When I talk to people directly about the impacts of HHI’s work in orphanages, one of the things I tell them is that several orphanages I have visited have reported that, “after HHI training, children die less often.” This is an amazing and almost breath-taking claim – that when HHI trains orphanage caregivers how their direct actions, their nurturing, snuggling and simple acts of love and kindness actually can mean the difference between life and death for a baby! This was proven in studies in orphanages in Eastern Europe after World War II, that children in institutions who were only given food and water often died. What they lacked was love – what could be a more basic human need?

I was asked by a friend yesterday why I have never really publicized this profound outcome of HHI and I admitted that I was afraid that it might make HHI look too grandiose, that we were making outrageous claims and that we could somehow loose credibility. She looked at me with a bit of confusion and again asked, “yeah, but you have heard orphanage directors – several of them – tell you that babies hadn’t died since HHI’s training?” My answer, “Yes, more than once”.

Then, today’s NY Times ran a story about orphanages in Sudan that yet again showed demonstrable proof that teaching and supporting orphanage caregivers to show love to the children kept children from dying. A clip from their article reads, “Nurses are trained to hold and play with the children as they feed and care for them. Medical care has vastly improved. In 2001, 479 children died. In 2006, 186 did, according to UNICEF.”

“Investing in the health of children and their mothers is a sound economic decision and one of the surest ways for a country to set its course towards a better future,” said Joy Phumaphi, vice president of Human Development at the World Bank. She is speaking after the release last week of UNICEF’s State of the World’s Children 2008 report.

With Child Survival as the theme for the report this year, UNICEF acknowledged the central role that front liners (such as the ICDS teachers HHI trains in India) play in saving lives of children. The report speaks to a variety of ways that child mortality can be reduced, stating that currently 26,000 children under age 5 day each day from preventable causes. The child mortality rates are most atrocious in Africa, as high as 1 in 6 children under 5 dying. I am beyond eager to see HHI get started in Africa! And, in India, Orissa is tied as the state with the highest child mortality rate – and we just began our work there last summer.

I believe that HHI is not “the solution”, but I do believe that we are a simple, cost effective and and critical part of a easily scalable larger solution. We have just finished our new and expanded curriculum and we are doing everything in our power to now spread the word and get our services out into the world. To this end, I will spend next week in DC meeting with a variety of international child health groups to find ways to take HHI to the children who need us most.

I was recently asked to nominate mothers that I know who are initiating positive change and making our world a better place. I consider myself fortunate to know many of these women, one in particular is HHI’s Master Trainer in India, Sujatha Balaje. Here is what I wrote to nominate Sujatha for an honor that would fit her perfectly….

Sujatha was a natural fit when Hands to Hearts International (HHI) needed to find our first local Trainer in India. She was smart, capable, vibrant, and tenaciously committed to serving disadvantaged children. HHI is dedicated to improving of the health and well-being of orphaned and vulnerable children through improved early childhood care. Sujatha began HHI’s operations in India and she single-handedly established HHI as a new model of excellence in care for orphaned children.

Orphanages often live in an atmosphere of mistrust and apprehension, they do not welcome outsiders into their facilities for fear of judgment and negative exposure, though the caregivers are desperate and eager for training. Sujatha worked over time to build trust with each individual orphanage and slowly her efforts paid off in spades. In the first year and half she provided 20 HHI trainings on early childhood development to 277 caregivers who care for over 1,800 orphaned and vulnerable children!

When I have gone to orphanages to speak with the Directors about what differences they have noticed since Sujatha has trained their caregivers, many of whom have only a few years of any formal education, the first thing several of them said was simply, “we haven’t had a baby die since the HHI training.” As if this was not powerful enough, they continued to describe their children as sick less often, recovering their health faster if they did get sick, needing less medicines, gaining weight, being more responsive to the caregivers and easier to soothe. They also reported that the women were now more responsive the babies, calling them by their names for the first time, more confident in their work, more nurturing to the children and that they practiced improved hygiene.

