Away from the lush faux-jungle campus of Asociacion Nuestros Ahijados, away from the cheerfully painted playground and spacious, spotless classrooms, another cornerstone program sponsored by the God's Child Project sits. Only a ten-minute walk away, the Casa Jackson Center is still cheerful, still spotless, but quieter; more serious.
Casa Jackson is a small hospital that serves children from birth to eleven years who are significantly malnourished. In Guatemala, where an estimated 49% of all children are undernourished, their services are a critical support for the children who come to them. Some of the children are from concerned, loving families who bring them to the center or to a field clinic to have their health assessed by a doctor; some are transferred here from larger hospitals and medical facilities nearby; others are placed here by social services after being found abused, neglected, or abandoned. Regardless of the way they arrived here, they all leave the same: healthy and well-nourished.
Many of these children suffer from a variety of medical issues upon arrival. There are skin infections, parasites, respiratory illnesses, and a host of other diseases to contend with. A number of children arriving at the center have diagnoses of cerebral palsy, spina bifida, and other neurological or motor impairments. The medical staff at Casa Jackson consists of a part-time pediatrician, nutritionist who carefully plans each child's daily meal plan, and a host of loving nurses, male and female, who provide medical support as well as attention and affection. A steady stream of volunteers support the nurses' efforts and aid the staff in cleaning and doing laundry. Casa Jackson may be nestled in the interior of a third-world country, but the care provided by the staff is the best possible given the scant resources available to them.
All children leave the center healthy. This is a fact. Until they are healthy, they do not leave; the average child's stay at Casa Jackson ranges from several weeks to several months. Upon release from the center, without further support to their families, many children would return weeks or months later in the same condition they arrived. They would return to their dirt floors, eat meals of coffee and tortillas, and catch the same parasites from the same unfiltered, unboiled water they drank before. In many other programs, this would lead to a revolving door of critically ill children and full dependence upon the program's services.
Casa Jackson is not like many other programs. The center, in conjunction with God's Child Project, employs a team of social workers who work with the families and focus on all of the issues that brought their child to the center. There are generally two fundamental issues underlying every child's stay: a lack of education regarding proper sanitation and nutrition, and abject poverty. Mothers need an understanding of the dangers of drinking untreated water and how to avoid these dangers. They need basic education regarding proper nutrition for themselves and their children, as many of these mothers grew up on the same diet they feed their children. They need education about how to breast feed, and the benefits of doing so. Many families need water filters, fuel for a fire to boil water, and assistance building a home that has a concrete floor to prevent children from catching the many parasites and infections lurking on an uncovered dirt floor. Casa Jackson works hard to provide all of these.
In 2010, the center provided care for 95 children. Of them, only five needed to return for further treatment after returning home. The numbers speak for themselves.
Two of those children are at Casa Jackson today. Unfortunately, both have a questionable social history and have come to Casa Jackson through the social services department after being removed from their parents' homes. Their past is not fully known and their future is uncertain, but for now, they will remain at the center; well-fed, well-loved, and well-cared for. But unfortunately, love, food, and education cannot solve every issue faced by these little girls.
Gricelda is two and a half years old. Her eyes flutter and dart side to side as she listens to the nurse speaking to her as he changes her diaper. Every few minutes, she lets out a half-coo, half-moan in reply. Her arms, bent tightly at the elbow, end with her tiny fisted hands resting on her chest. The nurse rolls her gently to her side to remove her wet diaper and place a clean one beneath her. Her impossibly thin legs are bent tightly at the knees. Gricelda has been blind from birth and has a diagnosis of cerebral palsy. Her mother can visit only with the permission of a judge, and her father visits when he is able. The team at Casa Jackson does not know the details of Gricelda's life before coming to the center, but the issues facing her here are readily apparent.
