organization that is making a difference, saving the lives of children, one child after another.

The story of one of those children, 16-month-old Ntseliseng, speaks to both the sadness and the hope. When she arrived at TTL in April, she was an orphan on the verge of death, fighting undiagnosed HIV and other illnesses, an infestation of scabies, and malnutrition so severe that her tongue barely fit in her sunken cheeks. Her stomach was distended from hunger and her legs were completely undeveloped.

Three months later, after 24-hour intensive care and nourishment at the TTL safe-home, Ntseliseng had transformed into a happy and healthy toddler, on a successful regimen of medication for HIV and taking her very first steps. She was soon reunited with a loving aunt who TTL helped find and who has stepped forward to be her full-time caregiver. She remains in good health, and her future now looks bright.

This year I've seen many children like Ntseliseng, and it's been difficult. Sometimes I curse the rotten luck these babies have received in life, born orphaned into pain and poverty. Sometimes I question why I am so lucky, with all my family and friends, with my health. Sometimes I feel unavoidably uneasy about the disparity. When I sat down to write this letter, I felt the same sense of awkwardness we all feel when we ask for things from others.

But I don't care about that. I want you to know that this isn't about me. It isn't really about you, either. It's about all of us realizing that $50 can literally save a child's life, or that $100 can give a child another chance, a chance he or she certainly deserves after getting such a raw deal at the start.

Touching Tiny Lives here in Mokhotlong receives a majority of its funding from the Touching Tiny Lives Foundation in the U.S., the organization that hired me to work here and an organization that survives on donations from individuals like yourselves.

With the funding from TTLF, the staff of TTL provides transportation for children to mountainous clinics and hospitals that are otherwise impossible to reach; delivers life-saving food packages to children in their rural villages; rehabilitates the most ill and malnourished babies in the TTL safe-home; and supports HIV-positive pregnant women and new mothers so they don't transmit the disease to their babies.

Even a small amount of U.S. money goes a long way here in Lesotho. Please help. I wouldn't ask if I didn't know how much your support matters. Donations referencing this letter or my name can be made at www.touchingtinylives.org.

All my love and thanks,

Kevin

Coughing in a Storm

2010-12-13T02:41:00.000-08:00

This weekend passed by in what seemed to be one massive rain cloud, a cloud that would not pass through town itself, that lingered and dumped much-needed rain on Mokhotlong in torrential bursts and constant drizzles.

An ever-changing pattern of angry dark grays and wispy light grays clouded in around the mountain peaks, obscuring them from view and making the town itself seem like a giant ship cast out and isolated in a raging storm.

Here the rain is a joyful event, it means life, and the people in town seem to hole up away from the pervasive wetness not in dreary acceptance, but in appreciative retreat -- retreat from wetness and worry all at once.

Amidst the bubble of rain, though, even in TTL's warm and dry safe-home, Nthabiseng's slight cough and congestion progressed to the point where her breathing became worrisome -- where we thought she could soon stop breathing all together, and at any moment. We took her to the hospital on Saturday afternoon, and there she was looked over by the doctor and admitted in the children's ward. A chest X-ray was taken today, but no doctor has reviewed it yet.

So, while the sky has opened up at last and the sun has made its first appearance in days, we are still in the dark as to Nthabiseng's condition.

Here, what seems like a chest cold can just as easily be TB. It's a scary thing to wonder about the fate of a child who one day is giggling happily, and the next is laboring to breath, and whose antibiotic prescription doesn't seem to be working.

"Do you think it's TB?" you find yourself asking the doctor.

"Could be," he says.

"Ach," you say, and you look into the sky and the clouds billow greatly there, and you wonder about it all and the fate of one tiny child in such a big world.

Mokhotlong Marathon!

2010-12-04T02:11:00.000-08:00

TTL Fellow Eric finished the Mokhotlong High Altitude Marathon strong today, and when we got back to the safe-home, the bo'me gave him lots of cheers:

What a World AIDS Day

2010-12-01T23:50:00.000-08:00

Yesterday I found myself taking styrofoam-encased lunches from the hands of a doctor and putting them into the hands of poor Basotho -- children and women and men -- one after another after another.

I was just one cog in an assembly line of food distribution. The pace was rapid, with wranglers urging the long line of children -- separate from the long line of adults -- to move quickly past me as I did my best to keep up. A lunch would come into my right hand, I'd pass it to my left hand, then pass it into the hands of the next child, even as my right hand was accepting the next lunch.

Yesterday was World AIDS Day, and the food distribution was part of a large-scale HIV-testing event planned and paid for by the Baylor International Pediatric AIDS Initiative, a close working partner of TTL's.

The event was supported by TTL and a host of other groups -- including Kick 4 Life, which uses the influence of sports to fight HIV, and the Ministry of Health. Counselors and nurses from the Mokhotlong Hospital and the St. Martin clinic were on hand, as were representatives from the World Food Programme, Peace Corps and a few other organizations.

Aside from lunch time, which saw all hands on deck helping with distribution, Team TTL -- Eric, Matello and I -- spent the day weighing and measuring all children under five, screening them for malnutrition.

About 200 people, many of them young students, were tested for HIV and given a free meal, and TTL screened about 20 children. A handful were underweight, and we are going to follow up with them as potential clients.

In the morning we set up tents around the local school, and various testing stations were established therein. TTL was stationed in a classroom with a dirt floor, a few posters of multiplication tables and fractions on the walls and a crumbling drywall ceiling that was falling to pieces beneath the corrugated metal roofing. With us were a few nurses from Mokhotlong Hospital who were giving immunizations to the same kids we were seeing.

Throughout the morning and into the afternoon, we weighed and measured kids as they cried for fear of the scale and the length board. I got peed on twice, which is par for the course.

At moments when the stream of babies slowed, I watched out the window as school children stood in single file lines, waiting for their turn to be tested. Many of them were completely without their caregivers, and I thought about how scary the process could potentially be.

Their status wasn't told to them right away after the test. Instead, different cards were handed out requesting them to return to the clinic with their caregivers at different times for the results. This made me feel a little better, but I felt bad for the kids nonetheless.

Still, their being tested is important, and events like this one make a real difference.

As the long day winded down, we again packed the vehicle with the tents and climbed inside. Two counselors from Mokhotlong Hospital had gotten a ride with us, and climbed in again for the bumpy two hour ride back to Mokhotlong.

On the ride back, I pictured again the smiling faces of the children as they rushed past me and I stuck a lunch into their waiting arms, saw again the little red ribbons pinned on their shirts that signified they'd been tested.

World AIDS Day 2010. What a day, I thought.

Paballo Goes Home

2010-11-28T10:53:00.001-08:00

Paballo, a definite candidate for cutest little girl in the world, is going home.

Here she is the day of her arrival at the safe-home and the day before her departure.

This is what TTL does:

Thanksgiving Poem

2010-11-24T22:21:00.000-08:00

Thanksgiving 2010

This past year has been a bit unnerving. Here's to giving thanks, sincere and deserving:

Thanks for my family. Thanks for my friends. Thanks for stability and ends meeting ends.

Thanks for my health. Thanks for my mind. Thanks for second chances, time after time.

Thanks for my shelter. Thanks for my bed. Thanks for education, for becoming well-read.

Thanks for experiences. Thanks for adventure. Thanks for my freedom, away from brute censure.

Thanks for humanity. Thanks for community. Thanks for talent, skill and ability.

Thanks for the future. Thanks for hope. Thanks for the reasons we have not to mope.

Most of all, thanks for resilience and my feeling near it. Thanks for the steady, iron-willed human spirit.

Happy Thanksgiving everyone!

1 Through 9

2010-11-23T00:00:00.000-08:00

Things have been so busy here that today, when I finally took a moment to do a headcount, and realized we currently have 9 babies in the safe-home, I was a bit surprised. I wondered if I could name them all.

Happily, I could, but it took a few minutes.

Here's an update:

1. Paballo (Girl - 18 months) -- She is adorable and sweet. She is also still a crier, but now it seems I comfort her. The other morning, after she had been crying for quite some time, 'Me Nthabeleng suddenly showed up in the fellows' office and handed her over to me. She immediately stopped crying and said, "Ntate," in her sweet little voice. I smiled and Nthabeleng laughed. Paballo goes home on Friday, where she won't be as coddled. Hopefully she will adapt quickly.

2. Retsepile (Boy - 20 months) -- After yet another sickness that had him losing weight, he finally seems to be back on track. The TB treatment seems to be working. He is finally gaining weight and sitting up, and appears to have a bit more energy. He smiles when I play with him, but he is still unable to move around and I think he gets envious of the other toddlers' fun. Hopefully he will be able to join them soon enough.

3. Retsepile (Girl - 3 months) -- She is still small, but is considerably larger than when she first arrived at TTL in September, shortly after her own birth and her mother's death. All her life has been at TTL. She'll likely remain here for a while longer, as she currently has no care-giver to take care of her while her father works. We're hoping to solve that problem.

4. Tseliso (Boy - 2 months) -- He arrived not long ago, too small and frail. He has wide, curious eyes and a shock of dark black hair. He's feeding well and hopefully will gain strength rapidly.

5. Khutliso (Boy - 16 months) -- He arrived last week with his grandmother, malnourished and lethargic. I helped complete the client intake form and then held and tried to comfort him while his grandmother packed her things and left. His eyes were so sad, I had to make a conscious effort to appear happy, hoping it might ease his fear. Now he smiles at me every time I go into the playroom, and I think the first-impression trick may have worked. I think we'll be good buddies soon, and with the help of plumpy nut, he will hopefully put on weight quickly.

6. Nthabiseng (Girl - 6 months) -- She has also been at TTL all her life. Her twin, Pulane, was here as well, but passed away. She's come so far, from the tiny premature infant she was when she first arrived to the chunky-cheeked baby she is today. She will likely go home next month, and I know the bo'me here, who have raised her, will miss her.

7. Nthabiseng (Girl - 28 months) -- She just arrived on Friday, malnourished but smiling. Her bukana tells the story of multiple counseling sessions for drug adherence, and multiple defaults. Taking medicine for HIV unsteadily, and missing doses, is very bad for you, which is worrisome in terms of her overall success on the regimen. Her mother is apparently gone, "disappeared" not long ago, and her father dropped her off in her village in Thaba Tseka before departing for Maseru himself. Hopefully, staying at TTL, Nthabiseng will get to a point where she is healthy and happy, on the right medications, and we can return her to her grandmother in Thaba Tseka. She is a very sweet little girl, and she seems to like me, giggling when I play with her. I acted goofy and made a fool of myself early on in our relationship, which always helps.

8. Kokonyana (Girl - 7 months) -- Severely underweight and on plumpy nut, she is a cute little girl who seems uneasy much of the time. I think she is still getting used to being fed. She wails every meal. Hopefully she will learn to like food soon, as she needs as much as she can get.

