Lesotho - Home Again

Back to the Mountain Kingdom

What was my connection to Lesotho after all? I had arrived in June 2014 to freezing temperatures, no electricity & no running water; I had endured 10 weeks of non-stop training where we were stripped of the indulgences of the developed world, indoctrinated into the norms of a foreign & confusing culture; given the incredible task of facilitating a reduction in HIV rates; moved to a new village & settled into a small home that I shared with 20 children & 3 matrons for 4 months; evacuated to South Africa for 3 weeks to escape the potential violence of a military coup d' état; medically evacuated after my fall & fractures - first to the Republic of South Africa & then to California for 45 days followed by an administrative leave for an additional 45 days in Washington DC to figure out my future in PC; & then finally transferred to The Gambia for three weeks. 

Why was I so desperate to come back? Perhaps the Peace Corps experience of culture shock & adversity had transformed me & created an almost unreasonable & certainly inexplicable bond to the Mountain Kingdom & the Basotho people. I was so happy to see the rolling lowlands & mountains of Lesotho from the plane, even happier to land once again on the airport's dry flat plateau.  I could not help but give dear Ntate Lerato, the PC driver who picked me up, a great big hug while I held back tears!  More hugs were in store as I greeted the staff at the PC Lesotho Headquarters & when I met with Wendy Van Damme, the Country Director, for a briefing & an opportunity to thank profusely for agreeing to have me return.

The next day Ntate Lerato drove me & my precious boxes back to Mohale's Hoek & my "Peace Corps House" on the St. Patrick's Church compound.  I'll always thank Tracy & Eloise for stuffing those boxes so full they did not meet the 100 pound weight limit & were never shipped, thus providing me the chance to negotiate my return to Lesotho.  I spent the day unpacking & arranging my home once again. PC Lesotho was kind enough to provide a reinstatement stipend so that I could shop for the essentials that had been given away when Sr. Juliana & Rethabile learned that I would not be returning.

It was not until the second day at home that I returned to see the St. Camillus & it was a wonderful reunion. They remembered me & came running for hugs & caresses. Seeing Sr. Juliana & Rethabile again seemed like a miracle; I had to keep pinching myself to really grasp that I was finally back home.

All is not well

The joy of seeing the kids again was followed by the shock that one of our newest little ones, 18 month old Thabelang, was hospitalized for malnutrition even though he had arrived at the Centre several months prior. Granted most of the kids arrive traumatized in various ways: certainly emotionally in shock & despair from abandonment & being placed in a strange new home amongst strangers & almost always undernourished if not malnourished. The stress of their little lives & new placement often results in emotional issues, isolating behaviors, difficulty sleeping, & weight loss. But… surely the Centre has sufficient resources to feed them adequately.  Or did it? Were other children underweight & at risk for malnutrition?

While I was away I had plenty of time to think on my PC experience & what I could do to improve not only my experience but to ensure I was making a positive impact on the lives of people I had come to serve.  I felt confident that my efforts helping to create a business & financial infrastructure were having a sustainable impact because of Rethabile's skills & talents (Rethabile is my counter-part & office "assistant" de facto manager). But I knew that I would regret missing the opportunity to interact more closely with the children. Sure - all our business efforts were targeted to provide  the Centre the financial means to house, feed, clothe, educate, & provide staff to care for them. In the early days I felt comfortable knowing it was not my  role to care directly for the kids… but I knew now I needed to make a personal change to get closer to the kids. Not being a mother or one who craved spending time with children, it was way out of my comfort zone to get up close to all the goo & mess that these little ones naturally exist in. I liked that the kids were near but I kept my distance when it came to direct contact (dirty bottoms, wet pants, buggery noses, skin rashes, and on and on). But… with the chance to return I had decided I would give up this discomfort & get more up close & personal with the kids.

We visited little Thabelang in the hospital; Mme Imamaleng, one of the matrons, was there full time to care for him. He was such a tiny thing, lethargic & weak. Like some of the other infants & toddlers he would not readily accept me, this strange white lady, until I had spent a couple weeks gaining his trust.  After seeing him the first time though it hit me full on… if this little one is malnourished what about the other kids!

