Jill's blog

Children involved in play activities – HIAM staff in the blue shirts

Why we must rehabilitate malnourished children.

Just like the rest of the body the brain is made up of cells.  When a baby is born it has about a 100 billion cells. But only 25% of the brain is connected between the cells, this is so the baby can breathe, cry, swallow and its heart can beat etc.  Cells in the brain, via the connectors are responsible for passing messages from one cell to another and to the rest of our body. In a healthy body this process of the neurons talking to one another is at a speed of up to 300 kilometres per hour, (working similarly to a landline telephone system).  Once an infant or child becomes malnourished the connections between the neurons within the brain are interrupted (disconnected). In children 2 years and under whose brain and body is at a critical stage of growth and development this can result in mental and physical retardation that is irreversible. In the rehabilitation of a malnourished child it is paramount that not only good nutrition be introduced but also play activities to stimulate the brain again. These two factors are essential for full recovery.  Good nutrition combined with play and interaction with others will reconnect the neurons and enable normal development to continue. Only in a dedicated facility can this process be implemented quickly at a pace as to minimise the damage to the infant/child’s development.  Only in a dedicated facility can we influence behaviour change in a parent.

Back to a comment I made on the 2^nd of March about the ‘Tour de Timor ‘ guys donating a playground for HIAM… well our playground  arrived at the port from Singapore  today but alas we do not have enough documentation to pick it up. After 3 visits to the port we feel we are now organised with documents coming out of our ears but….. still difficulties… below is my latest email to Ting in Singapore:

Dear Ting

Update… what can I say ‘it’s Timor’. It’s the land where it takes someone 19 weeks to pick up a pen and sign an MOU.

By end of Wednesday 2^nd June they said we had all the documentation required.  Atoi went back Thursday to arrange transport and they were closed.  It was a religious holiday that we were not aware of and they neglected to mention it to Atoi.  He went back Friday am and they asked him for money for customs/tax which they had not mentioned before; he said how much; he told them we were a ‘welfare program’, ‘not for profit org’ registered with the Ministry of Justice; they said that we would need to go to the Ministry and get them to produce the documentation for this; Atoi called me and I said forget it just pay whatever they want as we are being charged storage at USD$35 per day; Atoi said to them how much and we will pay it; they said we do not know; come back this afternoon (Frid) and we will have worked it out; Atoi went back and they said, sorry we have been too busy to do this come back Monday. So we have been ready since Wed but no luck yet.

Cheers Jill

Prepared site for our new playground.

We have used the old roof from over our shipping container offices at the Dili National Hospital where we were situated from July 2004 until September 2009.

When I was in Perth in January, I was introduced to Kelvin Hutcheson at a wine and cheese evening held by the Friends of HIAM.  When I was home again in April he contacted me offering some ideas about support.  The result of this is that he and his mate Brian are coming to the Centre next month to convert the second shipping container which is now situated about the first container; which is now our Horticulture training centre.  These two containers were donated to HIAM full of goods for distribution to schools and the poor in Timor-Leste via Peter Stewart, who is the Director of The Christian Centre for Social Action in East Victoria Park WA. Kelvin will convert the second container into a much needed storage facility for the Centre.  Presently we are having to pay USD $100 per month for the use of a dilapidated storage facility on the other side of Dili.  It’s hard to get to, and is not completely weatherproof.  Peter also has another container packed ready to come but just not quite enough funds yet to pay for the shipping.

Container for renovation for our new warehouse/storage facility

I arrived back in Dili today.  Things appear to be slowly coming together for Rosaria and Gabi.  Before I left we promoted one of our long term staff to nurse co-coordinator and she has shadowed Gabi and is now developing exceptionally well with the one-on-one intensive support.  So with direct communication to the staff they are working to the roster now and managing to do things without having constant direction and support.  You can’t help but feel that something terrible must have happened a long time ago that robbed this culture of their ability to show or use initiative.  It not even like that they are timid or afraid it appears that they have forgotten how.  I wonder if this is something that happens when a country is colonised for 450 years and treated as servants then brutally occupied for the next 24 years?

I only have two days with Rosaria then she is off to Jakarta with two other staff for a two week course on ‘the effect on the human body through to old age due to poor nutrition’ at a university there.  With the extra funds now from the President we are now able to spend a little on professional training for the staff.

I am returning to Dili through Bali this time.  I have been told that there are permaculture training organisations in Bali who may be interested to come to Timor to teach.  Yes there are but one was too busy to help and the other is far too expensive.  So our Garden staff will have to struggle on for a bit longer.  Their knowledge is of mono culture and they have little or no understanding of the concept of permaculture. Every time I get the garden into mixed beds of balance diets and go away they put it back into neat rows of single plants, lucky I’m a very patient person. J

Is there a permaculturalist out there with teaching abilities and able to show them how to plant and then structure a simple workshop for the mums in the Centre, who would like to volunteer for about 2-3 months? We would be extremely grateful for the support as I am at desperation point now.  HIAM can provide fully self contained accommodation on site, return airfare from Darwin and lunch each day.

Great to be home with the family.  My two dogs were straight back to mum’s room at night to sleep.  I hope to learn how to operate MYOB (an accounting software package) while I’m home and also design a database so that we can collate our statistics.  I have also discovered that I have had quite a lot of unwelcome visitors to my house…  ‘white ants’, so the entire back of my house needs to be replaced.  So not much time this trip to sit and ponder.  Celebrated Mother’s Day a week early as I am returning to Dili next week.  I had a lovely lunch at Hillarys Boat Harbor (yes named after my family) with 3 of my 4 children.

March 30: Many of the infants and children in the Centre have tuberculosis, so they are a lot more clingy to Mum.  Therefore the ‘Home Kitchen Garden’, program is not being implemented fully at this point.  It is very difficult for mums to work in the garden when you can’t put the child down.  Daily activities in the Centre are still chaotic but it’s a more organised, predictable chaos now so I have decided to go home for Easter and my daughter’s birthday that I have missed for the past 4 years.

March 20: We now have 8 families in the Centre.  It’s really hard going.  A lot more difficult than I had first anticipated.  The HIAM staff are not functioning as well as I had hoped.  Rosaria, Gabi and I are run off our feet.  Our 28 staff and 8 families feel like about 200.  We need eyes in the back of our heads to be able to monitor everything (patients/the family/staff).  It proves that it doesn’t matter how much training you provide – once they are ‘on the job’ it’s a whole different ball game.

14 March: First patient & family arriving 9am this morning.

First patient & family arriving 9am this morning. Little fella being encouraged to eat

Little fella being encouraged to eat

He is over 2 years old, with a weight of 7.6 kilos, which is moderate bordering on severe malnutrition. His father is a policeman so they have an income. This supports what Rosaria and I say about it not just being an economic situation here in Timor that is causing malnutrition. This little boy has been raised on white rice porridge until now. He has delayed developmental skills, hardly any muscle tone and he only says the occasional word.

His mother has had 5 children in 5 years. The youngest is 8 weeks old.  One child has already died. She is very depressed and has little interest in mothering (probably post natal depression) plus she is still grieving for the lost child).