Worldwide Orphans Foundation Newsletter
World Wide Orphans Foundation :: Orphan Rangers :: Newsletters :: November 2001 Newsletter
Worldwide Orphans Foundation Newsletter
Volume 1, Issue 3 - November 2001
What's New This Issue!
WWO's autumn newsletter features Orphan Ranger Kristina Hetling, who spent June and July 2001 in a government-run orphanage near Quito, Ecuador. Kristina built upon relationships established by Orphan Ranger Katie Kogut, who worked in the same orphanage the summer of 2000. WWO invites you all to read about how Orphan Rangers work to bring positive and lasting change to this and many other orphanages. This newsletter also welcomes Thao Nguyen back from Vietnam, and introduces Kala Lilani, who will be traveling to India. We are now planning our benefit art exhibition for April 2002. The exhibition will feature artwork created by orphans from Russia, the Ukraine, and Kazakhstan.
Kala Lilani Begins Project in India
Kala writes, "Children raised in institutions and with multiple caregivers often grow up without a sense of belonging or identity. WHO AM I? WHERE DO I COME FROM? WHERE AM I GOING? WHO DO I BELONG TO? and other such basic questions often plague these children throughout their lives. Beginning in November, I will work with a group of children at Preet Mandir orphanage in the city of Pune, to help them deal with these issues and to develop a healthy sense of self. I'll run group therapy sessions and recuit volunteers from the community to mentor the children on a one-to-one basis."
The Middle of the World: Kristina Hetling in Ecuador
The Ecuadorian capital of Quito is an enormous, crowded city nestled between snow-capped volcanoes that are visible on a clear day. Fortunately the orphanage where Kristina and Katie worked is located far enough outside of the city so the children escape the worst of the pollution, while enjoying the year-round spring-like climate. Kristina stayed with a family in a rural town called Mitad Del Mundo or "Middle of the World," so named because it lies where the equator crosses the line separating the Eastern and Western hemispheres. Kristina, a fourth year medical student at New York University, examined more than 30 orphans up to six years of age and noted ways to provide medical and resource assistance.
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Brothers, Esteban and Erick, spend their summer days in an orphanage and evenings and weekends at home with mom.
Danielita poses next to a swingset.
Kristina examines Raul's throat, while Cristian and Danielita look on.
The Children
During Kristina's stay, the orphanage cared for about 33 children, a number constantly in flux as new children arrived and others left to live with relatives. One child was adopted domestically during Kristina's tenure. Impoverished families, who appealed to the government for help, used the orphanage as a daycare. Thus, approximately 12 children go home to their parents each day. Five special needs kids over six years of age live in the orphanage as well. Kristina performed a standard pediatric assessment known as the Denver Developmental Screening Test with most of the children, and found mild to severe developmental delays in all of them. Only one child knew his colors.
The Staff
Each day, two female staff members are assigned specifically to childcare, but the entire orphanage staff, including the cook, washer-woman, and accountant, pitch in to help. One caregiver works with the 20 or so "big kids" who can walk and are potty-trained. The other caregiver tends the ten younger children including the three with special needs who are unable to walk. These women work 24-hour shifts followed by 24 hours off.
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Wilmer waits to be spoon-fed by a caregiver.
Kristina examines Danielita.
Raul, who cannot walk independently, enjoys some time trying out a wheelchair.
The Medical [In]Attention
Each week, a nurse is on staff five or six days and two doctors visit the orphanage three times. This medical attention potentially benefits the children, but the provision is fraught with problems. Kristina noted that the care is not thorough. Numerous medical charts and physical exams were incomplete and vaccine charts were totally missing. The doctors fail to practice basic hygienic principles thereby spreading germs. Often, they do not wash their hands between exams, and the cloth sheet that covers the examining table is changed only once a day after servicing all the patients. Equipment is antiquated and of poor quality. Further, the doctors lack necessary medical equipment, such as opthalmoscopes or otoscopes for examining eyes and ears. Sadly, Kristina found that the only blood pressure cuff at the orphanage is for infants and too small for most of the others. Sometimes the medical professionals used the working equipment incorrectly. For example, there were times when a baby would be weighed with his shoes and wet diaper on and other times when his clothing would be completely removed. This of course prohibits accurate measurement readings, which are especially important to note in case of illness, diarrhea, or vomiting. Kristina pointed this out to practitioners and weighed and measured all of the kids properly prior to her departure. Additionally, the medical staff fails to warn the caregivers about the parasites and bacteria in the drinking water. Unsupervised play with the outdoor faucet results in consumption of contaminated water and an increase in the amount of children infected with parasites and bacteria, which adversely affects both growth and general health.
