Tag Archives: child health

Staff Enriched Through Education Sessions

Breastfeeding Education Session Lecture

At Calcutta Kids we are currently revising our Child Health Initiative to strengthen and make improvements to our program activities. The revisions will be based on changes in international guidelines and lessons learned over the past six years. We recently carried out a similar process with the Maternal Health Initiative which included improved monitoring and evaluation, curriculum and protocol development, and in-depth trainings with our community health workers and other MYCHI (Maternal and Young Child Health Initiative) staff. Training and counseling will also be a major component of the child health redesign, particularly as we do not have a standardized training curriculum or comprehensive materials for child health counseling. Previous trainings have been informal and primarily verbal, using limited resources.

Case Study Group Work

At present we have two interns from George Washington University (Lisa and Lindsay) who are working on behavior change communication (BCC) at Calcutta Kids. Under the guidance of the MYCHI program coordinator and manager (Sumana and Danya), they are developing a curriculum for child health education sessions, and creating flipcharts with child health messages to be used by our community health workers and health clinic staff. The education sessions were launched this month comprising of all the relevant child health-related topics that we address at Calcutta Kids. So far we have held education sessions for our health workers and health center staff on Initiation of Breastfeeding, Postnatal Care, Care of a Low Birth Weight Baby, and Complimentary Feeding. Next month, we will be holding sessions on Immunizations, Care of a Sick Child, and Development Milestones.

Practicing Kangaroo Mother Care for Low Birth Weight Babies

Although most of these sessions are review for our old health workers, this serves as a comprehensive refresher training for them, and is crucial knowledge for new health workers and the health clinic staff. Our sessions have been both educational and fun for the staff, not only comprising of lectures, but also demonstration, case study competitions, and role play. The child health education sessions will ensure that all our staff have the same foundation of knowledge, which will enable them to give uniform information and messages to the community we serve. Following these sessions, our staff will be equipped with culturally appropriate flip charts to be used in home visits and community meetings. -Danya Sarkar

Swastha Kendra is Open and Fully Functional

The Swastha Kendra (Health Center) is now open to see patients five days a week. Over the last few months, we have been transitioning the space that was formerly the diarrhea treatment center into a health center that can treat all manner of minor illnesses. While before we had a ‘health camp’ once a week, we now have a fully staffed clinic in order to better serve the needs of Fakir Bagan. The patients are seen by a nurse for basic vitals, then see the female doctor for a full examination and finally receive any necessary medications along with counseling on proper administration and possible side effects of medications as well as beneficial behaviors in the home in relation to the specific illness or complaint.

This transition is an effort both to make the clinic space more cost-effective per patient treated, but is also an answer to the needs of the community. In the month of February, 226 clinical visits took place in comparison with an average of 126 visits from July to December. These 100 visits were made possible by the additional hours.

Transitioning to this health center approach has also allowed us to start implementing a clinical protocol based on the Integrated Management of Neonatal and Childhood Illness (IMNCI) guidelines. These guidelines are used worldwide for the simple diagnosis and treatment of childhood illnesses with minimal and inexpensive, but effective, medications. Having a full time doctor also allows us to treat more conditions than would be possible simply following IMNCI. It also helps to increase the level of confidence that the patients have in these relatively simple treatments.

The diarrhea treatment center is still fully functioning and will be an increasing part of clinical care as diarrhea season approaches. The only change is that diarrhea treatment is now a part of a larger clinic rather than sharing a space with the health camp once per week.

We have also incorporated a new nutrition corner where mothers can be counseled on a regular basis including observed breastfeeding and observed feeding of complementary foods. Look out for a post in the next few weeks about Ajay and Promila who have been taking advantage of this nutrition corner. – Dora Levinson

Note: We are looking for a sponsor to endow the Swastha Kendra and ensure that these services can continue. For more information about this endowment please write to Noah@calcuttakids.org.

A Mother’s Story

Rekha with Rani at the start of YChiNG and shortly after the birth of Madhu

Rekha Shaw is an out-going, energetic woman who participated actively in the YChiNG trial. Her two youngest children were malnourished and were in a terrible condition when we enrolled them in the program. Rani, at 29 months, weighed 7.31 kg (a little over 16 pounds) with a weight for age z-score (WAZ) of -4.296. Rani was stunted and developmentally delayed—she could not stand up, let alone walk. Her younger sister Madhu was faring slightly better but was still severely underweight: at 16 months, she weighed 6.58 kg (about 14.5 pounds) with a WAZ of -3.3. Both girls were very anemic, had high worm loads, and suffered from frequent acute infections.

Their mother, Rekha, has six daughters, a result of repeated pregnancies in an attempt to have a son. Tragically, she did have a son (born after the first four daughters), but he died just after birth for reasons she does not know. She lives with a mother-in-law who is not supportive and pressures her to bear a son. She also lives with a husband, who drinks and does not care for her or the children. She says, ‘There is nothing good about that man. He does nothing. He beats me.’ As her husband’s income was not sufficient, she began working outside of the home as caretaker (for an ill person) in order to provide for her children.

