Fiona McLean, HealthProm CEO 

Walking around the streets of Mazar-e-Sharif, the capital city of the Balkh Province, and venturing up into the mountains of the Charkint District, you do not get a sense of being in a country racked by war. It is almost surreal, being able to move around in relative safety, when you know that some 570km further south in the country there is the ongoing battle between the International Security Assistance Force (ISAF) and the Taliban.

This said, the people in northern Afghanistan, as elsewhere in the country, face many other hardships related to poverty and under-development.  The list of problems and challenges faced by the country and its people is extensive.  One of the most serious problems relates to maternal, infant and child health.

Afghanistan has one of the highest maternal, infant and child mortality rates in the world. Ironically, it is not the conflict that is claiming the most lives, but the basic act of giving birth. Maternal deaths are ten times higher than the number of civilians killed in conflict.

In Afghanistan today, one woman in every eight dies of pregnancy related causes and one in four children dies before his or her fifth birthday. The situation is even worse in remote areas, where nearly nine out of ten Afghan women give birth at home without any medical assistance.

The purpose of my visit to Afghanistan was to meet the in-country team, implementing HealthProm’s project to “Reduce maternal and neonatal deaths in the Charkint District”, as well as other key stakeholders, including the Ministry of Public Health, the Ministry of Economy and other international NGOs working to promote maternal and child health.  I also had the opportunity to conduct two project site visits and sit in on the monthly meetings of Women’s Support Group Leaders.

Whilst the external meetings were undoubtedly very useful, the most lasting impression was made by the women who are involved in implementing the project – from our in-country Project Manager, Azada Parsa, to the 40 village women who lead the Women’s Support Groups.

Azada Parsa is a qualified doctor, who not only manages and coordinates all project activities, but is herself actively involved in its implementation.  One of her key tasks is to train the Women’s Support Group Leaders on the risks of pregnancy and childbirth and what measures can and should be taken.

The Women’s Support Group Leaders are all volunteers. They travel long distances in often very harsh conditions to participate in the monthly meetings / training sessions and then commit their time and effort to support the other women in their villages.

As a result of their efforts far fewer women and infants die.

In order to continue this project, we rely on the support of a variety of donors.  We will be applying for institutional funding as well as grants from Trusts and Foundations.  Financial support from individuals also plays an important role in our being able to help Afghan women and children.  We would therefore like to appeal to our readers and supporters to consider making a donation to HealthProm. 

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I recently graduated from the School of Slavonic and East European Studies and started volunteering for HealthProm in November last year as Administration and Events Volunteer. I will leave in April with a renewed enthusiasm and a head full of quiz questions (if only the answers had stuck around, too!).

After graduating in August, I decided to take to the job market rather than continuing to study. I knew that my sympathies lay with the charity sector, but I wasn’t sure what it might actually be like to work in it. HealthProm has given me a fantastic insight and it has spurred me on to apply for jobs in the field.

My main focus at HealthProm has been organising fundraising events. My first introduction to the events calendar was attending the annual cello recital in November. Aside from being the first opportunity I’d ever had to venture inside one of those beautiful, grand houses in Kensington, it was a chance to learn and observe from a smoothly run event. Since that introduction, I have been responsible for organising pub quizzes and the Great Expectations cycle ride, took part in a Christmas fun run and co-ordinated activities with the Brandenburg Choral Festival to co-host a concert just before Easter. The pub quiz questions posed the biggest challenge, but the task also appealed to my insatiably curious nature. I look forward to bringing a team down to the quizzes and putting some of the new obscure knowledge to the test!

Over the six months here in the office, I’ve been given the opportunity to work on quite a range of activities alongside events. As well as providing administrative support, I have worked on setting up a Google Adwords account, collaborated with a Russian partner organisation to update an EC database, done a little research, put together a Welcome Pack for donors, taken part in team meetings and in-house training.

In short, HealthProm is easily the most varied and interesting role I have done. Moreover, it’s been a brilliant set of people to work with. I’ll be sad to leave the ladies in the office and can only hope there is such a good atmosphere and sense of humour in the next place I find myself! In the meantime, I’ll get thinking about what community fundraising I can do to help HealthProm continue its work with vulnerable mothers and children.

________________________________________________________________________

Anna, we can’t thank you enough for all your hard work over the past six months. From writing quiz questions, to dressing up as Santa to battling through EU administration, you’ve managed it all with a smile on your face! We are going to miss you immensely but wish you all the best for the future as you move on to great things. Don’t forget us!