9. Mpho (Boy - 5 months) -- He has been at TTL for quite some time. His mother has been ill since his birth, during which his twin passed away. We are hoping his mother recovers. In the meantime, we have seen some improvement in his chronic skin rash and are hoping it will go away for good soon.

It is quite a sight to see the safe-home in action with so many clients currently residing here. Each of them has such an amazing story of survival. They are all fighters, tough before they should need to be.

It's also heartwarming to see their progress. Like TTL's motto says -- "One Child at a Time."

10,000

2010-11-21T03:45:00.000-08:00

Living and working at a safe-home for babies, it's easy to lose track of time except as it relates to the babies themselves.

On a day-to-day basis, the progression of time seems marked only by specific realities of the babies' lives, like how many days in a row one child's weight has increased, or the length of another child's hospital stay.

Overall, the moments that mark my mental calendar are special milestones in the babies' lives, like when a child walks unassisted for the first time, blurts out a first word, celebrates a birthday or goes home healthy. In a world where many children die before reaching these early milestones, the significance of TTL's vulnerable clients reaching them is accentuated. Witnessing these moments is a miraculous way to mark the passage of time.

I first thought of the special nature of milestones here recently, when an entirely different sort of milestone was reached on this blog: 10,000 visitor hits.

While not as emotionally compelling as a child's first steps, the number is important in its own right as an indication of the large and growing network of individuals who care about TTL and what is going on here.

Living in Mokhotlong, seeing what TTL is doing on behalf of children on a daily basis, I gain strength from my sense of that network. Writing this blog has become cathartic for me, partly because I see it as a direct line to all sorts of people who I know can and will help TTL in times of need.

We want to keep giving babies renewed chances at health and happiness. We want to make sure they reach the milestones of young life that shouldn't be denied anyone. As TTL continues to seek new and better ways to serve children in the remote reaches of Lesotho, our network of family and friends continues to gain importance in that fight. The more people who care, the better prepared TTL will be to face the future.

Reaching 10,000 hits on this blog is a milestone I'm genuinely happy to have reached, and I thank all of you for caring and taking the time to check in on us here at TTL. There is no doubt we need you.

Last I heard, out of a national population of about 1.9 million in Lesotho, there are an estimated 270,000 orphans. That's about 14 percent of the population, a staggering statistic that highlights just how many children in this country are in need of critical, life-saving support.

To continue providing that support, to continue giving little babies the chance to walk for the first time or to speak a first word, we're going to need all the help we can get -- and you all checking in on how we are doing, 10,000 times over, makes me confident that we will indeed get it.

So, thanks!

Holding Down

2010-11-20T02:07:00.000-08:00

Frustration and anger came yesterday in throbbing, repetitive doses as I held down a little boy's arms so a nurse could give him two shots in the thighs. He wailed on the hospital bed. I furrowed my brow and tried to concentrate. I tried to understand but couldn't, didn't want to.

It was neglect for the sake of neglect, utter disregard for a child, and I was angry. I still am. I feel powerless. I'm shaken.

Rethabile is a double orphan and a former client of TTL who spent six months in the safe-home last year. He went home happy and healthy, to a family that includes his grandmother and his aunt. The TTL staff had high hopes.

It wasn't long before our outreach team realized the family was neglecting Rethabile, giving the food provisions to other children, leaving Rethabile filthy, untouched, unloved, unfed, unwanted.

There was much back and forth before Rethabile was graduated from the TTL program.

Fast-forward to last week, when Rethabile's aunt brought him to TTL once more. Now a severely malnourished boy of 28 months, he had a severe rash that was causing welting all over his body and head. He had severe edema -- excess watery fluid collecting in the cavities or tissues of the body -- in his arms, hands, legs and feet. His feet were so swollen they looked like balloons that would pop with a needle prick.

His aunt had skipped the hospital because she didn't want to stay there with her nephew, even though that was clearly where he needed to be. She just wanted to dump him at TTL.

We escorted her to the hospital, where we told her we would pay for the bills and check in on her again the next day. The next day, we found she had left after talking to some nurses, who told her to see the doctor. Not wanting to stay at the hospital, she had taken Rethabile back to his village -- and in such horrible condition.

I was confused by the situation. I knew the aunt and grandmother were caring for other kids as well, and that the food situation in the home was unstable. I know of the difficulty of hygiene in a packed rondaval, and sympathized.

Still, knowing Rethabile was suffering, TTL had to do something.

Yesterday, Matello, our outreach coordinator, managed to get the police to go with her to Rethabile's home to talk to the family. Once there, they were appalled.

I had just returned from Maseru when Matello arrived at TTL with Rethabile and his grandmother, who had agreed to accompany her grandson to the hospital at the insistence of the police.

I drove the group to the children's ward, and Matello and I spoke about the situation.

Rethabile looked even worse than before -- no surprise. He was filthy. Matello pointed out his long fingernails caked in dirt and stuffed with dried papa. He had a constant cough. His feet were still swollen, and were ice cold to the touch.

All the other children in his family had appeared well. Weren't sick. Weren't malnourished. Why him?

After the doctor admitted him, I helped the nurse hold him down as he received the first of many shots. I was also holding down the anger. I felt it rising and cleared my throat.

The thoughts ran quick: Who in their right mind…? Why…? Didn't they realize…?

Then: Was it their fault? Was the poverty to blame? Were there alternatives? Were they as devastated by this as we are? Was this neglect or lack of resources?

Then I thought of the other healthy kids, and the uncut fingernails, and the refusal to go to the hospital until the police came, and the filthy clothes...

The anger boiled up again, and again I suppressed it, consciously making sure that it wasn't escaping through my hands as I held poor Rethabile to the bed.

"It's OK," I cooed gently. But I wonder if that's true.

Afternoon Smiles

2010-11-10T04:47:00.001-08:00

Retsepile and Paballo:

A Muddy Birthday Story

2010-11-09T07:29:00.000-08:00

Today I turned 25. It was definitely a memorable birthday.

Namely, I spent a few hours this morning trudging through deep mud and heavy rain in an extremely remote village, anxiously asking various herd boys if I could borrow their cows to help pull my truck off the muddy mountain slope where it was stuck.

It all started this morning, when Matello, our outreach coordinator, and I set off to a village in the Mateanong region of Mokhotlong to drop a special TTL client back at home.

Retselisitsoe has a cleft palate, and TTL has remained in touch with her over the years -- even though she doesn't need our normal means of support anymore --while trying to figure out a way to help her receive surgery. We recently began working more closely with Operation Smile and the Smile Foundation, and they helped facilitate a meeting with a doctor in Maseru on Monday for Retselisitsoe and another TTL client with a cleft lip.

Retselisitsoe had a few rotten teeth pulled, will heal for a month, and then will go back to Maseru to have her surgery, while TTL's other client will likely go to South Africa for her procedure in coming months.

The ride to Retselisitsoe's home, amidst the lasting rain clouds that had first arrived over Mokhotlong the night before, was gorgeous -- but treacherous. Mountainside villages poked out of the heavy, low-lying clouds we drove through, the yellow thatched roofing of the rondavals accenting the lime-green, grassy newness of Spring. The road, cut deeply with crisscrossing rivulets and larger streams as well, was bumpy.

I approached particularly muddy patches like a shortstop sliding into home, gaining a bit of speed before leaning back to cruise through.

Just after turning off the main dirt road onto a smaller path leading up the mountain to Retselisitsoe's village, the truck literally began sinking into the ground -- the same ground that two days prior had been flat and dry. Despite the four-wheel drive, I couldn't back up. I inched forward by maneuvering the wheel left and right and tapping the gas, then turned slowly off the side of the road onto a large patch of grass that I thought would allow me to turn around. The truck sunk deeper. It was all mud. We were stuck.

I looked at Matello, she looked back, and I said, "I don't know what to do."

The words sounded silly in my head, and I forced myself to take a deep breath, gather myself and think.

"Let's take Retselisitsoe home," I said. "Then we can try to borrow some cows to get us out."

We hiked the rest of the way, about 20 minutes, to her rondaval, where her grandmother met us with thanks. The going was muddy and wet, and we all kept sliding a few inches on the soles of our feet with each new step. I took off my baseball cap and put it on Retselisitsoe's bare head, and she looked up at me from under the brim.

Her getting surgery is worth all of this, I thought. One thing at a time.

While her grandmother went to talk to the village chief about helping us get our truck out of the mud, Matello and I sat in the rondaval quietly. I looked over at her, and pulled my chin out of my palms long enough to say, "It's my birthday."

Matello looked surprised, and then we both laughed at the humor involved.

Retselisitsoe's grandmother returned, and said the chief was sending some men to help. I didn't think manpower was going to work. I thought cows were definitely our only option.

Along the hike back to the car, we kept asking people about cows, with no luck. Just up the hill from the truck, Matello yelled to some herd boys. They pointed to where the cows large enough to pull a truck were, and I spotted them -- like ants on a distant mountain slope.

Still, the boys came to help themselves, joining us and the men the chief had sent. Eventually, there were a total of four men and four boys at the truck with us.

They pushed as I tapped and played with the gas pedal. They maneuvered rocks under the wheels, in different positions as the truck spun around. Finally it was back on the road.

We made it back to TTL about an hour and a half later. I was muddy and thankful to be home.

What a birthday, I thought. And worth every muddy step.

Snowballing updates

2010-11-04T07:16:00.000-07:00

The past few weeks have been busy ones, and but for our Internet connection being out, I would have written sooner.

Much has changed here at the safe-home.

Clever little Boraki has gone home, drastically more healthy than when he first arrived.

The elder Retsepile is now sitting up often and smiling all day long. He smiles wide and waves to me each time I enter the playroom. The TB treatment seems to be working, he is no longer vomiting and has no diarrhea. He is gaining weight finally. Seeing him is amazing. He is such a far cry from the boy whose life the doctor gave up on just a few weeks ago. I am so happy we have finally found the right course of treatment.

Recoveries here at the safe-home seem to work in snowballing fashion, with a slow progression of improvements suddenly gaining momentum until the child is improving by leaps and bounds. I hope Retsepile hits this stride soon.

We have two new clients in the safe-home: Tseliso, a tiny boy who was born at the end of September and whose mother passed away; and Kokonyana, a 7-month-old girl who is lively but underweight.

Kokonyana isn't scared of anyone, and immediately began playing with me the first time she saw me. She's got an adorable little face.

Still, chubby-cheeked Paballo remains the sole toddler at TTL who is able to move around the play room on her own, which she does occasionally in a funny sort of all-fours walk.

In past situations like this, with former groups of babies, the toddler in Paballo's position has become a bit of a playroom diva, confidently wandering around with an air of entitlement to any toy or book she wants. But not so with Paballo.

Her new position seems to have given her a sense of vulnerability rather than power, and the result is that she tries to cling to 'Me Mamosa, who she adores, all day long.

I have, however, managed to infiltrate this little plot to monopolize all of Mamosa's time, and have successfully become accepted by Paballo as one more person who she'll let hold her -- usually, and with conditions.