After donning my mask, scrub top, and smock, I brought Gricelda to the playroom on the third floor of the center. I held her close and firm, feeling her small body jerk with uncertainty each time I released my grip slightly. We sat together on the padded mat as I tried to engage her in some sort of play. She displayed many of the behavioral tendencies expected of a visually impaired toddler; she cried when she was moved, she pulled her hands away from any item I brought to them, and she soothed with touch and soft singing. Eventually I held a soft stuffed bear to her chest and hugged her arms around it. She opened her hands and allowed me to rub them along the soft fur of the toy, and then promptly began to doze off. I took a minute to touch her cheeks, her nose, her hair. Like my young patients at home, she was impossibly soft, impossibly delicate, and incredibly lovable.
As I laid Gricelda down to sleep, an impish toddler with a massive cast from her chest to her toes grinned at me and waved her arms from her crib across the room. Magaly, who suffers from microcephaly and recently had an operation to correct a spinal defect that left her unable to move her lower body, is also two and a half, and while her needs are vastly different from Gricelda's, her story is equally as sad.
Magaly was first treated at the center for several months in the spring of 2010. During her stay, two volunteers (from the US and Canada) began championing her cause back at home, raising funds to build the family a home with an ever-important concrete floor, money for the operation that would hopefully save her from a life of paralysis from the waist down, and, equally as impressive, purchasing all the formula and supplements needed to feed Magaly until she was ready to begin eating solid food. She was sent home with her family to what the staff thought was a much brighter future.
Magaly returned to the center late in the summer of 2010. Her father, an alcoholic, sold the house piece-by-piece. He sold the formula and supplements provided to the family. He beat Magaly's mother brutally and often, as Magaly sat by helpless, confused, and completely traumatized. She returned to the same center, but as a different child. Her constant smile and infectious giggle had been replaced by tears, tantrums, and inconsolability. Her parasitic infections had returned and she was again dangerously underweight. Over the past five months, she has had her operation, grown healthier and stronger, and her mother had the courage to press charges against Magaly's father- a rare, brave act in a country where out of 30, 000 reported cases of domestic violence, only 50 are ever prosecuted.
I crossed the room and reached a hand into Magaly's crib. She smiled, babbled happily, and reached her arms up to me. I asked her if she wanted to come out. Her grin widened as she clapped her hands. I picked Magaly up from her crib, straining under the weight of her massive cast and trying to keep her reclined at a forty-five degree angle to prevent putting pressure on her spine. She immediately began craning her neck around to look side to side, behind, all around, and asking "nene?" I brought her into the other rooms to see the "nenes" (babies) and she shook her head. She spotted a baby doll in another crib and began gesturing wildly with her slender arms and repeating happily, "nene! nene!" I retrieved the doll from the crib and we sat together on one of the mats outside of her room. She hugged her doll to her chest and babbled some more. We dressed and undressed her 'nene,' put it to sleep and woke it up, and pretended to feed it. I tickled her and pretended to sneeze, letting my hair fall and tickle her forehead. She let out more giggles.
Magaly appeared the most excited of all the children for lunchtime. As the soup bowls and cups of water were brought in, she began squirming and wiggling in my arms and clapping her hands together. We sat together on a white plastic chair; I held her steady as one of the nurses spooned chicken and rice soup into her very eager mouth. She had an uncanny ability to find any shred of chicken mixed in and spit each out immediately, as many toddlers her age. Every few bites, she cooed, "ahwa" (agua) and the nurse held a cup to her mouth as she gulped it down.
Magaly's mood changed as soon as I placed her in her crib to change her diaper. She began crying, shrieking, holding my hand and shaking her head in protest. The nurse explained that Magaly, who is quite bright despite her microcephaly, knows the schedule well. Naptime follows the post-lunch diaper change, and Magaly is no fan of naptime. I tried to soothe her as I pulled her terry-cloth pants down over her cast. A large hole was left for diaper changes and bathing, but as she spends much of her day lying down and is not yet able to sit upright, urine seeps into the surrounding area of her cast. The nurses put an absorbent cloth in her diaper to minimize this, but the odor of stale urine coming from her cast belies the limited success this technique offers. With a new, clean diaper fastened securely around her cast and her pants back on her slim legs, she calmed and again began begging for me to take her out of her crib. I stroked her cheek and tried to soothe her as I explained that it was time for her to take a nap. She calmed eventually, as the nurses assured me this tearful protest was routine for her since returning to the center this summer.