The HealthProm team X

________________________________________________________________________

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by Mirkholik Mahmudov, Project Assistant, Kishti Project, Disabled Women’s League “Ishtirok”

Fostering understanding on disability among the next generation: community outreach staff, parents and children from Kishti shared experiences and information with high school children.

Today the community outreach team, Matluba, Nigina and Adiba, plus Shahnoza and nine Kishti parents with children (total 22 from Kishti) visited high school Hilol, where we conducted our activity club.

Class leaders and students of different classes welcomed us very warmly. We didn’t expect such a welcome. The head teacher of the high school said the first speech and made us feel like valued guests. The children of the school prepared a program for us.

Nigina held an open lesson on who is a disabled person and what is disability. She gave some basic information and examples on this subject. The children listened attentively and it was obvious that they were very interested. During this open lesson the number of participants increased and students started communicating with our children and parents from Kishti.

We gave information about our centre, Kishti, what kind of services we provide and if they are interested how they can help us through volunteer work.

After that we asked the question and distributed white paper and all the students started answering our questions about “Who is disabled person and what is disability?”. Below you can see some answers to these questions:

“I think that we should not make fun of them and we are all equal. These people are very kind and nice (smart). These children become human beings ” 11th grade student.

“I think that people with disabilities are very good. They are children of destiny. I wish them much happiness and health” 4th grade student.

“My brother is disabled. I love him very much, because he is also human. I love him as he is. Disability is not a disease! Because I do not feel that he is different “4th grade student.

Everyone enjoyed the parachute game in the school yard

The reason why we asked these questions is that we want the young generation of Tajikistan to understand that people with disabilities are equal members of society and they should be treated as equal.

We put on coloured paper handprints of our children and school students. They were happy to do it. Ruslan drew a picture and gave it to the student of 11^th grade. Each student took handprints from Kishti children. At the initiative of the students, they prepared gifts for our children. Umed from Kishti Kids Club read a poem for all the students. Each high school student talked with a child of our centre.

At the end, we used a parachute game in the yard. All children enjoyed it much and did not want to let us go. We took a picture as a memory and teachers and students asked us to come again. Our kids loved it too and in a good mood we returned to the Kishti Centre.

Learn more about HealthProm and the Kishti Centre

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by Dr Azada Parsa,  In-country Project Manager of HealthProm’s Safe Motherhood Project, Afghanistan

Pregnant women in Afghanistan often have to travel long distances by donkey to reach medical help

Amina had a normal delivery of her fourth baby at home, helped by her neighbours. She then started to bleed severely. All the women tried to find a way to stop the bleeding. But it was before our project started and there was no vehicle.

The family was very poor and couldn’t even find a donkey to get Amina to a distant health centre and midwife. She lost lots of blood and they could only watch her dying.

After her death her husband gave the baby to another poor family for care. But the foster mother couldn’t provide him with milk and he died too.

The father took care of his three small daughters as best he could, but hardship and grief wore him down. He had a dispute with a man who had employed him then didn’t pay him, and he injured the man with a knife. Now he is in prison for three years and his daughters, now aged between 9 and about 12 live alone in the village.

Azizagha, the safe motherhood group leader, helps the girls as much as she can, giving cast off clothes. The oldest girl takes care of people’s sheep on her own in the mountains, even when there is snow, and so provides some food for her sisters. Azizagha is afraid that she may be eaten by wolves. There are a lot of wolves in the district now.

Although Amina died eight years ago, Azizagha cried as she told the story to me. She explained that since women have become aware that they can do something to prevent maternal deaths they grieve about women who died needlessly in the past.

Before the project started many women like Amina died in childbirth.

We will, of course, help Amina’s daughters. Sadly, there are probably many other children in similar plights in the district.

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I started volunteering with HealthProm in March 2012 after discovering the charity online. My first few tasks for HealthProm focused on translating case studies and various articles. I was then asked if I would take on the role of administrating and expanding HealthProm’s presence in the world of social networking. With experience of raising awareness online for other charities and time spent promoting societies at university I was more than happy to take on the role.

Social media is a great way to engage and communicate with HealthProm’s audience. It is a very important tool not only for communicating, engaging with our supporters (and finding new ones), fundraising and sharing our latest news and information with the world but also for keeping up to date on the latest research, news and events in the third sector and generally around the world.