Orphanage Routine
Although orphanage life is guided by a loose daily routine, bathtime and mealtime are consistently problematic parts of the day. Bathing and eating represent times when a child's immediate physical needs must be promptly attended to. These are considered very important for healthy childhood development because they are special shared moments between a parent and child. In the orphanage, however, the caregivers are burdened by the multitude of children, and are ill-equipped to meet individual emotional needs. This treatment deeply affects the children, and in spite of a silent response, the tension created during these stressful times of day reflect in behavioral problems and developmental delays.
Bathtime
Around seven o'clock each morning in the dormitory for the older children, one caregiver is responsible for bathing all 33 children. In assembly-line fashion, about eight children crowd under a single showerhead, are soaped up and rinsed down in record speed. With only one caregiver to attend to so many children, Kristina discovered that the boys were not being taught to thoroughly clean themselves. In addition, hand-washing and regular tooth brushing are neither taught nor required.
Mealtime
Mealtimes are also stressful for caregivers and fail to address individual developmental and emotional needs. Around eight in the morning, the children eat a breakfast of white bread and a fruit shake. At noon, they eat a lunch of meat/rice/potato soup, then rice with a meat and vegetable dish, and a glass of real juice. The caregivers struggle to feed large groups of hungry and rowdy children as quickly as possible. There is no time to respond to individual needs; if babies do not eat fast enough, the food is taken away. Kristina explains, "At a certain stage, most toddlers use mealtime as a chance to express growing independence and to reject attempts at being fed. Parents need to have patience during this normal stage of human development. Unfortunately, mealtime at the orphanage is the time when the least amount of patience is available and these toddlers miss this chance to work toward autonomy. When a child would refuse food, he or she would be harshly reprimanded, be briskly carried from the table and thrown in his crib screaming. Sometime later, he might be brought back to the table, only to repeat the struggle again, amidst a chaotic atmosphere where tensions run high."
Special Needs Children and the Lack of Therapy
The lack of therapy for the special needs children was brought into focus when Kristina's sister, Tasia Hetling, a special educator who works in early intervention, visited the orphanage. She saw a possibility for many of the children to be functioning at a higher, more involved level. Many services are ruled out because of the poverty of government-run orphanages. One deaf boy suffers from not being taught sign language. Kristina explains, "Javier struggles to survive in an environment where he cannot communicate his needs fully or understand the staff and his peers. No one at the orphanage can sign fluently! Javier is often physically aggressive and for this reason is criticized by staff and ostracized by the other children." Another eight-year-old boy, who was born with deformed legs and who cannot walk, has not been permitted to leave the baby room because of this disability. He still sleeps in a crib and is not potty-trained. He languishes among children six years younger than he, not receiving cognitive, social and emotional stimulation from children closer to his own age. He would benefit from using a wheelchair and Kristina investigated this possibility. She found an organization to donate appropriate wheelchairs to the three boys in this orphanage who need them.
A Lasting Impact
Now in her fourth year in medical school, Kristina finds her work deeply affected by her experience in this orphanage; "With firsthand awareness of babies playing unsupervised on dirty floors in an orphanage in Ecuador, I hope to become involved in advocating for the public health of children nationally and internationally."
Orphan Ranger, Thao Nguyen Returns from Vietnam!
Thao writes, "I arrived home safely after a four month stay in Vietnam as an Orphan Ranger for Dr. Aronson's WWO Foundation. During most of my time in the country, I made extended visits to orphanages in Hanoi, Hoi An, and a malnutrition clinic in Ho Chi Minh City.
On my own time, I also had the opportunity to swim in the placid emerald water in the Halong Bay and wilt in the sweltering heat of the Mekong Delta.
In hindsight, my work experience for WWO in Vietnam was incredible and I would like to thank Dr. Aronson and the supporters of WWO for making it possible. You have given me some of the dearest moments in my life, getting to know those very special children in Vietnam. "
Thao comforts three month old, Yen, from Mam Non 2 Orphanage in Ho Chi Minh City.
Word From the Doctor
"I am incredibly proud of the work done by the Orphan Rangers. With seven orphan rangers having now traveled to five countries, and another on the way to India, we are unlocking the secrets of the lives of orphans. All of the rangers' research and service improves the lives of children abroad and those making new homes in the U.S. "
- Dr. Jane Aronson, Founder and Executive Medical Director
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