Great Coffee, A Great Start to a day!

Great coffee! Tom, Ed and I left the guest house this morning at 7:30 AM for the Grande Cafe "downtown" Bangui. We took a break from the daily grind and enjoyed a cup of Cafe au Lait and a pastry. From there we scurried back to the guest house to pick up Rebecca, Christophe and Luther (Rebecca is the nurse in Bangui, Christophe is the one responsible for orphan program in Bangui and Luther is the one responsible for orphan program in Berberati). We had a 9:00 AM meeting with the leadership of the city's only hospital for children, National Pediatric Center.

The 6 of us met with 6 representatives in the Assistant Administrator's office until 10:45 AM. It was another great meeting where we built new relationships between the our staff and the hospitals officials. These relationships are very valuable because we send our orphaned children to this hospital for care ranging from broken bones to AIDS treatment. Having a relationship with the leadership reduces hassels in the admitting the orphans, making payment, and getting help in the communities with their social programs.

During the meeting we discovered that this one little hospital is "caring" for 1,342 HIV positive children, in addition to all of the other children they serve. The World Bank is providing ALL of the AIDS anti-retroviral drugs at the moment. For them, the challenge is not access to these drugs, but the limitation of the number of beds (patients they can accommodate) and the amount of follow up work in once the child returns to the community (to make sure that they continue to take the meds and take them properly). Interested fact: One of the reasons that hospitals in the developing world struggle so much that 90% of all the fees charged for service go to pay for contract staff. That leaves very little for operating income, improvement, etc. In this case, the government does pay for most of the basic operating costs on a monthly basis. (see inset photo of hospital).

One of the people in the meeting shared with us that issues do exist for people diagnosed with HIV in some communities. For example, if you are HIV positive, you qualify for the drugs and some food from the World Food Program. However, the family may decide to "kick out" the HIV positive person or child. So to survive, the person sells some of the food to survive thereby weakening themselves at a time when they need that nutrition urgently.

Off to another meeting at 11:00 AM with one of the 10 regional Ministry of Health centers. The one we met with is in the North side of town and is responsible for 2 states, Ombella Mpoko and Lo Baye, covering a combined population of 676,435 (11% of country). Most of our 8 centers in the city of Bangui are in these areas so this was a strategic meeting. The meeting was with a man named Fidel and it was extremely valuable - praise be to the Lord! We learned that this man would connect us to all of the programs happening in the region for vaccinations and health training. For example, we learned that just recently, every child can have all of the core vaccinations for free, like DPT, polio, yellow fever, BCG, etc. Rebecca was excited to say the least. We learned about how the regional office works so we can leverage this information in other regions of the country as well.

This was also a great lead as this center is responsible for sanitation - including water works, latrines, sewer and garbage. We have an immediate issue with contaminated water in Kiamba. We hope this new connection can help us make progress on getting issues in that area resolved.

Around 1:00 PM we made it back to the guest house where we all had lunch and then took a break until 2:00 PM. Are new focus was to boil down all of our findings to 2 of the most important things we need to improve/fix and then work on solutions that don't include budget increases or major changes in staffing, etc.

After about one hour, we decided that we can best improve overall health by doing the following 4 things:
1. Implement a standard Grow Chart Record, tracking height and weight quarterly.
2. Implement a semi-annual Parasite Management plan, October and April.
3. Complete the vaccinations as needed for all children.
4. Begin to develop a Community Health Training program.

Tomorrow, we will be working on improving feeding through frequency, community training for small gardens micro-nutrients and identification of higher nutrition value foods. Since dinner, Tom and I spent some time working on budget issues and then I worked on these notes until 9:30 PM. Another 13 hour work day ;-0

While finishing this, the power went out - I am sitting in the dark typing on my laptop.

-Matt Storer

Update for Tuesday, Sept 22, 2009

Ed and I started today out with a walk across the street to see the old large Catholic Cathedral here in Bangui. We spent some quite time there and then a gentleman asked us to leave and proceeded to lock the front doors rather abruptly. We continued talking on the front steps about our past and some of the similar perspectives that we have about God and our walk here on earth.