Namely, those conditions are that I carefully orchestrate a string of diversions that will distract Paballo from her otherwise favorite activity of obsessing over where Mamosa is.

I walk her around the office and point at birds and horses out the windows. I lead her around the playroom, pointing at and picking up various stuffed animals, acting as if each one is a newfound treasure. I hold her favorite, noise-making toy in front of us and start pulling its levers with as much enthusiasm as possible.

While it's working, Paballo is all smiles and giggles.

When it fails, she suddenly starts crying loudly, as if she's just realized I am an impostor. This most recently occurred during lunch time, when I failed to keep her engaged during the 20 second interval between her lunch and her after-lunch bottle.

Her face goes from a broad smile to a look of victimized accusation -- "How did you lure me into this trap?"

I can't help but laugh. Just as soon as the bottle has once again gotten her attention, she is laughing too.

Double Jeopardy

2010-10-21T02:23:00.001-07:00

Talk about double jeopardy.

Sadly, in this country, the rates of HIV and TB co-infection are among the highest in the world.

The vivid reality of that fact was recently brought home for us here at TTL, as we finally determined what has been plaguing Retsepile and hindering his health and recovery.

After being hooked up to life-saving fluids just two weeks ago, he had returned looking a bit better and we had begun feeding him plumpy nut, mixed with porridge to make it easier for him to digest, to continue to improve his weight and health. But like clockwork, he began vomiting and having diarrhea yet again, and his strength rapidly deteriorated once more.

Though we had started him on ARVs for his HIV and were working as diligently as we could to ensure his food intake was on target, there seemed to be an underlying problem that was preventing him from improving.

Under the suggestion of Dr. Chris from Baylor, we took Retsepile back to the hospital, where a chest X-ray finally read correctly showed signs of underlying TB.

Retsepile's ARVs were stopped, as they weren't doing him any good -- and were in fact weakening him -- with the underlying issue unaddressed, and we started him on the first phase of TB treatment.

After spending the required amount of time in the hospital letting the medicines take hold, Retsepile is now back at the safe-home.

He is emaciated. His limbs look like nothing more than twigs with skin draped over them. His face is gaunt. Still he smiles. Still he fights all that is against him. Still he pushes on.

He is now eating well and his vomiting and diarrhea have stopped.

I am crossing my fingers that we have finally nailed the problem on the head, and that Retsepile will at last begin to recover.

Visions

2010-10-15T06:39:00.000-07:00

In the doorway of a rondaval in a remote village, I notice a knife blade with no handle that has been forgotten on the floor, left behind for the barefoot children of the house to hop over while coming and going.

I raise an eyebrow at what is meant to be the "road" to our next destination, then engage the 4-wheel-drive and proceed over boulders, across a stream and up slopes I fear might overturn the car, but that I know will get us to our next client.

In the next rondaval, I watch as our infant client crawls over her mother's chest, as the mother lays on an old mattress, bedridden with TB. I worry about the child's exposure, but nobody in the family seems concerned. A young chicken clucks around the room before dropping feces casually on the ground, near the blackened bucket the family uses for cooking.

I find myself haggling with a middle-aged Chinese shop owner, in a mix of English and Sesotho, over the return of money paid for baby formula that was never delivered. She eventually consents to my logic and forks over the cash. I consider this a lesson in business negotiation, and feel a sense of accomplishment.

I consider going to the bathroom in the TTL outhouse, even though the fierce seasonal wind has ripped the door off and shattered it into a half-dozen pieces, leaving the inside of the outhouse viewable from the street. I consider this because, just as the door was torn off, the town's water was shut off, making our toilet unusable. I think about all the other outhouses I've seen around town with no doors. I bide my time, mulling over the prospect. When the electricity shuts off, but the water comes back on, I consider it a fortuitous trade off.

I watch women on the side of the road meticulously butcher the carcass of a donkey -- for later consumption without regard to whatever it was that killed the donkey -- as toddlers sit nearby, amidst the foul stench, watching the whole, bloody ordeal.

I watch a man ride a horse across a dirt field in front of me, a small, baby-sized coffin on his lap.

I see a town so dry and windy that an everyday, panoramic, 360-degree horizon of mountain peaks becomes nothing but a wall of brown dust, blown as high as the clouds and making sky and earth indistinguishable from one another. In the dust cloud, nothing is clear but my immediate surroundings. I see rain finally come and people clap and sigh with relief.

My boss is away and I find the task falls on me to turn down two job applicants who I know are desperate for work. I try to do this with as much compassion as possible. I know we can't hire everyone, but I still feel mean. I also feel more like an adult than I ever have before, for reasons I don't fully comprehend.

Sitting in the playroom, I laugh when one of the bo'me comes in with a food tray, and the two toddlers in the room old enough to react start giggling, clapping and squealing with delight at the prospect of lunch time, patting their still-distended bellies with their tiny hands.

I go to the shop that supplies the town's weekly delivery of fresh fruits and vegetables, and dig through too-green and too-rotten bananas until I find a dozen that seem to meet my standards. I think back to the grocery store near my home in the U.S., and the towers of perfect, huge, bright-yellow bananas. Somehow, the dozen I find here seem superior.

I fly through two books in one weekend, enjoy them both, and wonder when the last time that happened was.

I climb a ladder to change an outdoor lightbulb. The task is simple, uncomplicated by human fragility, ego, sadness. It's easy. It's relaxing.

I repeatedly go over medical instructions for the hospitalization of one of the safe-home babies with a visiting doctor, asking him questions about signs of extra-pulmonary TB, chest X-rays, ARV regimens, anemia, mixing plumpy nut with porridge, antibiotic dosing and nasogastric tubes. Then I wonder if I will have to finagle a bed for the client at the hospital, or if one will be available.

I read about philanthropic decisions made for reasons like "cost-per-beneficiary," and scowl.

I finally win over a baby after a few weeks of effort, and she finally trusts me, even in the morning when she's cranky, and when I first realize it I get excited. Then, when I realize my excitement, I blush a bit.

I realize I'm doing and feeling and seeing lots of things, but still what I care about most is the approval of a two year old.

Little Ones Back Home

2010-10-12T10:34:00.000-07:00

Two months ago, on Aug. 11, one-day-old Nkamoheleng arrived in TTL's care.

Her 18-year-old mother had died during delivery in the family's remote rondaval. Nkamoheleng had consumed nothing but small amounts of water since her birth. She was 2.4 kg, or just about 5.3 pounds.

Today, Nkamoheleng went home to live with her grandmother. She looks healthy and coos gently. Her pretty round face glows. She is now 5.1 kg, or more than 11 pounds. She is a wonderful example of TTL's strength in care -- even for babies so very young.

When I first wrote about Nkamoheleng coming to TTL, I wrote that, "In so many ways, the immensity of need here in Mokhotlong is wrapped up in Nkamoheleng's story," and hoped that "the rhythm of TTL success will soon resound there as well."

Now, two months later, it resounds quite loudly.

In addition to Nkamoheleng, little Refiloe went home today as well.

Refiloe arrived here one month ago, on Sept. 10, after her mother sadly died in delivery as well -- a too common occurrence in this country.

Refiloe will go to her maternal grandmother, still small at 2.65 kg, or about 5.9 pounds, but healthy enough to live with her family with the support of TTL outreach.

The departure of the two young girls leaves us with six babies in the safe-home.

Paballo and Boraki are starting to move around independently more and more, which is fun to watch.

Retsepile, after being so ill in the hospital so recently, is doing better but is still not out of the woods. His condition is so severe that he won't be for a while.

Still, he is smiling often and is much more engaged in general.

Dr. Chris, of the Baylor International Pediatric AIDS Initiative, came by today and saw Retsepile, as well as Nthabiseng, who has a cough, and Mpho, who still has skin problems. He tweaked all of their treatments and care plans, which I'm confident will help.

As for Nkamoheleng and Refiloe, now that TTL has helped them through the tragic start to their young lives, I hope they will thrive.

Visiting Old Friends

2010-10-05T22:45:00.000-07:00

Today was a long day of driving far out into the rural Mokhotlong mountains, hours away from TTL, to visit with some old friends.

Namely, Seithati, Ntseliseng and Karabo -- three former residents of the TTL safe-home and three of the babies who I have become closest with in my time here.

When we got to the Linakaneng Clinic, Matello, our outreach coordinator, and I headed inside.

The first face I saw was Karabo's, who just left TTL about a week ago.

She recognized me at once and smiled big, sticking her arms out. I said hello to her mother, who I know well, and picked Karabo up. She laughed and gave me a "high five." The other women in the clinic laughed themselves and talked quickly to each other in amused tones, and I could tell they were amazed by the clear relationship between Karabo and me. I just smiled, and handed Karabo back to her mother as Matello and I began talking with the clinic nurses about a variety of issues -- among them a shortage of Kaletra, an ARV medication for HIV that one of our clients at the clinic is on and needs more of soon.

After a few minutes I walked outside, and standing there by the door was Seithati -- my all-time favorite TTL baby. I'd been there when we'd found her almost 8 months ago, and had seen her go from a shy malnourished child to an out-going, brilliant, healthy, rambunctious toddler at TTL.

Now, I recognized her at once, said her full name out loud in surprise and laughed, and she smiled up at me sheepishly.

"Ay, Ntate," she said.

I could tell she recognized me, but she was back to her old shy self, despite still looking relatively healthy.

"Come here," I said in Sesotho after kneeling down, and she walked over to me. I picked her up, and she wrapped her small fingers around one of my own, just as she always used to do. It sounds sappy, but my heart melted.

"Ho jwang?" I asked her. "How is it?"

"Ho sharp," she said. "It's good."

I laughed and put her down. She looked up at me with curious eyes.

She continued to take everything in as Matello and I weighed and measured all of our baby clients, some of whom I didn't know, and gave out some food provisions.

Seeing Seithati again was a great experience, despite our finding out that she has a cough that has been lingering for a while. I hope as the weather continues to improve, she'll get over it.

After the clinic, Matello and I headed off again, further out along the ever-deteriorating road, until we reached a designated meeting spot with another client.

There was Ntseliseng, being carried up the hill by her aunt, who had claimed Ntseliseng at TTL while I was in the U.S. at the beginning of September.

I jumped out of the car and said, "Hey uena, Ntseliseng!" -- "Hey you, Ntseliseng!"

Always the expressive one, though she still doesn't talk, Ntseliseng raised her eyebrows and smiled wide, showing her surprise at seeing me. Her face was as animated and telling as an adult's, and it got a big laugh out of me. She laughed too.

I was happy she remembered me, and went over to her. Her aunt untied the blanket that was holding Ntseliseng on her back, and I scooped my old buddy into my arms. She smiled.

We went into a nearby home -- the owner of which had pleasant experiences with TTL in the past -- and weighed and measured Ntseliseng. She was so scared of the process she peed on the scale, which I ignored as I scooped her back up before taking the scale outside to dry off. She had the signs of a rash -- which thankfully had already started clearing up -- but overall she looked good.