While I know the HHI Training to be extremely useful, what has taken it to the next level, to actually bring about the magic connection between orphaned children and the women that care for them – the most critical ingredient in child health – is Sujatha’s passion for Hands to Hearts’ mission and the individual connection that she makes with every woman and child she works with.

When I visit orphanages in India, I can immediately recognize Sujatha’s presence. If she has given training there, the first give away is that all the women flock to greet her with smiles on their faces in babies in their arms, eager to tell her stories of how “their babies have gained more weight this month!” I also witness the women singing and dancing with the children, giving all the children massage, and the women refer to the children by name and with a new empathy – the bonding that happens go both ways.

I am honored to know Sujatha as a friend, colleague and inspiration. Her children are fortunate indeed, but beyond that thousands more children who do not have the touch of a mother have a new chance at love and care because of her tenacious work, talent and dedication.

All orphanages who have had HHI’s support have demonstrated improvements – some dramatic and some more modest. The outcomes are heavily dependent on the quality of management and support that the caregivers have and thus that they can pass along to the children. Yesterday I visited at an orphanage that whose caregivers received HHI’s training in July of 2006. The management and all of the caregivers have fully embraced HHI’s practices and the improvements in child health were amazing. The Director reported that even after eight months, the caregivers are still using HHI’s techniques to nurture the 36 children in their care.

The outcomes she reported for the children were that their improved health has remained consistent and they still have significantly less trips to the hospital, this has meant that children are able to be adopted (in country) much faster and are spending less time in the orphanage. The children are now singing, laughing, smiling, making eye contact, and they now respond to their names being called. The caregivers carry the children tenderly, not “like logs of wood”, they respond immediately when children cry and consistently give the children more attention. They show greater empathy and are bonding with the children, calling them by their names, singing to them as they spend time together and overall they are happier and take greater pride in their jobs.

Today our trainer conducted a follow-up visit at another orphanage that received HHI’s training a few months ago. This orphanage is in a very difficult situation, today they only had 3 women caring for 57 children! They are not able to apply many of HHI’s recommendations, as they can barely feed and diaper all of these children. However, what was interesting to note was that even in this compromised state the women reported that they felt more confident in how they provided for the children, each child now had their own crib and the sanitary conditions showed improvements.

I never cease to be amazed in the tenacity of people’s will and their ability to overcome seemingly unbearable odds to make a difference in the life of another. HHI is not a panacea, it is a tool, an extremely simple yet powerful tool, that when applied can make monumental changes in the lives of orphaned children and low-income women.

I am about to return to the US and HHI’s accounts are almost empty. This provides me no end of frustration, but as much as I grumble, struggle and fuss to about having to raise money from people/foundations/companies, I recognize that what I do in an honor. My creation has touched the lives of thousands, in ways that I can see and ways that I will never know of. I cannot compare the challenges I face with those of the people HHI serves. I am continually inspired by their compassion, courage, hard work and dedication.

Hands to Hearts International (HHI) has dedicated itself to two interconnecting problems in the developing world – the plight of orphaned children, laying untouched in cribs, and that of women trapped in a cycle of poverty, without the education or economic opportunity to contribute to their families or communities.

Around the world there are millions of orphaned children – due to AIDS and other diseases, political instability/conflict, the stigma of unwed motherhood, and extreme poverty. Most countries try to deal with orphans by creating orphanages and hundreds of thousands of children (country data varies widely), ages zero to three, are being raised in orphanages. Faced with scarce resources and circumstances of dire poverty, most orphanages have too few caregivers and too many children. Often lying untouched in cribs, the children suffer most directly from these circumstances.

The mission of HHI is founded on two principles: To nurture children and empower women.

unproductive adults.”
World Health Organization – Infant/Caregiver Report

While HHI is not an all-encompassing solution to such a massive and complex issue, it does offers a critical component for healing and a way to shift the systems and community situations that perpetuate this crisis.