AHOPE

I had a wonderful time visiting AHOPE, http://www.ahopeforchildren.org/index2.html. I can say that much has changed in the last 5 years- and yet there is, as one can imagine, always room for more improvement. The younger kids are at "Little AHOPE," which is, interestingly enough, at the "Old CWA" care center. I recognize it from photos (it is not where my children were kept when we were not allowed to see them in the care center). It is much nicer than the old little AHOPE. We met with the nurses and the director for quite some time. I presented some interesting case studies of kids who had come home and things we have learned and what we provide them as far as health care, counseling referrals, etc. when they come home. They had excellent questions and we really had a great discussion. The nurses asked great questions about resistance and adherence and child development. They have many new programs in the last 5 years. I will try and describe them here the best I can:

Little AHOPE is for double orphans from birth through about age 8. There are more boys than girls—this is unexplainable. It is not due to adoption of girls over boys—it is just that more boys come in than girls. It could be families keep the girls to work, or perhaps the girls are not tested? I think in the older portion of this younger group there may only be 6 girls. They were all in the little dining room and it was stark how obvious it was that the boys outnumbered the girls. The babies were all in a small room and sitting in bumbo chairs (http://www.amazon.com/Bumbo-402-Baby-Seat-Blue/dp/B0007ORN7M) and seemed to be happy and well cared for. Pudgy little folks. I was able to interact with a child who will be coming home to a family in Denver—hopefully soon. A nurse gives meds at 6:00 pm before dinner. The kids line up alphabetically and are given the meds—they do not fight it and it goes smoothly. I shared my concern that filling a belly with lots of liquid antiretrovirals may make a child lose his appetite for dinner or breakfast.

Big AHOPE is for kids about 8+ to about 16. The thing is there is no more room at big AHOPE so as this occurs more of the 8 and 9 years olds are staying at little AHOPE. Big AHOPE is also for double orphans and they get all of their care and meds there. They go out to their different schools. They no longer are schooled onsite. This is an improvement. They have a new "Dean,” a nice fellow who gave us the tour. He is working on developing life skills, and creating a more stable, constant environment for these kids (45 kids—only 15 girls). He lives on campus and his room is right next to the boys’ dorms. These rooms are small and somewhat crowded—though better than some orphanages (and worse than others). He is there 24 hours a day. He is kind of “on watch” at night as well. His words: "very important tobe here at night." Kids get their meds by the same nurses as at Little AHOPE—but at 7:00 pm, after dinner. They give the nurses a very hard time, and they are finding the same issues with adherence in this adolescent community that we do in the states. We spent quite a bit of time on adherence education.

Over the past few years, they have had some kids who have had some family members come forward, and those kids have gone home. They have become part of a community project. They found this was not as successful as hoped with just a single monthly home visit, and so they now visit them twice per month in their communities, and the families come once to AHOPE per month—so 3 times a month they check in. They provide a meal package for the child, although it is often eaten by the whole extended family, and the child ends up with adherence issues. Therefore, they decided they needed a new program, so they started The Child Development Center.

The Child Development Center is a place where kids who live close enough come every day, 7 days a week, from morning to night. They gets meals, school fees, medical help and psychosocial support from AHOPE. This program has been very successful—they quite literally have a van which goes around and picks up all the children. If they live too far, they are part of that previous program I just mentioned. I have the numbers written down but my memory is that this serves about 75 children. They are very proud of the success of this program. And I was impressed by how well they are meeting the needs of children with HIV so they can stay in their families. Many of the kids attend the WWO school and also other local schools.

The newest program, which is not yet implemented, but it sounded like it was soon to be implemented, is a transition program for the older youth. The children who are about ages 13- 16 will be moved into condominiums in the community. It’s modeled after the SOS Program. http://www.sos-usa.org/About-SOS/Pages/default.aspx. The SOS program is a family centered program for orphans. The director, Sidesse, is very excited about this because her hope is that these kids, who will not likely be adopted out of AHOPE, will learn life skills and spend their adolescence in more of a family environment. There will be one person who will work 6 out of 7 days a week living with the kids and tending to them, caring for them and teaching them. They will be in small groups of about 6-8 kids.

They chose 13 as the cut-off age because there is this slow-down with adoptions (which many of you know about )and with that slow-down it will be almost impossible for a child 14 and older to be adopted by the time they are 16 (which is the legal age limit of adoption in Ethiopia). I asked if they were bringing these concerns to Ministry of Women’s Affairs (MOWA), and they are. There have been many discussions about how many of the oldest children will “age out” before being adopted, unless they are identified by 13, or 14 at the latest. These kids in the transition homes can still be adopted—they will still show up on a list of waiting kids—but they are going to be very careful not to plan for an adoption because it’s so unlikely. So, the kids will not have any unrealistic hopes for families who may never come. But, if a family does want to adopt one of the older kids, they can still do that. This program has not yet begun and has its obvious merits—a place to learn to cook, clean up after yourself, give your own meds, take charge of your own health care, and to function in a smaller "family" like setting. But as with any new program there will surely be challenges along the way. I also would imagine that for those kids moving out of AHOPE—the only place many of them even remember—this could be a bit frightening. But surely it’s better than suddenly turning 18 and finding yourself on the street all alone!

Of note, the new Dean of Big AHOPE has also made some big changes in the last month. The kids now have to clean their own rooms and make their own beds and help clean up after meals. This was something they had never done before, and he has met with considerable backlash. But a month into it, he is finding it very successful and has even identified some leaders among the kids who really have matured and have taken on extra responsibility. He was very proud of this.

Finally, I have many pictures of the kids which I cannot post. I want to thank the 2nd graders and kindergarteners at Westerly Creek who donated so many band-aids and supplies to AHOPE and the other orphan projects I have visited. I also want to add that if you are adopting a child who is waiting for you at AHOPE—please email me as I might very well have a photograph of your child. I took quite a few, and a few short movies as well. God bless all of you who are adopting a child from AHOPE or any of the other agencies here in ET. I know the wait must seem unbearable, and having been here and seen the kids, I really feel for you and for the kiddos.