About 9:00 AM, we were back at the guest house and began to summarize our findings through all of the data collection activities that we've done since our arrival on Sept 17th. We concluded our immediate actions should solve a chronic parasite issue and increase feeding with more nutritional food. In addition, we concluded that long-term health solutions in the communities where our children live depends on educating and equipping them to improve washing methods, cooking more nutritious food, wearing shoes, techniques for mitigating malaria, etc.

Around lunch time, Christophe, Tom and Luther were added to our discussion. We drilled even more into what they think the priorities are related to the health issues we've uncovered. Christophe echoed the same concerns and recommended that we address the same priorities.

On a related subject, we discussed the idea of implementing ID badges to assist our program with identity management and facilitate a child's access to local clinics, school etc. Christophe and Luther suggested several positive reasons that an ID system should be used. They shared that the concept of an ID is well understood and accepted in their culture. At 3:30 PM we headed out to the Mercy Orphan Care Center to finish our time learning time with Rebecca and find out her views of what the priorities are related to the health issues we've uncovered.

At 6:00 PM we left to visit Rebecca's sister whose Husband's father just died up country. We gave them coffee, sugar and tea, shared our condolences as we all sat outside for about 45 minutes. Tom Peters (ICDI) shared a Bible verse from Psalm 62 and we prayed together.

About 7:15 PM we made it home for a dinner of left overs and fresh bread. Like almost every night, I plugged in to begin working on regular VisionTrust work - it doesn't stop while I am out of the country.

Praise the Lord, I got the internet to work tonight after being down for 2 days.

Why work in Central African Republic?

VisionTrust is working in Central African Republic because it is the most lowly ranked nation in human development in the world ranking - that means that the level of poverty, education, social development, health and GDP are some of the worst in the world. We were invited to participate in this work through our partner called Integrated Community Development International (http://www.icdinternational.org/) in 2004, just 1 year after the country's most recent revolution. Since that time, we've been able to work with 729 of the neediest orphans in two cities.

Today, our task force (Tom Peters of ICDI, Ed Luminati, Matt Storer and 3 others) visited a primary school in the Northern part of the capital city. We met with two different school administrators, each responsible for about 1,800 girls. The first 1,800 meet in the morning and the second group meets in the afternoon. I doubled checked the statistics from these administrators with the statistics that I found at http://hdptcar.net/blog/education. For more part, this school was a reflection of the nationwide numbers. For example, the average teacher to student ratio is close to 1:120. In classrooms where there are benches, the was enough seats for only 90 children - if you put 5 children on each bench! (See picture of Matt and Ed sharing one bench).

Regarding water and hygiene at the school: Imagine 1,800 children attending school for 4 hours with NO access to drinking water or water for washing AND not having functioning latrines. This is a typical situation for the government run schools.

The situation on the ground here is grave and frankly, disturbing. But these are just a few of the realities of the world that the children in our programs face. These are the reasons that VisionTrust exists. We are coming alongside of Christian workers who want to help their own orphans and make it possible for them to improve their education and health while spiritually mentoring them. One of our staff responsible for the program in the capital city told me today that the key to these orphans growing up to be good citizens is learning the Bible and finding faith in Jesus Christ. He compared poor children he knew growing up that completed University: Ones that weren't taught about God with those who were. He concluded that the ones who did not know God squander their new wealth received through better employment while the others, the ones with God, tend to give back to their community and help people move ahead.

This evening we met with one of the orphan groups called Asana, project CR-002. I met a young man named Oscar. He just completed his national high school exam and passed! He is 21 years old. He is excited about the possibility of going on to University and has already committed to being a volunteer teacher in the VisionTrust program to help other orphans. What an amazing story!

-Matt Storer

Broken Infrastructure: Central African Republic

Ed, Tom and I drove out to the Mercy Orphan Care Center, about 15-20 North from the ICDI Guest House. We met there with Madam Rebecca, the nurse for the orphan program. Ed talked with her about her training and experience, and learned about how she teaches the children about water and other related health concerns. She employs an animated flip chart that has Sangho and French words. For example, these are simple tools to encourage the children (and their caregivers) to find good sources of water that don't include run-off from areas where humans or animal deficate.