After saying our goodbyes, Matello and I took the long road home.

As I drove, I marveled at the strength of my feelings for the three little girls. They may soon forget me, I know, but I won't forget them.

Painted Black & White

2010-10-02T04:17:00.000-07:00

I tapped the brakes quickly and slowed the truck as it curved along the black line of pavement, snaking through the mountainside villages and overlooking the lowlands below.

A group of five adolescent boys crossed the roadway a few dozen yards ahead, almost in slow motion, their stark white eyes staring back at me from their painted faces -- a charcoal, midnight black, covering their arms and chests as well. They wore some sort of brown animal hide or dirty sheepskin skirts, and each carried over one shoulder an enormous, charred-black log.

"What was that?" I asked Nthabeleng as we zoomed past on our way to Maseru, and they appeared smaller and smaller in my rearview mirror.

"They are going for circumcision," she said.

"Whoah," I said.

I'd heard about the "initiation schools" that young teenage boys go through here, where they are taken to the middle of nowhere, circumcised and "turned into men." But seeing the ritualized preparations of the process, the boys in what seemed a trance-like state, was another thing entirely.

"Why are they painted black?" I asked.

"I don't know," Nthabeleng said.

A few hours later, we sat in the new mall that was built in Maseru at the end of last year. There are escalators and shining storefronts and nice bathrooms and even a movie theater. It's like nothing else in the entire country.

In other words, I was drinking a cappuccino.

I thought about the vast difference between this world and the world of the initiation schools.

Then, up the escalator in front of us, came a handful of students in uniforms. Then another handful. Then a whole chattering school of them, wide-eyed and nervous.

"Are they on a field trip here?" I asked.

"Yeah," Nthabeleng said. "They want to teach them, "What is a mall?," "What is a lift?"

In all, we saw about half-a-dozen school groups at the mall. I thought of young American kids barking at their mothers for Cinnabunns and ridiculously priced clothing at malls in the U.S., and smiled at the eager excitement of these Basotho kids -- buying nothing, but enjoying it nonetheless.

The next day, Nthabeleng and I were again driving through the countryside, this time on our way back to Mokhotlong, when I noticed a gathering of people in a field to the side of the road. At the center of the gathering were a handful of young teenage girls -- dressed only in grass skirts, painted white from the waist up, and dancing.

"What was that?" I asked Nthabeleng again.

"Female circumcision," she said.

"They do that here?" I said, surprised.

"Yes," she said.

I sat with a far more intense feeling of pity for the girls than I'd had for the boys, thinking back to the mall and wondering what sort of connection my mind was trying to make between the two rituals and the new mall.

Then it came to me, painted black and white.

Nowhere else have I seen such stark examples of modernity and ritual, in such close proximity.

They were each, unto themselves, indicators of the upheaval I see occurring in Lesotho.

Many people in this country still live like they did thousands of years ago. Others live entirely modern lives. And in the transition of the population from the former to the latter, there is generational chaos.

Quite often since I've been here, TTL outreach has found a baby in terrible condition, cared for by a grandmother without the means or knowledge to provide proper nutrition, and left behind by a mother who "disappeared" one day in search of a better life in Maseru.

I wonder how long the people here will continue living in remote villages, or even in towns like Mokhotlong, before the desire to meet the modern world overpowers their devotion to family, to history, to the past. I wonder if they would be better off if they abandoned their simple lives in the mountains. I wonder how much of their suffering is directly linked to HIV, and if they would be otherwise content to live another thousand years in the mountains, if only they had their health.

I can't quite grasp the complexity of this moment-in-time for Lesotho. All I know is that babies are getting caught in the crossfire, and too many middle-aged people are dead from AIDS to stem the tide of consequences.

A Struggle and a Departure

2010-09-27T02:29:00.000-07:00

He waved.

I waved back, felt a shot of emotion and tried to smother the grimace I felt rising to the surface of my face.

Retsepile lay in the hospital bed with a nasogastric tube going through his nose into his stomach, his hands wrapped up completely in bandages and tape to prevent him from pulling the tube out. His face looked gaunt, so much so that he resembled a skeleton more than a little boy of 18 months. His body, under his clothing, appeared almost as nothing, a long, thin stretch of bones and skin.

The small wave of his bandaged, club-like arm was the most movement I'd ever seen from him. During the preceding days in the safe-home, he lay motionless and silent -- staring back at me wide-eyed, but showing no specific acknowledgement. Until the wave, I'd been unsure of how much he was taking in.

Now, in another environment, surrounded by other women and children and hospital staff, he had recognized me, and used the little strength he had to show it by waving.

Utterly emaciated. Shockingly alive in a way I would have thought impossible, even in a world of impossibilities. Retsepile began having serious diarrhea that very morning. Already in horrible condition, 'Me Mamosa took him to the hospital at the first sign of further deterioration. After placing the nasogastric tube through his nose, the doctor at the hospital said Retsepile "probably won't make it," a phrase that made Nthabeleng angry and saddened me.

That was Friday. On Saturday morning, one of our outreach workers and I drove the two-and-a-half hours to Retsepile's remote village in the St. Martin area of Mokhotlong district, to find Retsepile's mother and bring her back to the hospital to be with her son. In the rolling hills of the village, windswept and with a beauty unmatched in many parts of the district, we parked near the St. Martin clinic, where dozens and dozens of villagers had gathered for a game of net ball -- which is basically basketball with no dribbling, played on a stretch of dirt and with a hoop that had no backboard. After absorbing the stares of the crowd, who all must have wondered what I was doing there, I set off with Nthabeleng, our outreach worker. We hiked uphill for about 10 minutes -- the sun and the wind and the willows and the narrow dirt paths up the steep slopes making everything seem dreamlike -- into Retsepile's village, where we found his mother at home in her rondaval.

Today, Monday, she is at the hospital with Retsepile, who is still fighting against the predictions of the doctor. His diarrhea has slowed, and I'm starting to gain hope again for him. He is a fighter, and if he continues on it will be an amazing victory of will.

Aside from Retsepile heading to the hospital, here at the safe-home, our group continues to change.

As I mentioned before, Ntseliseng left while I was away. She and I had gotten close. The fact that she walked out of the safe-home on her own is absolutely remarkable. A young aunt came forward to be her care-giver -- a wonderful thing after Ntseliseng's mother died so tragically just before she came to us.

Today, Karabo went home.

Karabo came here not for her own illness but because of the illness of her mother. Still, she has grown and thrived here at TTL, and looks fatter still than when I left the country at the beginning of the month.

She is happy, smiles and knows me well, laughing and playing with me even while the other babies here, all of whom are still getting used to me, look on warily. I will miss Karabo's chuckle. I will miss having a play buddy in the safe-home, although I am confident that I will win the others over soon. Boraki is starting to smile at me more, though he is still nervous.

It is a happy thing that Karabo is going home. All throughout her stay here, her mother has come to visit routinely. Watching her interact with Karabo, I know she is a caring woman with a gentle touch, a warm smile and a genuine love for her daughter. Now that she is healthy again, Karabo will be in good hands.

In anticipation of her departure, I spent the morning playing with Karabo, her sweet giggles vibrating against my chest as she dug her forehead into my neck. I threw her in the air and she squealed. I helped her pick the toy she would take along with her. When the time came, I carried her out and put her in the car seat, talking to her in happy tones to make the moment less scary.

She laughed with me until it was time for the car to leave. Then she looked nervous as I kissed her cheek, said good-bye and closed the door.

Another tough good-bye, but another victory for TTL.

Let's hope Retsepile will pull through, and be one of those victories as well.

Hitting Home

2010-09-21T07:32:00.000-07:00

What a whirlwind trip and a strange set of experiences.

After seven months in Mokhotlong, I returned to the United States for a two week vacation at the beginning of this month. I am now back in Mokhotlong for another five months.

The quick back-and-forth provided a heavy dose of perspective.

Of course, I grew up, and have lived most of my life, in the world I returned to. But somehow it all seemed different.

Traveling from Mokhotlong to my parents' home in Maryland consisted of a 4-hour drive from Mokhotlong to Maseru, a 1-hour flight from Maseru to Johannesburg, an 18-hour flight from Johannesburg to Washington, and a 1-hour drive from Washington to Maryland.

Despite the many legs and the many miles, it seemed like a shockingly quick transition. It was startling to find myself in such affluence in the United States, just a few days after being in the extreme poverty of Mokhotlong. I had the strange sense that a long sea voyage across the Atlantic would have somehow been more appropriate, would have at least given me time to digest things mentally.

Culture shock is an overused phrase, but I had it -- in the reverse. I felt overwhelmed and caught off guard by familiar things, was surprised that old things felt new, that the dull realities of my former life seemed sharp, that I'd taken so many things for granted before.

After the relative isolation of Mokhotlong, I was surrounded by family and friends. There was a ton of food. Everything -- from the lawns to the roads to the neatly lined fences -- looked too perfect and beautiful at the same time. Showering barefoot felt weird. Dollar bills looked too long and skinny. The ease of communication and the efficiency of services jumped out at me. My four-month-old nephew, who I met for the first time, seemed huge compared to the babies in Mokhotlong, and he is.

People asked me about my experiences at TTL again and again, and I couldn't find the right words. None seemed sufficient. I offered all I could, but felt I was conveying a glossy, wrapped-up version of it all. I tried and failed to convey what it feels like when a baby lies dead in your arms, or when another one has recovered from deaths doorstep, laughs happily and kisses you on the cheek.

Searching through my memories, I tried to pull out the most poignant, the ones that would help others understand. But in the furious pace of life that comes during a short stint to see so many loved ones, and which comes in the U.S. in general, I felt the memories fleeting, becoming cloudy even in my own head. At times, the feeling made me not want to share the memories, made me want to isolate them from dissolution, to quarantine them against the threat of their disappearance. It was as if they might all vanish into the wind at any moment.

Partly because of that, returning to Mokhotlong has been equally strange. The long travels again went by in the blink of an eye, and when I was suddenly back, again so far from the home I had just left, it was a new world once more that met me.

Winter has left and the trees have all turned green. Ntseliseng has gone home. Karabo and Boraki look much bigger. And there are a handful of new babies in the safe-home to get to know.

I cooked my first night back, something I do a lot here but didn't do once in my two weeks in the U.S. I woke up in the morning and it was warm outside -- not frigid like the mornings before I left. Everyone welcomed me back, and I starting trying to catch up on things.

I was happy to see that TTL had continued chugging along during my absence.

I now have five months left here, and I plan to make the most of them.

After returning to the United States and coming back to Mokhotlong once more, I have a more profound understanding than ever of the vast differences between the two places, of the privileges I grew up with and the basic amenities they lack here, of the disparity, the need, the potential.