As the children settled down in their cribs, the director of the volunteer program at Casa Jackson, Andrea, explained that both Gricelda and Magaly have multiple doctor's appointments scheduled next week, although the program does not yet have the funds for them. The staff is anxious that the appointments will have to be cancelled and rescheduled for a later date if they cannot raise the 650 Guatemalan Quetzales (roughly $85USD) before next week. Magaly is scheduled for a follow-up on her surgical procedure and is scheduled to see a neurologist for concerns regarding her microcephaly, and will need another surgery after removal of her cast to take the remove the screws from her hips. Gricelda is scheduled to see an eye specialist, and it is expected that she will need several surgeries on her eyes in the coming months. Both will need extensive follow-up in the form of post-surgical consultations and, for Magaly, physical therapy.
The staff and volunteers at Casa Jackson know that despite their best efforts, they cannot guarantee what will await Gricelda and Magaly when they leave the center. Children with special health care needs, in all but the most developed countries (and even in them, at times), are often marginalized and forgotten; they rarely receive the opportunity to benefit from the medical care that can drastically improve their quality of life and the ability of their families to care for them adequately.
Without Magaly's recent surgery, she had no hope of ever being independently mobile outside of a wheelchair. For a child in a developing country, where job prospects are slim even for the most able candidates, being confined to a wheelchair or potentially walking on your own two legs is critically important difference. For Gricelda, any improvement in her vision could lead to an improvement in her quality of life. It is no secret that vision is a foundation of development for many children. Visually impaired children are often tentative, anxious, and hesitant to engage in the two activities critical for learning: exploration and play. For a child with loving parents who have the time and resources to maximize their child's opportunities for learning and development in other ways, it is very possible to overcome developmental challenges and build a new foundation. For Gricelda, who has a number of loving caregivers but may not receive the stability and consistency she needs when she leaves the center, an improvement in vision would likely lead to decreased anxiety and avoidance of her environment and consequently, an increased motivation and ability to explore and play.
Generally, donations for the center are received through the God's Child Project (Asociacion Nuestros Ahijados' US-based partner organization) website. Unfortunately, this money reaches North Dakota (the site of the Project's US administration) before being transferred to Guatemala. This process takes several weeks. In light of the time-sensitive need for donations to cover the cost of next week's appointments, if anyone is interested in donating to the center to assist in covering medical costs for the girls, the director has requested I have money transferred directly to my account so that it can be accessed immediately by ATM and provided in time for the appointments next week. Please email me at AGridley@live.com and I will provide you with the information needed to complete a transfer. If anyone has any hesitation about transferring into a private account, I will provide you with the e-mail address of the program director so that you may confirm your donation was received in full.
For those unable to donate, thank you for your interest in my trip, and the work being done through Casa Jackson and Asociacion Nuestros Ahijados. The breadth and quality of the services they provide to the community are really incredible. Their work touches upon so many of the grave issues plaguing the Guatemalan community, and programs are thoughtfully designed and sensitively implemented with the assistance of their foreign staff and the 75 local social workers, teachers, nurses, pediatricians, dental specialists, and support staff they employ. Few programs are equally as successful at empowering the communities they serve as they are addressing their immediate needs; Casa Jackson, Asociacion Nuestros Ahijados, and God's Child Project are among this minority.
Please visit http://www.casajackson.org/ to learn more about the problem of malnutrition in Guatemala, the comprehensive services offered at the center, and the extensive services provided to families to prevent reoccurrence of malnourishment. A PayPal link is provided for donations, if you wish to donate to the program for any future needs beyond the 650Q needed for next week's appointments.
Gracias!
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