Rani and Madhu with mother Rekha at the YChiNG graduation

Despite all odds, Rekha was determined to give her youngest daughters a chance to succeed…. and we were determined to help her. After six months in YChiNG, the two girls have made significant gains in growth and development. Rani is still in the severe underweight category but her WAZ has improved to -3.207. Most importantly, she has learned to stand up and now she walks! Madhu’s weight has increased tremendously and she moved from severe to moderate to mild underweight in the past six months, a remarkable achievement. They have both improved in anemia status, have increased appetites, and learned to feed themselves with a spoon. We are so proud of Rekha for her courage, and so pleased to see Rani and Madhu now running, drawing, and playing in our center! -Danya Sarkar

YChinG Graduation Event

Recently Calcutta Kids held a graduation program for children who participated in a 6 month trial to address severe malnutrition in Fakir Bagan. The thirty-three children enrolled in YChiNG (Young Child Nutrition Group) were invited to a weekly feeding and GMP session at the DTC. They had access to the Calcutta Kids pediatrician, free medications and micronutrient supplements, and free routine and follow-up pathological tests. Read more about the YChiNG trial here.

Mothers listen to program coordinator Sumana Ghosh and mother Rekha Shaw

The graduation program marked the close of the YChiNG trial and was an opportunity to celebrate with the mothers and children who had participated in the program. Some children made remarkable strides in weight gain and growth, while those who did not fare as well (mainly due to lack of attendance) were given encouragement and asked to return for weekly meeting sessions.

The graduation program was a fun event that mothers and children enjoyed thoroughly. The MYCHI Program Coordinator, Sumana, talked about the YChiNG program and its impact. She thanked the mothers for participating and working hard to better the nutritional status of their children. Three mothers shared their stories and experiences with YChiNG. Rekha Shaw, whose youngest daughters Rani and Madhu participated, spoke about the improvements she had seen in her girls because of the program. Shanti Shaw, whose son Sujay had been hospitalized a year earlier due to severe malnutrition, described his recovery and how they were assisted by Calcutta Kids. Sabitri Prajapati spoke about her son Ayush who was born with low birth weight and was not growing well until he participated in the YChiNG program.

Mothers and children had lunch together, with mishti (sweets) and tea afterwards. We listened to Hindi music, and watched the children dance. At the end of the program, Calcutta Kids gave each child a colorful melamine bowl and spoon to encourage enjoyable, active feeding at home. -Danya Sarkar

The Story of Irshad

Irshad with his mother

In 2002, Irshad, was 10 years old living in the slum with his parents and siblings in a tiny dwelling. Irshad was a child-laborer who worked 9 hours a day making locks for metal trunks. His daily wage was 10 rupees (roughly 20 cents). Each week he would collect his money, give 55 rupees to his father, and keep 5 rupees for himself.

After one such week, he decided to use those 5 rupees to rent a bicycle for a few hours. He had never ridden a bicycle before, but having spent so many hours watching other children, he was sure he would get the hang of it quickly. For a while he rode around the slum with enormous joy and pride and sense of accomplishment. But his joy was short-lived. While riding past a woman frying Indian sweets, he lost control of the bicycle and fell on the frying pan of burning oil.

Irshad was rushed to the government hospital where he was diagnosed with 60 percent burns, which began at the base of his neck and ended half way down his right thigh. He was injected with numerous painkillers, but after 3 days in the hospital little had been done to heal the burns. His cries of anguish were incessant, while, day-by-day, Irshad grew weaker. His older sister then came from the village and decided that her brother should die at home in peace surrounded by his family, rather than in this hospital with people in every bed, every inch of floor space used, blood stained sheets, doctors who had become numb to the pain which surrounded them, and dead bodies which lay covered until staff from the morgue made their evening rounds.

Noah was having lunch with his dear friend and teacher, Lucy-didi when a message came to her house with the news that Irshad was dying in his home. Lucy-didi and Noah rushed to the house where they found Irshad lying naked on the cold dirt floor of his family’s dwelling with his head resting on his father’s lap. The burns were inflamed and infected; he was in excruciating pain. Within minutes they had put together a makeshift stretcher and together with his father, carried this dying child through the slum to a private clinic operated by a friend.

Noah with Irshad (right) and Kalyan in January 2012

It took hours for the nurses to clean and dress his burns and infections. While this was taking place, Lucy-didi and Noah each held onto Irshad’s hands and Lucy-didi sang songs to him throughout the day and evening. Each day Lucy-didi and Noah went to visit Irshad, and day by day their young friend became stronger and stronger. After three months of hospitalization, Irshad was strong enough to leave the hospital. His scars were deep, both physically and emotionally, but his youthful strength had returned, an inspiration to all of us.

Shortly thereafter, Noah was called to Irshad’s house and told that Irshad had a gift for him. Noah arrived at his house and found that Irshad had borrowed a tape player and was putting on his favorite Hindi film-song. The boy then began dancing passionately, and continued for 10 minutes, perspiration dripping from his forehead and his chest, but delirious with joy. Noah felt like the dance was just for him; he speaks of it as the most beautiful thing he has ever seen.

Irshad later had minor surgery which allowed him to walk with greater ease and he visits regularly with his Calcutta Kids friends. His hope is to be a doctor like the doctors who saved his life.

Noah and Irshad remain very close. When Noah was married in January 2012, Irshad was one of his groomsmen.