More Arrivals

2010-09-16T12:47:00.000-07:00

Here's another update from Eric:

Hello again,

It has been busy the last few weeks as healthy babies go home and others continue arriving here at the safehome. We have added two more little one in the last few days, totaling nine babies currently at TTL. Refiloe (on the right) arrived last Friday, just two weeks old and weighing 2.3 kg. As has happened quite often recently, the mother unfortunately passed away during birth. We will keep her here as the outreach teams contact other family members in search of a suitable home. I was informed yesterday of our newest arrival, Retsepile, by Nthabeleng yelling that I 'have another one'. He is 18 months old and extremely malnourished, weighing only 5.3 kg. He is HIV+ and will be starting ART on Monday. Paballo, who arrived last week, is eating for two now and even smiling when you rub her bulging belly. Ntseliseng, a staff favorite, went home last week after making a truly remarkable transformation. I hope everyone is doing well and lets hope the good fortune continues here at the safehome.

All the best,
Eric

New Arrivals

2010-09-08T10:10:00.000-07:00

I haven't posted in a while because I am currently in the U.S. visiting family and friends.

But, Eric, our new fellow, sent me an update yesterday on the safe-home's two newest residents, Retsepile, far left, and Paballo:

Yesterday was a busy day here at the safehome. In addition to the usual crying, laughing and howling wind, there was added noise thanks to two new arrivals.

Early in the morning, before heading out on outreach, Matello was at the hospital and met a man who obviously needed some support. His wife had just given birth to a baby girl on Friday. The mother unfortunately passed away shortly after birth, leaving the father unsure what to do and needing to make funeral arrangements. Their first two babies together died shortly after birth and the father turned to TTL asking to make sure this one doesn't die as well. So we have welcomed Retsepile to the safehome. She weighs 2.6 kg, is eating and appears healthy.

Shortly after lunch we received our second surprise of the day. A young mother showed up at TTL with her 16 month old daughter. Paballo is so malnourished. At 66.5 cm, she weighs just 4.7 kg. The child had been suffering from diarrhea and was taken to the hospital. The child was discharged from the hospital, even as the diarrhea continued and the child lost still more weight. So the mother brought her here and we decided to keep her in hopes of seeing some improvement. The diarrhea has stopped today and the next challenge is getting her to eat.

I have included photos taken this morning and I will keep you updated on our progress here.

All the best,
Eric

Taking Selloane Home

2010-08-27T08:12:00.000-07:00

I scooped her up in the doorway of the playroom, and she turned in my arms and waved goodbye to 'Me Mamosa and the other bo'me in the room.

"Say 'bye-bye' to Ntseliseng," I told her, as Ntseliseng waved from the ground.

Selloane waved back. Then she looked down at my chest, and started nervously playing with my sunglasses, which I had stuck in the front of my collar. She may not have understood she was leaving for good, but she definitely knew something was up.

She cried when I put her in the car-seat, didn't know what was going on.

Once I climbed into the big Land Cruiser, sat in the seat next to her and handed her the light purple, animated stuffed bee she calls "Ausi Palesa" -- or, roughly, "Sister Flower" -- she calmed down, took a deep breath.

On the way out of town we stopped at a local store to buy her a new pair of shoes, which I immediately put on her after getting back in the car, and which she stared at happily.

Then there was the two hour trip -- rough and jolting -- to her remote village, not far from the rural Moeketsane clinic.

This is where, on my first week in Lesotho, we'd been directed to Selloane's rondaval by the elderly neighbor whose own grandchild was already a TTL client. This is where we first saw Selloane, tiny, malnourished, wasting.

Now, as we arrived once more in the village, just after I'd finished doing my best to feed Selloane two final yoghurts on the bumpy road, I recognized the dirt slope up to the little gathering of rondavals, Selloane's grandmother standing outside.

We stopped on a slope nearby. I unbuckled the car-set and handed Selloane over to 'Me Matumaole, one of the safe-home caregivers who had come along on the trip to make Selloane's transition easier.

We all walked over and said our hellos. A bunch of other children -- one Selloane's older sister -- began gathering around, staring at Selloane in her neat clothes and new shoes. Selloane nervously looked back.

Her grandmother and grandfather came over, and they both started talking quickly. All I could catch was Selloane's name, the first mention of which brought abrupt giggling from all the other kids -- they recognized her at last.

We went into the small, dark rondaval, and a handful of women joined us, all of them talking to and about Selloane. I gathered they were all amazed at her healthy appearance.

Selloane nervously moved about the room, time after time returning to me and stepping between my knees as I sat, her forearms on my thighs, looking back at the women who kept asking her to come to them. Time after time, I slowly pushed her forward, back toward her family members and neighbors.

It was a hard thing to do. I wanted to pick her up, just as she wanted me to. But that wouldn't have served our purpose. So I kept pushing her forward.

The elderly neighbor, the same woman who had first referred Selloane to TTL, came in next, and apparently couldn't believe her eyes. She started undressing Selloane and poking at her full legs and belly, drawing laughter from Matello, our outreach coordinator, and a big smile from me.

We gave Selloane's grandmother a bunch of food, candles, matches, laundry soap, a few other essentials and a bag full of clothes for Selloane.

Then, suddenly, it was time to go.

"Bye-bye, Selloane," I said, waving to her as she sat in her grandmother's lap.

She still looked nervous, but she slowly waved back.

Then we were back in the car, driving away, hoping she will do well, that she'll soon fit in with the group of kids who sat outside the rondaval smiling at her, that she'll grow up and thrive and be happy.

That's my wish. And because of TTL, there's a chance it will come true.

Winds of Change

2010-08-23T01:35:00.000-07:00

The "windy season" has hit Mokhotlong, and the larger physical world finally seems to be on an even pace with TTL's swift current of change.

Winter has lost its teeth, although it still gnaws away roughly enough at night. Spring is rapidly approaching. The trees are budding light green, the air has lost its crispness and gained a soft relief, and the nearness and strength of the sun in this altitude are again things to be reminded of.

Not to be outdone -- and amidst the swirling, temperamental and powerful gusts that now shake the safe-home daily and deposit a layer of dust on everything in their path -- the pace of recovery among the seven babies now in our care continues to quicken.

They are seven now because Neo left on Friday, gone home with her mother and father after a stint her mother spent at the hospital. Despite both parents being in the picture, Neo's home life is a bit unstable, and I worry about her suffering for the insecurity. Still, our outreach teams will continue doing monthly check-ups to monitor her progress, and for that I rest a bit easier.

Boraki is back in the safe-home after spending a few days last week in the hospital with a high fever. He came to us so small and fragile that I was scared the fever would overcome his tiny immune system, but after a few days on an IV drip, he returned all the better.

I've since gotten him to smile a handful of times, making popping noises in his direction as I played with Selloane and Ntseliseng. In my time here, I've come to understand that the fastest way to get a child to trust you is to show him that other children trust you, and that seems to be the case with Boraki. I hope to win him over soon -- not least to push him further toward normal movement for his age. Despite being 11 months old, Boraki is still limited to sitting up on his own, in the style of a much younger child. Hopefully, as he continues to eat and recover, he'll start moving with the best of them.

Selloane continues to do extremely well, and will probably go home soon -- a thought that is a bit sad for me. She just recently began saying my name -- "Ntate Kebenny," just like Seithati used to say -- and I've no doubt become attached.

Ntseliseng, who I'm quite attached to as well, continues to develop in leaps and bounds, now walking -- confidently if a bit unsteadily -- across the entire playroom, an amazing feat given the state of her legs just a month or two ago.

Karabo just started an ARV regimen for her HIV that is making her nauseous, but hopefully she'll get used to the regimen, or the doctor will tweak it, and she'll be on a steady medicinal track soon.

Mpho and Nthabiseng, the tiny little boy and girl who have both lost a twin, are continuing to eat and grow.

Last Sunday I took Nkamoheleng to the private doctor in town for what seemed to be an infection in her eye. The doctor and I discussed her being born at home, the complications that can present for properly cleaning the baby after the delivery, and how that might be the cause of the eye infection. We got some drops for her eye, and it has cleared up nicely. Otherwise, she seems to be doing well.

As the world outside TTL gets tossed about in the wind, things continue moving and shaking in the safe-home, just as they always do.

It's a strange, whirling, unsteady feeling of balance.

Six Months In

2010-08-16T08:10:00.000-07:00

I feel like a different person. I believe I am one.

A lot can happen in six months. That's always true, everywhere.

But when what happens is completely new and foreign and more intense than anything you've known before, the scope, the importance, the affect are all magnified.

I have now been in Mokhotlong for slightly more than six months. Half a year. Roughly 180 days. A period of time that seems to have gone by in the blink of an eye, but one I can also sift through endlessly, recalling more deeply-imprinted memories, more wrenching emotions, than I ever could have imagined prior.

I tend to analyze periods of time in my life the same way I analyze everything else -- scoring them, comparing them, holding them up against my expectations. But that doesn't really work with these last six months. They are different, almost illusory.

How do these past months score? The adjectives I would use to describe them seem contradictory in my head. They have been amazing, disturbing, shocking, uplifting, frustrating and remarkable. How will I respond to those who ask me about my time here? Yes, it was an amazing experience, but then there were also babies dying, and disease, and poverty, and terrible injustice…10 out of 10 on the amazing scale…15 out of 10 on the sadness scale…

How do these past months compare? They don't. They are in a league of their own. My life here seems detached from the rest of my life. Parallel. I worry when I return it will be like they never existed. A short stint in Never Never Land. A dream to lurch out of, awake and sweating, the visions fleeting and rapidly being lost despite a furrowed brow to remember in the dark.

How do these past months hold up against my expectations? They neither match them nor exceed them. All expectations on coming to a place like this are simply misguided. The immensity of the experience just isn't something you can predict. You see a line into the future, and then you make an abrupt turn into reality...

I wonder how this experience will shape who I am the rest of my life.

I will never think of death the same way. I will never think of life the same way either. I don't think I will ever feel sorry for myself again, but who knows?

I've definitely grown here. I think I am a bit less impetuous and a bit calmer. You can't hold a dead infant in your arms and remain the same, or think you are impervious to pain, or think your youth is invincible, or think it doesn't matter if you help other people or not.

In the blink of an eye I feel years older. My entire worldview has changed. I feel a deep sense of privilege for having been afforded the opportunity, relatively early in my life, to have this experience. I wonder what I will do with it moving forward.

Here's to another six months.

Nkamoheleng' story

2010-08-13T08:13:00.000-07:00

As the days continue passing by, the immensity of need in Mokhotlong continues setting ever deeper into my psyche -- throbbing like a headache, assuaged only by the equally-constant rhythm of minor triumphs we experience here.

There is another baby girl in the safe-home. Her name is Nkamoheleng. Like all the babies in our care, she comes with a story -- a string of facts that amount to a threatened existence and a desperate need for help.

Nkamoheleng arrived at TTL on Wednesday, just one day old, weighing 2.4 kg, or about 5.3 pounds.

Her 18-year-old mother died while delivering at home, in her rural village. Her grandmother brought her to TTL the next day, seeking our help. Nkamoheleng had consumed nothing but water since the day before.