I started by creating a Pinterest account for HealthProm, as a way to share the amazing work we do through photos-links online. The idea behind Pinterest is to share your own photos and pictures, called pins that are linked to a webpage. If people like your photo and want to pass it on they will re-pin or share your pin on their account. Pinterest is a great way to raise awareness of what HealthProm stands for, the amazing projects we do and the smiling faces of the people we help, as well as creating relationships with other charities and organisation. At the moment we have 146 followers and hundreds of people have ‘re-pinned’ our photos! And on Facebook we have 174 followers!

My main focus with social media expansion has been on Twitter, as this is greatly used by third sector organisations across the world. It’s one of the best places for finding out the latest news, research and what events and campaigns are coming up. It is very rewarding and interesting work; Twitter has a great community feel and is primarily about sharing, engaging and informing and is full of lovely people and organisations.

We have more than doubled our Twitter follower based since summer, with over 400 followers (and counting) made up of individual people, charities and other organisations. Many were gained whilst tweeting zealously through the Paralympics and a BBC documentary ‘Ukraine’s Forgotten Children’, during which I tweeted about HealthProm’s work to reduce institutionalisation and help abandoned children, especially those with disabilities and special needs in the FSU region.

Continued updates about HealthProm’s projects, events and people has forged a very strong support base on Twitter, Facebook and Pinterest that I enjoy maintaining. I have helped build some very strong relationships on social networking sites for HealthProm that are looking to create some very exciting opportunities for HealthProm in the future.

I hope I have encouraged you to head over to HealthProm’s social networking sites and join us, all it takes is a few clicks of a button and you can have access to daily updates from HealthProm and a lot of wonderful photos of smiling faces from those we help.

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by Alexandra Kulikova, HealthProm supporter

HealthProm staff and trustees were very grateful to Matthew Barley, violoncello, and Reinis Zarins, piano (centre) for such a wonderful concert!

On 5 December HealthProm held its 6^th annual recital in memory of Mstislav Rostropovich. Baroness Smith and Greg Hands MP, Patrons of HealthProm, invited the guests to the beautiful home of Sir Vernon Ellis, chairman of the British Council and president and previously chairman of English National Opera.

Following welcome drinks, Robert Scallon, HealthProm treasurer, greeted the guests of the recital, which has grown into a beautiful annual pre-Christmas tradition, and updated them on the latest developments and achievements of the charity. He was joined by Jane Ebel and ­­­­­Rachel Tainsh, who shared some more details on the success recently made in Tajikistan, where approaches to childcare alternative to institutionalisation are still fairly new.

The current Early Years Centre project at Kishti, in particular, is increasingly recognised as a centre of excellence in early childhood development and has involved professional training for in those working in the health and social sectors. Notably, therapeutic music-making approach to creating music, establishing

HealthProm Project Manager, Rachel Tainsh, captures the audience as she describes HealthProm's work in Tajikistan

positive relationships and fostering the child’s individual potential, will be incorporated into the Kishti centre training scheme. The approach has already proved as very beneficial for building communication skills and improving self-confidence with the children for further integration into society.

The recital performed by two brilliant musicians – Matthew Barley, violoncello, and Reinis Zarins, piano, – featured selected pieces by Beethoven, Rachmaninov, Stravinsky, Prokofiev and Britten. As part of the latter’s centenary celebration on the Around Britten 2013 tour, Matthew will be working with vulnerable children in a variety of settings in Moldova and Tadjikistan next year. These initiatives are of great value for a country, where about 1 million people are living on less than one dollar per day, as pointed out Greg Hands MP, Patron of HealthProm, who took the floor after the concert. Having spent several months in Eastern Berlin in his university years, Mr Hands has visited most of the former Soviet republics and has found it a natural decision to engage with the HealthProm as its Patron and encourage its endeavours in the Central Asia.

A charity raffle, with kind gifts from Made&Told, Mimino and ABO London, was followed by a generous dinner during which the guests seized the opportunity to talk to the HealthProm leaders and supporters to learn more about how much is yet to be done in the area of child health and social care and how every little bit matters.

HealthProm extends its thanks to all the donors and individual supporters who are helping to expand the scope of the charity’s work, to Barclays Bank for the generous support of this event and, in particular, to Matthew Barley and Reinis Zarins for a beautiful performance, Sir Vernon Ellis for providing a magnificent venue for the event, and to all the guests who have made this evening happen.