I knew that a community caregiver would come to the Centre to weigh the kids but I had never looked at their health books. Rethabile & I went through each of the kids' books and I was really shocked at what I found. The under age 5 kids' weights were not documented regularly so it appeared that there were many gaps of months, in addition, the date & weights were entered on the growth chart so haphazardly as to make the growth chart completely unusable.  As I corrected the entries it became very clear that most of the under 5 kids were just at or below the low normal weight marker & that their low weights had never been discussed with the matrons or Sister Juliana. In addition, it was clear that many had not had the expected sequence of vaccinations or Vitamin A administration. To make matters worse, we found that the 2 infants (2mo & 4mo) were being given leshelelshele (sorghum cereal) in a bottle & not formula.  And, little 2 year old Reatlehile, normally so robust & even chunky had lost several kilograms. What was going on?

Rethabile & I quickly realized there was a significant shortage of protein rich foods for the kids & a complete lack of formula for the infants.  The cow, purchased in the spring had given birth & was producing milk but the poultry layers had been slaughtered in March as they were deteriorating from poor cage management & a broken watering system. Winter was coming on fast & the produce from the vegetable garden was meager. This was all too much to bear - if anything I felt I could not let these kids suffer the consequences of poor nutrition. I insisted that we begin to petition the local aid agencies with a letter requesting donations of food, formula, or cash. I think Sr. Juliana was a bit dismayed but I was willing to go begging for handouts. We took our letter to the Ministries of Health & Social Development, the World Food Program, the local hospital, the Red Cross, & any other aid agency we could find. We searched the internet for aid programs & contacted other PCVs who worked with orphanages. A PCV contact suggesting contacting ePap, a South African company that produces a fortified cereal & donates the cereal to those in need. Our first win was a huge delivery of ePap from Basil Kransdorf, the generous CEO of ePap. This donation would provide cereal for about 4-6 months. No other organization was able to offer assistance.

Poor Reatlehile, if it was not for his weight loss we might not have made a trip to the health clinic early during this period. Though everyone insisted he was eating "too much", his weight loss was significant & we insisted we take him in. Worms were suspected & he was given medication. We also found out, since we had all the 5yrs & under kids, that most all were underweight & that they qualified for food supplements!!!  We were able to bring home a huge batch of fortified rice compliments of the World Food Program. 

Donations bring formula & protein rich foods

The nurses & nutritionists were not very happy with the low weight status of the kids St. Camillus & the fact that we had one child hospitalized for malnutrition.  We convinced them that we needed their help & that we were trying everything possible to turn the situation around.  With quite a bit of pleading & reminding & treats of home-made banana bread we were able to get the nutritionists to come visit several times to weigh the kids, teach the matrons about nutrition, & help us create a daily menu based on a nutrition plan that addressed nutrient needs & portion size by age.  I was able to accomplish this by reaching out to Alice Dufresne & Natalie Lujan who provided me the necessary pediatric data. After a fair amount of badgering I was even to get the hospital to provide us with a "hanging" scale for kids under 25 kilograms. Now we could start to weigh the kids ourselves!

The kids love to be weighed even if hanging from a peach tree!

So began our journey to recovery.  We began taking the kids for regular health check-ups, conducted monthly weighing sessions, finalized the weekly menu based on our resources.  Outreach to family, friends, & The Lesotho Connection resulted in a inflow of donations. TLC upped the monthly stipend by $200 & we built a pool of cash for the purchase of formula. Slowly we were able to build trust & support from the matrons to augment the protein in the kid's diet & introduce nutritious snacks. We showed Sr. Juliana that the weekly menu was affordable. We also involved the matrons & Sr. J in the weighing sessions so they could understand the principles of the growth chart & how important it is to discuss each child's needs & progress.

Taking the infants for well checks at the clinic

Sr. Juliana was also vitally involved. She visited the Ministry of Agriculture to request a donation of seeds but a local manager suggested she submit a grant to have a greenhouse built that would enable production of vegetables all year.  As a result we were put in touch with Ntate Thabang, a local farmer who produces seedlings for sale in his jumbo-size greenhouse.  By month's end we had a grant proposal for the greenhouse & had submitted it to the Ministry of Agriculture & a couple other NGOs.  This effort was the "seed" that brought a whole new vision of farming to Sr. Juliana & the St. Camillus Centre.

Karabo modeling a knit cap I made

Always heaven