I can't help but to picture a dark rondaval, a woman in labor, dust in sharp rays of sunlight, sweat, complications, tension, more dust, blood, hushed commands from the matriarch or neighbor or whoever was brave enough to take the lead, more blood, devastating moans, and then a sudden silence from everyone but the tiny baby, crying for breast milk from a mother who she'll never know.

I wish that somehow we had known, that we had managed to get the teenaged mother to the hospital, that things had gone differently. But the facts are the facts. The sad first chapter of Nkamoheleng's story is already set in stone.

Thankfully, Nkamoheleng is eating well now, with no diarrhea or vomiting. She has a cute, round face. Minutes ago, she looked warm and content, wrapped in a blanket and held tight by one of the bo'me.

She doesn't know the tragedy that swirled around her in her first moments of life, the odds stacked against her. What she does know is that she is warm now, and full, and held.

In so many ways, the immensity of need here in Mokhotlong is wrapped up in Nkamoheleng's story.

Hopefully, the rhythm of TTL success will soon resound there as well.

Fresh paint

2010-08-09T23:29:00.001-07:00

Some colorful changes have hit the TTL campus.

The grassy area behind the safe-home is now lined with half-buried tires, colorfully decorated in peach and white paint. Two brightly-painted tires, stacked atop each other, circle the thin tree in the middle of the yard as a makeshift bench of sorts. TTL's large garden has been completely tilled for spring planting. And on the front of our guard house, near the entrance to the campus, a large TTL sign has been painted to increase our visibility here. You can see the sign a long way down the road, almost to the entrance to the hospital -- a definite benefit for all those pointed in our direction by hospital staff.

Yesterday wrapped up a week of visits to the TTL campus by more than a dozen young representatives of Cadet 150, a military-affiliated program throughout the United Kingdom that, with the help of Sentebale, tackled a handful of projects in Lesotho this month as part of the 150th celebration of the cadets program.

The cadets' presence here was yet another benefit of TTL's great partnership with Sentebale.

During four separate visits, the cadets put their muscles to work tilling the gardens and digging the trenches that they eventually filled with the tires. They put their artistic skills to work painting the tires and the sign, which includes "Touching Tiny Lives" in bright lettering and the TTL symbol of the African continent with a handprint at the bottom. Everything looks great.

The cadets also donated lots of clothes and toys, and took time out to get to know the babies in the safe-home, who ate up the attention.

The backyard play area definitely has a spruced-up vibe that will increase the amount of stimulation for the babies when they head outside, and I know the sign will become a great beacon of hope for many of those looking in our direction for help.

The cadets have definitely left their mark on the TTL campus, just as I'm sure the babies here have left their mark on the cadets.

In that sense, I think we all benefited -- just as planned.

Lucky Number 7

2010-08-05T08:41:00.000-07:00

This afternoon, as four o'clock edged closer, things were slow in the office and I decided to see what was up with the babies.

I found them and the bo'me outside in the sun, on the swings behind the safe-home and playing by the slide. I pushed Selloane and Neo in the swings for a bit, and the afternoon felt unencumbered and light and happy. After a while they were out of the swings and looking for their next adventure. Soon it was a race between them, Karabo and Ntseliseng as all four decided it was their chance to explore the TTL grounds.

Along with a few of the bo'me, and later with Eric as well, the four girls and I ran around the property, laughing and playing. I caught them when they fell and cheered them on when they walked independently.

Not long ago, Karabo was only crawling. Ntseliseng was barely moving at all. Neo had a sort of bent over, all-fours walk she did, but that was about it.

Now Neo is taking off in quick strides, Ntseliseng has started taking steps all on her own, and Karabo isn't far behind. Their progress is amazing, and seeing it in full display made the afternoon that much more special.

Around 4:45 we called it an afternoon and brought everyone inside.

Minutes later, as often happens here, the struggles of the greater Mokhotlong world suddenly appeared at our doorstep once more, shattering the bubble of smiles.

One of our outreach teams arrived with an 11-month-old boy, Boraki, who only weighs 4.3 kg, or less than 10 pounds.

The last thing written in his Bukana is, "No food security at home. TTL please assist."

Boraki was exposed to HIV through his mother, but his tests haven't come back yet to tell us his status. He breastfed for seven days after birth, but then switched to a mixture of sour porridge, papa and formula from a rural clinic.

That pattern has done him no good. He's such a tiny little boy.

Along with the four older girls, he joins our other tiny two, Mpho and Nthabiseng, who have both lost a twin to death but who are fighting on themselves.

Here's hoping Boraki is lucky number seven.

This is what we do

2010-08-01T03:23:00.001-07:00

Bo'me Q&A

2010-07-30T06:40:00.000-07:00

Working on a daily basis as a fellow at TTL, sometimes you forget how attached you are to the babies in the safe-home.

On any given day, there are so many things that hold your attention other than the babies. Still, they are always there as well, always ready with a smile when you are tired of work and slip into the playroom for a baby boost. Through incremental interactions, you become close to the babies -- some more than others, but all of them in some way. The babies who stay the longest make their way deepest into your heart.

I thought of all this today because of yet another departure: Nthati left this morning after having been here at TTL for more than six months.

Born on November 2, 2009, Nthati arrived at TTL on January 19, 2010, severely malnourished and exposed to HIV and TB. Her mother had passed away, and she was just over 4 pounds.

Today, she is a chunky baby girl at 18 pounds, who we have confirmed through testing is HIV-negative and TB-free.

She still has the chronic skin rash that has persisted for months and which has stumped multiple doctors, but it should be manageable under her grandmother's care with the continuing help of TTL outreach. And believe it or not, the rash might even clear up in a less sterile environment, with fewer soaps and products. It's happened to a TTL client before. We are crossing our fingers that it happens again.

When I said my good-byes to Nthati, I thought about all the times I'd held her and all the giggles -- and pouts -- I'd gotten out of her.

Then I thought about the bo'me, and how much more time they'd spent with her. I wondered how they were feeling about Nthati's departure. Happy? Sad? Both, like me?

Suddenly, I felt what I used to feel working my old job as a reporter: a desire to go straight to the source. So, I asked M'e Mamosa, our safe-home coordinator, to answer a few questions for me. Below is a condensed version of our quick Q&A:

How do you feel about Nthati leaving?

"I'm feeling happy because she is good now, but I'm worried about her skin."

Do you and the other bo'me miss babies when they leave?

"Hey! Too much…When they are back at home, we are still missing them"

It's easy to get attached to the babies here, huh?

"Mm, yes, very much. We know them like our own babies, and we are friendly with them like our babies."

M'e Mamosa said she and the other bo'me often reach the point where they feel a motherly connection with the babies in the safe-home. They sometimes want to take a baby home and raise him or her as their own, to help protect the baby from the hardships that are all too common in Lesotho, especially in rural Lesotho. But they know the babies must and should go home, and are fully cognizant of their temporary but critically important role in the babies' lives.

The hardest times are those when a baby goes home from TTL healthy and happy, thanks in large part to the care they received from the bo'me, and then TTL hears down the line that the baby has passed away.

With watering eyes, M'e Mamosa recounted one such instance not long ago, when a baby boy named Retsilisitsoe, who she had grown extremely close to, passed away after leaving the safe-home healthy.

"That one…," she said, trailing off. "When we found he (had died), I was feeling so sad."

I didn't think it was possible, but with Nthati's departure and the subsequent conversation I had with M'e Mamosa, I now have an even greater admiration for the bo'me here at TTL, who put their hearts and souls into the babies in TTL's care.

Every TTL success is a testament to their dedication, including healthy little Nthati.

Never far away

2010-07-25T05:41:00.000-07:00

The way life works here is that death is never far away.

Sadly, I was reminded of that once more last night, when Bokang, our security guard, came calling my name at around 11:45 p.m.

The same dreaded words as last time -- "Sir, there is a problem" -- met me in my bed.

"With the babies?" I asked in the darkness.

"Yes."

Again I rushed down to the safe-home to find a tiny infant -- this time Pulane, one of the premature twins I recently wrote about -- dead on a pillow. So small, so vulnerable, she'd suddenly stopped breathing. The three bo'me on the night shift sat around her, obviously emotional and looking to me for guidance.

In that moment I thought how sad it was that I already knew what to do, that the death of a baby in my life has a precedent, that I knew the steps to take.

We wrapped her in a sheet and I cradled her in my arms -- so tiny, like a doll.

Despite the emotional haze, I thought how profoundly present death makes one feel -- in a room, in a moment, among the living.

I took Bokang with me, locking the gate behind us, and drove to the hospital as Bokang sat holding Pulane in the back seat. At the gate I spoke with the guard, asked him to join us at the mortuary.

Inside that cold room I found a freezer compartment that was empty, one of the few that didn't have "Se kenye mofu ka mona" -- "Don't put a body in here" -- written on the door.

There was no mortician, and no paper or pen to indicate, per the standard procedure in the mortuary, who the baby in my arms was. I looked at the security guard and Bokang, and they looked back at me. I went out to the car, wrote Pulane's name and TTL's information on a piece of paper that I ripped from our vehicle log-book, and went back inside, slipping the edge of the note under the sheet Pulane was wrapped in. I had a strong desire to do more, but there wasn't anything else to be done.

As I turned to leave, I saw Bokang and the hospital guard looking into a large, walk-in freezer at the edge of the room. They were talking in low tones to each other, but I made out the word "bana" -- children.

I glanced through the open freezer door, and there on the floor lay the bodies of three boys in their underwear, varying in age but likely in their early teens. Their faces were obstructed, but the site was jarring. The soles of one boy's feet were stained in blood. I found myself staring.

"Are you ready?" I asked.

Ten minutes later I was back in my bed. Like I said, death here is never far away.

My high hopes for Pulane and her twin sister, Nthabiseng, now rest with Nthabiseng. I hope the amazing fight in her is enough.

S.P.@.T. -- V3

2010-07-24T03:14:00.000-07:00

Sticking Points @ TTL, Volume 3:

1. Flashlight on a cell phone: the best app ever.

2. When you reach the point of preferring mutton to chicken at the local corrugated-metal lunch place, there is initial confusion. Do you really want mutton? Yes. Yes you do.

3. Twins are increasing in number. It's just a theory.

4. Little boys' homemade toy cars, with their frames and steering poles made of metal wire and their wheels made of aluminum cans, are awesome.

5. Fresh dried fruit is delicious. Pears are the best, followed closely by peaches. This is up for debate.

6. Where babies are concerned, high-fives are contagious.

7. Roadblocks are inherently flawed, because donkeys don't obey them. Nor do police.

8. Cold nights don't suck as much when the days in between them are sunny.

9. Sun hats on babies are hilarious and adorable.

10. Lambs have tails.

11. Little known fact: Candy isn't the best philanthropic gift for malnourished babies. I know, weird.

12. Days may start getting longer again, but it's still winter.

13. Moms make the best care packages.

14. Carrying something heavy (read: generator) with someone half your height (read: Nthabeleng) is made even more difficult and awkward when laughing uncontrollably.