I've said this before, the problems in Central African Republic rival few other places because it seems as though all basic infrastructure is broken: water, sanitation, schooling, food sources and social. The water is broken to the point that public water sources in some communities in the capital city have been closed. We've approached the city officials to get permission to drill wells in these locations only to be strongly turned down because that is the "business" of the water company. They don't want to approve because that will take away from the water company's sales (remember, their distribution point is closed!). Even if the water company approved the
well, and they opened their distribution point, there would still be a water shortage. Everything is done by the bucket. In communities where the distribution points are open, people line up as early as 4:30 AM because most of them close by 8:00 AM and then reopen later. Pure water is the CORE to good health.

Sanitation is poor. While most houses use an pit, they have the pit right outside of their home and their homes are right next to each other. In most cases, the pit is no more than 15 yards away from their hand dug well. A good latrine should be about 5 feet wide and 10 feet deep, yet above the water table.

Schooling is a challenge because the governmental system experiences servere inconsistencies with paying teachers and providing the basic infrastructure necessary to teach students. The statistics paint a grim picture of a system in a shambles: there is one teacher for every 92 children at the primary level and nearly half of all teachers in CAR are parents with either very basic training or none at all. Net primary school enrolment rates have nearly stagnated for the past 15 years at 55%; and only 31% of children end up completing primary school.
However, even these numbers do not truly reflect the gravity of the situation: in Haute Kotto prefecture, for example, there are only 14 trained teachers for over 29,000 children in need of primary education. (taken from http://hdptcar.net/blog/education/).

Food security (or the level of access to food) is low. Recent information says that 2/3 of all people make less than $1/day while another 20% make between $1 and $2 per day. Given the level of poverty and the increase in food prices, the average number of times a person eats per day has dropped from 1.8 to 1.3. Yes, that is right. About 1 time per day. In addition, Ed and I have confirmed that THE meal eaten in homes at night includes a mush made from boiled casava flour dipped in casava greens with a little bit of palm oil. This offers some caloric intake but hardly any nutritional value.

The social challenges are vast. The concept of the "Limited Good" is an African concept that, on one hand it offers community and family support. On the other hand, it dramatically limits investing for the future and positive change. It is commonly held in traditional societies like CAR, that there is a limited amount of "good" to go around. In other words, the amount of good luck, money, etc. available is held to be finite, so every time one person profits, another loses. Societies that subscribe to this philosophy tend to display strong levels of equality among members and to be strongly resistant to social change. This seems to prohibit any one person
standing strong to invest in long lasting change - like large plantations, forestry projects, fish ponds, etc.

More to come later,

-Matt Storer

Pure water riddle: Why wouldn't a poor African boil water to purify it?

I met 2 young widows today

I met 2 young widows today. One cares for 17 people in one household, including 11 children. The other one cares for 6 of her own children. I also met 2 sets of grandparents, both caring for their children's children - about 13 on average. Their average income for the month is around $30! Where am I? Bangui, Central African Republic (CAR).

As Ed Luminati and myself (Matt Storer), went from house to house visiting the orphans in our program, our goal was to sit and talk with the caregivers and learn more about social, health and educational issues they face.

You see, in Central African Republic, the VisionTrust program in partnership with ICDI, works purposely to keep orphans living with their single parent if they still have one, close relatives or Christian families in their community. Why do this instead of building orphanages? The primary reason is to encourage children to grow up in a "family" environment and participate in the community activity like normal children. This concept is natural to most African communities (the orphanage was introduced by European and Western culture). This "Community Based Care" program is also less expensive to operate and therefore allows more children to receive assistance. For example since late 2004, we've been able to open 11 locations that serve 729 orphans. The program registers and pays for schooling and provides for food, health care and spiritual mentorship.

While this solution is ideal, it requires very good supervision by local staff to monitor the orphans, much like social workers in the USA. We continually work to improve the health and well being of the orphans. This is why Ed and I are here in CAR now, investigating how we can solve some tough community issues like mitigating the spread of disease including malaria, TB, and AIDS.

Please pray for us while we continue to complete our research from now until Sept 24th.

Thanks!