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by Francesca Ebel, HealthProm volunteer

Me (far left) with Sultanat, Olga ( HealthProm volunteer) and Tracy Beard (St Quintin's Centre Manager)

Last week, Saltanat, a member of our Kyrgyz partner organisation ARDI, journeyed to London for the first time. Being the mother of a disabled child herself, she requested to visit a local day care centre which provided support for children with both physical and intellectual disabilities.

After some research, St Quintin’s centre cropped up: a state-of-the-art centre in the Kensington & Chelsea borough offering activities and support for local children and their families. As we made our way to the quiet side street off Ladbroke grove, Saltanat told us of the troubles she had faced when caring for her son, who was born with cerebral palsy.

Kyrgyzstan lacks both the infrastructure and the awareness to provide substantial support to those who are affected by disabilities. Saltanat was told by her family to abandon her baby to an orphanage. The ARDI centre itself encounters real difficulties: not just through their lack of funding but by the consequences of the social status that accompanies working with disabilities.Those that have the courage to work there (most social workers are parents of the children like Saltanat), suffer from severe back pain due to the continuous lifting and carrying of disabled children.

The poignancy of this story was highlighted as soon as we entered the centre: the entire building is fitted with a network of harnesses and pulley-systems for transporting the children – the golden rule at the centre is to never lift a child. This was by no means the only difference.

Tracy Beard, the centre manager who helped to found St Quintin’s 3 years ago on a £2 million governmental grant, spent 3 hours introducing us to the staff and the modern, high-tech facilities at the centre: a sensory room and garden, a ball pool and trampoline, a wheelchair swing and even a Makaton iPad app!

St Quintin’s is run by a huge team of part-time playworkers who are very dedicated and enthusiastic: there is one worker for each child. They run a full range of activities themselves: from arts & craft, storytelling and hydrotherapy sessions to trips to Disneyland Paris.

The centre provides a huge amount of family support including parent pamper days, a siblings club and a father group. By the end of our visit we were not only amazed by the quality of the social support that the centre exemplified, but also by how outdated the Kyrgyz system is. In Britain, disabled children are made to feel normal; in the Kyrgyz Republic, they continue to be excluded.

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In June I ran a half marathon (uphill!) through Chamonix in the French Alps. It was to raise funds for HealthProm’s work supporting women in labour in Northern Afghanistan. When a 4-wheel-drive can’t get to their village, the women can only reach the clinics by donkey. HealthProm and partners are developing a saddle with air bags which will make the ride much safer and more comfortable for them.

Before the race I wondered how the challenge of the run would compare with childbirth.  The burqua-clad women of Afghanistan, trundling down the mountainside on a donkey in order to get to the clinic, were very much in my thoughts and while I would happily do both again, I can confirm that running up mountains is the easier option!

Hot baths and last-minute bandages

After months of training in exotic and not so exotic locations, early in the morning and late at night, and the somewhat over-zealous testing of five- toed socks, trainers and trail shoes, camelpacks, gels and rehydrate drinks…on the day, it actually boiled down to whether or not my Achilles tendons would hold out over the 15 mile Alpine circuit!

I guess if it hadn’t been the tendons, it would have been something else: hips, knees, lung capacity (although this has never been one of my problems!)and it’s always handy to have an excuse; so after umpteen hot baths, repeated applications of ralgex and deep heat, there was little more I could do.

But at the last moment I was told about a British physiotherapist in Chamonix who was offering to strap people up the night before the run. So I paid him a call and was well rewarded.  I came out trussed up  with bright pink and black sticky tape from my heel to my knees and a much needed boost to my confidence.  I did ask him to keep on going with the tape but he felt it wasn’t necessary.

The big day arrives

Saturday 30^th June dawned bright and hot: not a cloud in the sky and not much of a breeze either. The temperature on the flickering pharmacy lamp on the street the night before, had registered  30 degrees at 7pm, so it was going to be a scorcher!  Persuaded they would not be  necessary, my cousin and I ditched some of the items on the obligatory equipment list (such as a breathable jacket) and set off to join the others at the start line by 8am.

Alas, as we drew close, we heard the organisers announce that four of the items on the kit list were absolutely obligatory and anyone not carrying them would be disqualified: a mobile phone, water, a whistle and that breathable jacket.  There would be spot checks along the way.  My heart sank.  I couldn’t believe that after months of preparation and training, we might be sent home for the lack of a whistle!