15. Healthy babies are happy babies.

Familiarity

2010-07-20T23:07:00.000-07:00

It's funny how things sneak up on you when you least expect it.

For instance, I suddenly feel a level of comfort, like I have finally settled into the rhythm of life here in Mokhotlong -- a sort of regular mix of the irregular.

Eric, the new TTLF Fellow, just arrived and moved into Kirsten's former rondaval. So far this week I've been trying to introduce him to all things TTL. It will be great having another person here to help again.

Eric's arrival makes me think back to my own arrival here more than five months ago, and how different everything seemed to me then. Now everything is far more familiar and I feel like I fit into it all. I'm more comfortable with my role here, with colleagues, with the babies, and with the people in town. It's a nice progression to have made and a nice feeling to have.

The feeling isn't hampered by the fact that the babies continue to do well. They are growing rapidly and are getting more and more rambunctious. They are all girls except little Mpho, and interact with each other in an endearing way.

I remember not too long ago when sickness was tearing through the safe-home and all the babies seemed threatened and the world felt like it was crumbling apart. There's nothing like the death of a little baby in your care to make you lose your level of comfort with your immediate surroundings and with the world as a whole.

At the other end of the spectrum, there's also nothing like the smiles of a handful of little girls, who have gotten to know you, who trust you and who run to you with big smiles whenever they see you, to instill that same comfort back again.

Baby Binging

2010-07-15T23:55:00.000-07:00

Do you know what a premature baby eats?

Let's take Nthabiseng, one of the new twins who is eating well, as an example. It's really pretty amazing.

She's eating about 30 ml of formula every two hours or so. That means she eats about 360 ml of formula a day. That's more than a third of a liter.

She only weighs 1.5 kg -- a little over 3 pounds - and, for reference, is smaller than a regular 2-liter bottle of soda.

Imagine being that size, and drinking that much milk.

Trying to size it up in some comparable way for myself, all I can picture is a big recycling bin full of milk sitting there for me to drink each day. I don't think I could do it.

Premature babies have to fight constantly to stay alive, and so they need the nutrients of regular meals. Dr. Amy from the Baylor International Pediatric AIDS Initiative came by yesterday to check on all the babies here, and said the twins are right on track with their eating -- a great sign.

They were losing weight at home but have stopped since getting to the safe-home. That they are now suckling and eating well with no signs of vomiting or diarrhea should mean they will start growing quickly.

I have high hopes for these two. I know we have to get them nice and strong before they can go home, as they'll have to contend with 7 older siblings once back, but I think we'll get them there.

Even though I've seen so many babies transform here for the better, I still get excited every time I see the same promise peak out once more. It's intoxicating.

Cross your fingers

2010-07-12T07:15:00.000-07:00

Imagine this:

You are a young mother in your late thirties. You have seven children. Your husband is working in another country. You are HIV-positive. You sell homemade beer for a living. You and all your kids live in the same, run-down, one-room rondaval. You are trying to make things work, but you're just barely hanging on. It's all too much. One child just got accidentally burned with hot water. Another one just got accidentally burned with fire. They are healing, but medical attention isn't exactly at your fingertips. You live in the middle of no where.

Then, in the midst of all this, you give birth to twin girls, bringing your total number of children to nine. They are premature. They are tiny. They are rapidly losing weight. What can you do?

Just last week, TTL was put in touch with a woman in that exact situation.

Her twins, Pulane and Nthabiseng, are now in the safe-home, bringing our total number here to ten.

The twins were born on May 11 at just over 3 pounds. They are adorable, especially when asleep and wrapped in blankets here at the safe-home, but are so tiny it is hard to imagine that they are real, living, breathing baby girls.

They still aren't eating very well, but I'm hoping that the more they get used to the formula, their surroundings and the care and attention of the bo'me, the more they will eat.

Their situation was so dire when we found them that a full recovery and a bit of a growth spurt here will be an amazing accomplishment, and another triumph for TTL.

These two have a long way to go, but they are in the right place for the journey.

Cross your fingers and wish us luck.

A Sixth Sense

2010-07-08T08:58:00.000-07:00

It's official: I'm developing a sixth sense.

I noticed it today for the first time, and it made me happy. It's still developing, for sure, but it's there where it wasn't before. In a way, it's many senses combined into one. It's a sense of babies.

It's a sense of how to react to babies, a sense of when to leave them alone and when to get in their face. It's a sense of how to sway to make them close their eyes in your arms, and a sense of how to be firm without scaring them.

It's a sense of when they need to burp, and when they are about to spit a spoonful of vegetables right back out.

It's a sense of when to push them forward, and when to follow behind them just in case. It's a sense of when they want to stop playing and just sit in your lap for a while.

It's a sense of when they are wet, when they are currently wetting, and when it's just gas.

It's a sense of how they like each bite of dinner mixed on the feeding spoon, and how to trick them into eating when they don't want to.

It's funny how, when you work in an office that is part safe-home, you subconsciously get attuned to the various fluctuations of baby life. You start to sense those fluctuations from the other side of the building, just by picking up on the sounds that cut through the cement walls.

Today there were screams throughout the day, echoing through the office. Most of them were happy screams, with a ranging cadence only possible in early childhood, when screaming just to scream is fun. A few were sad screams, when a time-out imposed by the bo'me wasn't taken-to kindly.

Like I said, this sixth sense of mine is still developing -- and I'm far behind the babies themselves in developing it. They can already read me like a book from a mile away.

Selloane, for instance, has developed an obsession with a new game where she immediately walks up to me whenever I enter the playroom, giggling and grinning from ear to ear. I bend down, put my hands out in front of me, growl and essentially feign derangement, and she runs away screaming. Then we do it again.

But a few times today, when I went into the playroom to ask M'e Mamosa a quick question, Selloane somehow knew I was in work mode. Instead of running up to me grinning, she just walked up and clung to my pant leg nonchalantly, smiling up at me and wondering if the grown-up talk would end soon.

I looked down at her and smiled. Then I crossed my eyes and stuck out my tongue, and she screamed and ran away giggling.

Freedom and the Fourth

2010-07-04T01:34:00.000-07:00

I woke up this morning to a quiet breakfast and a warm cup of coffee in the sun. The simple pleasures in life mean a lot here, and I felt at ease.

I let my mind wander and suddenly remembered that today is the Fourth of July.

While there certainly won't be any fireworks in Mokhotlong, there is something else, something far more relevant and important about this day for me here: the profound sense of appreciation for the United States I've gained.

I've appreciated my country before, but never so much as now.

I guess it takes a stint in a country like Lesotho to fully comprehend the luxury of living in the United States. I know there are people struggling with nothing in the U.S. also. And of course there are things about my home country that I would change.

But to such a vast extent, I realize more than ever that I am so lucky to have been raised in a country where the roads are maintained, where grocery stores brimming with food are everywhere, where hospitals are fully stocked with supplies, where the government is stable and where corruption is regularly confronted by a vast system of checks, balances and the fourth estate.

I appreciate more than ever the ease of transportation in the states, the ease of communication, the ease of entertainment, the ease of information.

I appreciate that, because of my loving family, I never had to worry about my next meal or where I would sleep or if I would be warm enough. I appreciate the great education I received, which has given me all the freedom in the world.

I appreciate the fact that, because of the stability I've been afforded in life, I was able to develop the network of friends who I now miss more than ever and appreciate more than ever.

This Fourth of July, I feel like I'm really celebrating in the right way, perhaps for the first time, just by appreciating the independence and freedom that life in the United States provides.

What I've seen firsthand here is that, when there is no food and no water and no medicine and no support and no transportation, freedom is a hard thing to come by.

Happy Fourth of July.

Caught up and caught off guard

2010-06-30T03:35:00.000-07:00

Lately, I've been caught up -- namely in a million administrative tasks. They are the duties that help make this place run smoothly, and they come in floods.

Then, yesterday, I was caught off guard -- once by a moment of happiness, once by a moment of sadness.

In the midst of my administrative work, both moments were like sudden flashes of light in a dark room: shocking enough to make me close my eyes for a second in adjustment, and bright enough to give me a clear dose of reality apart from my office bubble.

The first occurred when I slipped into the playroom to take another look at the babies. We have a total of eight now.

We have Ntseliseng and Selloane, who I mentioned last week, as well as Nthati, who has been here the longest and who seems to be doing really well. We have Mamello, who is three months, Karabo, who is wild at one year, and the twins Bohlokoa and Bohloeki, who are staying strong and doing better.

We also recently took in Mpho, a tiny little boy who was born on June 6 at less than 4 pounds and referred immediately to TTL. He was born a twin, but his sibling didn't make it.

My moment of happiness came with Ntseliseng.

I've been trying to get her to use her legs more and more, pulling her onto them and holding her hands as I lead her forward. In the past, she has burst into tears or sort of welled up in resistance each time I attempted this exercise. Her legs are tiny, and it's tiring for her to use them.

But yesterday, the reverse happened. I pulled her onto her legs, and amazingly, she laughed. I walked her forward, and she giggled with each step. I verbally encouraged her more and more, and she looked back at me and then around the room, as if to say, "Hey, everybody, look at me!" She kept laughing with each smile from the bo'me.

For me, it signified a possible turning point in her development. If she associates making an effort to use her legs with accomplishment and encouragement, maybe she'll start making that effort more often.

After a few feet, I stopped backing away from her, and let her fall into my chest. She pulled herself up to a standing position, holding onto my shoulders. She was out of breathe a bit, but smiling. I smiled back.

It wasn't long after when my moment of sadness came.

I was sitting in TTL's front office when one of our outreach workers, Kokonyana, came in with a mother and baby. The mother pulled up the shirt of the infant, who was crying, and I could see what appeared to be a bulge in the baby's side disappear and then reappear on her other side. It seemed almost as if it were pulsating back and forth.

Kokonyana gave me the baby's bukana, and I saw the words "bilateral hernia" scrawled in black pen.

I'd never heard of such a thing, but guessed what it meant.

I also saw that the Mokhotlong hospital had referred the baby to the hospital in Maseru. Another one of our outreach workers told me the mother is mentally ill, a complicating factor in the entire situation. I looked at the nonchalant way the mother held the baby, and heard the wail of the baby, and cringed.

We supplied the mother with a fresh can of formula, a bottle brush and soap, and then took her back to the Mokhotlong Hospital to see what we could do to help facilitate her trip to Maseru. We were able to get her admitted to the C Ward, where she will receive assistance and transportation to Maseru. It's all we could do at this point, but it didn't diminish my concern.

Both moments, like I said, were like sudden flashes of light. I think I am still blinking from both...

Striking Transformations

2010-06-24T07:44:00.003-07:00

I opened the door to the play room today and there they were: Selloane and Ntseliseng, looking back at me and smiling from ear to ear.