-Matt Storer

Ed Luminati and Matt Storer make it to Central African Republic - by Matt Storer

Traveling from the USA to Central African Republic (CAR) is not a terrible trip, but it is a long and exhausting one. Ed and I (Matt) left the USA Tuesday morning from Colorado Springs for Chicago and caught a red-eye flight to Paris, France. We arrived on Wednesday at 9:30 AM. Tom Peters from ICDI met us around noon. We boarded the next flight to Bangui, CAR at 11:20 PM. Another red-eye, arriving at 5:30 AM Thursday morning.

After waiting 30 minutes to clear immigration, we waited another 90 minutes for our 5 bags full of internet and power gear and school supplies. 2 bags didn't make it - 1 was the internet gear and the other was my personal suitcase. I am now stuck with nothing but my computer and the clothes on my back for the next 7 days.

After filling out lost baggage forms in French, we all made it to our partner's guest house (http://www.icdinternational.org/) for breakfast and 2 hours of sleep. At noon we met with Jim Hocking and a few other ICDI staff to discuss the status of the mission to over 700 AIDS orphans and explain our goal for the week related to health care.

From that meeting we went to another meeting at the Mercy Orphan Care Center to meet the staff that work directly with the orphans. This is the HQ if you will of our ministry. It is the central distribution point for 8 program in Bangui and houses the offices of our staff. The facility built by ICDI has food storage, training room, medical clinic, wood working shop and sewing school. The staff gave us good reports on progress we've made in helping the children do better in school, receive medical treatments and dedicate themselves to following God. We spent time planning the week out in detail as we hope to interview several caregivers, schools, medical professionals, etc. throughout the week. We finished at 6 PM.

From that meeting we went back to the guest house for dinner and then met more with the leadership until 9:00 PM. Ed and I are tired ;-)

What world do you live in? In my world, a precious 9 year old just died from AIDS.

A precious little girl named Verline Mbodekette died from AIDS on 8/20/2009 in Central African Republic. She was 9 years old and was born with HIV. During the last month of her life, the VisionTrust staff admitted her to the local hospital for care. Within hours, workers at the hospital determined that she had died in their care. Verline’s caregivers took her home and when they arrived at the house many people were crying and making noise. Apparently she was not dead because she "woke up." She was rushed back to the hospital and put on an IV. Sadly, she died the next day.

Perhaps for you, your world is defined by a fast-paced schedule and your personal relationships with family, friends and co-workers. However, Verline’s world was defined by 729 other AIDS orphans under the care of VisionTrust, a broken health care system, a non-functional school system, and the death of parents and close relatives.
In Central African Republic (CAR), life is…

… not about getting a job that is exciting, but simply finding paid work for one day.
… not about fixing up the basement for entertainment, but simply finding suitable shelter for a family of 11 made from clay, sticks, rocks and tin.
… not about buying another car for sweet-sixteen, but simply walking 2 miles to the nearest public grade school.
… not about buying organic meat because it is healthier, but simply finding enough food to survive for today.
… not about finding super deals during back to school sales, but simply trying not to damage the one nice shirt when washed in a creek and hung to dry in the bushes.
Together with our partner in CAR called Integrated Community Development International, we strive to create a better world for the orphans in our care. A world defined by love, trust and consistency through providing basic needs like shelter, food, medicine, education and spiritual mentoring.

As I write this, I am preparing for a trip to CAR with our Director of Health Services, Ed Luminati. Please pray for us. We will be meeting public school officials, the Minister of Health, and local medical professionals in the community. In addition, Ed and I will be conducting an extensive review of the fundamental issues blocking the advancement of basic health care like religion, social structures, politics, awareness and lack of training. Our primary goal will be to improve the foundation of basic health care knowledge among the people in the communities where we work and co-develop a plan to take proactive steps to properly care for all of the AIDS orphans in our program.

This deep level of work requires an incredible amount of time, talent and treasure: It also requires you.

If you want to help children like Verline, I need your participation this fall. Our biggest need right now is to have enough money to continue building that “better world” for the thousands of VisionTrust children throughout the world. In response, we’ve established the Better World Fund. Would you consider donating a special amount each month to this fund? You can also help by volunteering in your church or community to raise awareness about children in need, or you can commit to praying for VisionTrust and the children we serve. Please take action this month by completing the enclosed response card. You can learn more about how to get involved or donate online at www.visiontrust.org. Thank you for your participation!

Defending the fatherless with you,

Matt Storer