"Hi!" I said, waving.

They both giggled. Ntseliseng waved. Selloane bolted in my direction, and I scooped her up and spun quickly in a circle. She grinned, her dark eyes seeming to sparkle, and I laughed out loud in amazement.

In the last few days, both girls seem to have hit a turning point in their recoveries, and suddenly seem like brand new, energized versions of themselves.

The transformations are absolutely striking.

Selloane, who will be three in October, was so shy for so long. She used to sit quietly and stare. When she was sick, she frowned and looked miserable. She didn't want to be held or played with or, as far as I could tell, acknowledged.

But ever since her fever broke, she's been opening up and gaining weight, going from 7.2 kg on June 12 to 8.2 kg today. Her face has filled out, and while it used to be a big event if she showed even the slightest hint of a smile, she now gives big, cheesy smiles all the time. She literally looks like a different kid. She's loud, happy and expressive, wandering around the playroom with all the energy a girl her age should have.

Ntseliseng, who will be two in September, is smiling and making lots of noise now as well. She still isn't walking, her legs still tiny and extremely underdeveloped, but she is crawling and scooting on her butt more and more. She happily ate her entire lunch of carrots, chicken and rice today, is breathing regularly and looks better and less gaunt every day.

All this after being on death's doorstep so recently, and being on a roller coaster of health fluctuations for the last month. Ntseliseng got here tiny and ill, recovered and started to do better, and then hit the wall of illnesses that swept through the safe-home last month and spiraled quickly downhill. I wasn't sure she was going to make it. There were moments when I thought she would stop breathing at any second.

But now she seems to be back on track. She's gone from 5.6 kg on June 6 to 6.7 kg on June 12 to 7.1 kg today. She's getting less and less fussy with me when I try to pull her onto her feet and exercise her legs.

After the happy greeting I got walking into the playroom earlier today, I played with Ntseliseng and Selloane for about a half hour just before lunch. They both like playing a game where they stick their tiny hands toward my face and I pretend like I might bite. They shriek in laughter and yank their hands away. Ntseliseng also likes playing a game where she puts her face less than an inch from mine, then looks directly into my eyes until she or I break and roll away in laughter.

At one point I was on my back, and Selloane sat on my chest smiling as she watched Ntseliseng pull herself up onto my chest as well. They both seemed happy and content and comfortable, laughing down at me -- such a far cry from a few weeks ago.

I caught myself marveling at their improvement, and again laughed out loud.

One second, a thousand years...

2010-06-22T01:45:00.000-07:00

I can't believe I've been here almost five months.

Then again, sometimes I feel like I've been here forever, and so has everyone I meet here, like we're all locked in some twilight-zone representation of the world, one that only changes at a glacial pace and will continue on doing so forever through its peaks of sadness and cheer.

Time here is at once ephemeral and permanent. It is strange from the smallest sense of the word to the largest sense of the word -- from one second to a thousand years.

One second here can last forever, and lock into your consciousness for good -- packed so densely with emotion that you'll never forget it.

When a baby is struggling to breathe and you are sitting with her in a hospital with no resources, and a cold, dark winter night is all around you and seems like it is closing in fast to take hold of both you and the little one in your arms, seconds seem to last an eternity. They tick away in your head and you count them slowly, happy for each one and scared for the next. Each new second is your connection to the future, but might also be that sad thing they call a "Time of Death" for the helpless little baby in your arms. You hold on tighter.

One second.

Sometimes, for just one second, when I'm just waking up or am about to fall asleep, I will forget where I am. And then there is the next second, when I remember, and my mind and my body again go through the physical shock and awe and confusion and wonder and shivering adjustment of realizing that I am in Mokhotlong, at the edge of the world, or the peak of the world, and that I am staying here.

Just one second is time enough here for vast changes to occur. Things happen in a flash and you're left to wonder why and how.

On the other end of the spectrum, a thousand years can seem trivial here. It's easy to get the feeling that the impact of a thousand years wouldn't be that great here, wouldn't change all that much, because the last thousand years haven't changed much here either. In certain villages, I feel like I could fall asleep, wake up a thousand years ago or a thousand years from now, and be absolutely none the wiser.

When I set out on outreach, and hike to a rural village and find nothing but a few stone rondavals with thatched roofing on the edge of a cliff, and all around me there is the enormous blueness of the panorama sky so big I wonder if its grounded and I'm the one floating above, I think of 2,000 years ago and wonder if people were living the same way back then. And then I think, yes, they were, and the feeling is strange. Thousands of years seem to flap away in the wind and I think, for just a split second, that I could be in Biblical times. The cell phone feels strange in my pocket, like a useless rock. No reception anyway. I'd be better off yelling from mountain to mountain like the locals, whose voices seem to carry so well and whose hearing seems mystical and far beyond my own.

Thousands of years vanish here to nothing.

I shudder at the brevity of time here when a baby is taken away, too soon, because some wretched little virus or bacteria steals him away with no apologies.

I try to comprehend the enormity of time, in terms of history and how far back I can see into the past, when I look at the simple villages in the middle of no where.

Time here is something you want to change for people, something you want to make more malleable in their lives. You want to give them the tools to manipulate time, the tools that are so prevalent elsewhere in the world. They shouldn't have to walk for hours to get water, you think. They shouldn't have to walk for half a day to get medical support.

Time: In a way, it's what TTL deals in.

We reverse the horrors of months without enough food in a matter of weeks. We deliver support to families in hours in our outreach cars, covering distances that some of the family members may never travel in their lives.

Time, in a way, is what TTL gives people here. More time to live. More time to care about a child's development and growth instead of worrying about where the next tin of formula is going to come from.

Time is what we all base our lives around. How we operate within it and the tools we have to use it efficiently shape our standards of living.

To be able to help change time for people, to give more of it to young babies, is a powerful thing. It's a feeling I can grasp in one second, and a concept I feel I could mull over for thousands of years.

Time. It's a strange thing here.

3 Princes

2010-06-18T07:25:00.001-07:00

On a day-to-day basis, I never know what to expect in Lesotho. Every day is different. Some days are sad, some days are happy, and some days are one-of-a-kind.

Yesterday, for example, was a pretty unique day in that I happened to meet three princes: Prince Seeiso of Lesotho and Prince William and Prince Harry of England.

Sentebale, which Prince Seeiso and Prince Harry co-founded four years ago to help the children of Lesotho, is a big supporter of TTL's, and M'e Nthabeleng and I were invited to a small gathering at Sentebale's offices in Maseru to celebrate the organization's fourth anniversary.

There were about two dozen guests at the small luncheon event, most of them from the various charitable organizations that Sentebale supports.

Prince William and Prince Harry -- in the region in part to enjoy the World Cup -- served as the guests of honor at the event along with Prince Seeiso, who is King Letsie III's younger brother and Lesotho's ambassador in London.

Prince Seeiso is really amiable, and made his way around the room with a warm approachability. When he shook my hand he looked in my eyes, and when he read "Touching Tiny Lives" off my name tag it was with a genuine smile. Naturally, M'e Nthabeleng had him laughing out loud with a few quick quips in Sesotho.

Prince Harry and Prince William are both taller than I had imagined. They were dressed casually, and despite the formality of their positions, seemed in the small crowd like any other laid-back twenty-somethings. They also interacted with each other in the one-raised-eyebrow-means-a-thousand-words sort of way that only brothers can. It was endearing, and made me miss my own three brothers.

Unfortunately, M'e Nthabeleng and I never got to talk to them directly about TTL, but being in their immediate presence with our labeled name tags seemed like networking in its own right.

In his short speech, Prince Seeiso praised Sentebale's staff and partners, saying the organization's work has been getting sharper and more refined with each passing year. TTL's mission to help orphaned and vulnerable children fits perfectly with Sentebale's, and I consider our partnership -- which started in 2009 -- as part of that refinement. We are lucky to have Sentebale's support, which stems directly from the commitments of Prince Seeiso and Prince Harry to the kids of Lesotho.

In a way, monarchs are strange figures for Americans -- and for me -- to grasp. We lack relevant comparisons, partly because many of America's privileged aristocratic heirs -- at least publicly -- are socially-unconscious socialites with little to no responsibility.

Partly in light of that, seeing the three princes take time out of their obviously hectic schedules to meet with a couple dozen NGO workers was a cool experience.

They were there to say they care, that they take their titles seriously and respect the people on the ground, doing the work that they've helped make possible.

Lesotho, Sentebale, TTL and all the other organizations represented at the small gathering count on support from the outside world -- and to see three princes leading the way was an encouraging thing to witness firsthand.

"Feel it. It is here."

2010-06-14T23:56:00.000-07:00

"The FIFA 2010 World Cup in South Africa: Feel it. It is here."

Even though the World Cup isn't technically in Lesotho, Lesotho is geographically inside of South Africa -- and soccer fever is palpable here. The above slogan, which can be heard on the radio constantly, is poignant. You really can feel the tournament's presence.

South African flags have suddenly become ubiquitous on all the cars and trucks around town, and the sound of vuvuzelas -- or giant plastic horns -- can be heard blaring throughout Mokhotlong during all the matches. It's a contagious feeling of excitement.

On Friday night, Claire, Quinn, Emma and I all went over to M'e Nthabeleng's house to watch the tournament's opening game between South Africa and Mexico. Lesotho's team isn't in the tournament, but lots of Basotho -- including M'e Nthabeleng's teenage son Neo -- root for Bafana Bafana, the South African team, so the game was a big one.

On Saturday night, we all went to M'e Nthabeleng's again for the game between England and the U.S.A. At the beginning of the game, M'e Nthabeleng playfully insisted that I sing the U.S. national anthem.

We had big dinners both nights, and got to sample the local cuisine of papa and cabbage a la Chef Nthabeleng. I even pitched in by making a dessert Saturday night , which consisted of local makoenya -- or fried dough balls -- drizzled with melted chocolate and coconut shavings. They were, I'm happy to report, a hit.

The simple experience of watching the games -- both 1-1 ties -- with M'e Nthabeleng's family is one I will never forget. We all crowded around the television in her family room and cheered together for Bafana Bafana. They teased me by rooting for England as I cheered for the U.S. As we talked to each other about near misses on goal and the funny facial expressions of raging coaches, English mixed in and out with Sesotho. A single gas heater sat in the center of the room, but there was plenty of warmth and camaraderie to go around.

Although I'm not going to make it to South Africa for any of the games, watching them in Mokhotlong is something I wouldn't want to trade.

The only sad part of the World Cup being so close is the feeling that, even as the world turns its collective gaze on South Africa, it will forget the tiny country in its peripheral vision. The World Cup is occurring on Lesotho's front porch as we speak, and still I fear Lesotho will miss out on all the tournament's benefits.

I recently heard on the radio that more World Cup tickets were sold in the U.S. than in any other country outside of South Africa.

I hope my countrymen will do more than attend games and buy soccer souvenirs. I hope they'll look around them and see the need that is all too apparent.