One of the problems with runs in France, is that everyone takes them so seriously.  Most people train all year round and at altitude and for them, a long run means 4 hours into the bundu before breakfast.  Very few people run for charity and so the event lacks the amazing sense of camaraderie that you experience with a British Charity Run where participating is what it’s all about and you want to cry every time you read the back of someone’s t-shirt.

Fortunately, with this run, which is mainly along skinny mountain paths, if you’re not in the front cohort, you can only be as fast as the person in front of you, which suited me just  fine!

Stunning scenery

It was the most awesome run, in every sense of the word: 15 miles with an ascent of 2000m through the most stunning scenery imaginable (if you had the time and energy to look up and could simultaneously negotiate the tree roots without falling flat on your face).  Wild flowers were in abundance and the scent of pine filled the air.  And the mountain air is fabulously energising even when you’re ready to drop!  Only the last 1km defeated almost everyone: an open dust bowl with no shade and a vertical clamber up the ski slope to the finish at the lift.

My thanks to everyone who generously supported the run.  It made all the difference while I was out there for four and a half hours.  It also meant that quitting was not an option!

Written by: Jane Ebel, HealthProm supporter

Inspired by Jane? Find out ways you can help or get in touch!

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I began the music workshops at the Kishti Centre without any verbal introduction, just using song and music as communication as each child/carer entered the room and was seated. At the first session, there was a wide age-range of children and I was a little anxious if it would work within such a range. But actually it proved a gift, where some of the older children were more able to play and maintain a beat on a drum or a tambourine, while I interacted with some of the younger babies.

Stimulating creativity and bonding through music

I trust the music and that a kind of magic is created where the children are ‘held’ by the songs and by the nature of the human voice. I moved around the circle, singing to them, making eye contact, deviating from my song if they made a little noise and copying them to encourage their creativity. I encouraged the mothers to join in, to sing the songs that I sang. I chose a repertoire that is simple, often with few words so that it is easy to mimic and I encouraged the mothers to hold their children close so that they could feel the sound through their bodies (ostephonics – much of what we perceive as ‘hearing’ is actually felt through our bones).

Gradually I added other ‘flavours’ to stimulate the children – a pretty bright bell sound that they can ring themselves, or the soft beat of a drum. They would stretch out and feel the drum skin and intuitively bang it in time to the music. An egg shaker, small enough for even the littlest child to hold means they could create their own rhythm to accompany the song and promote physical movement.

I encouraged ‘play songs’, where the lyrics promote a combined movement of mother and child – wiggling, lifting up into the air and clapping. I also used a coloured piece of silk material which can be thrown up into the air and then floats down. They all gazed at it and watched it fall and felt the movement of the air. I also used it to create a little intimate space, hiding under it with a child and mother or used it folded as an opaque mask to play ‘peek-a-boo’ from behind.

I asked the mothers about any songs they knew or if they could share with me any words or melodies. We had a volunteer who sang the words ‘Ala megum’ (the lyrics of which I sing at a concert at the conservatoire the next day). She sang a line and we all copied her and the sense of her courage and of the sharing in the room was inspiring. For me, it felt that everyone in the room was included, took part, communicated and shared, and that the music created a focus as well as an atmosphere of creativity and joyfulness.

Music therapy and autism

The sessions at the Autism Centre were equally well supported, despite adverse weather conditions making it difficult for some mums to journey in with their children. Within the two sessions I held, the first began at a cracking pace, led by a young boy whose physical energy and dynamism were to direct the energy of the music I used. We danced, stomped and clapped and the mums and children around the edge of the room joined in and laughed and moved in time to the music. I was grateful for the help of Pam who generated a great energy accompanying the song on a tablac drum. The energetic child in particular was free to move and dance and run in the room without a sense of need to be restrained, and naturally he fell into the beat of the music and expressed himself in his dancing, a huge smile across his face.

Other children joined in the centre of the room, compelled by the rhythm, some clapped and bounced at the sidelines. Some children were more vocal and after hearing my voice felt free to sing their own vocal lines, one boy in particular created soaring melodic lines which we copied and sang back to him. He gained confidence and sang higher and longer more sustained musical melodies, of his own making, moving his body with the shape of the melody. Some children hid behind their mothers, so I offered a percussion instrument in a ‘peek-a-boo’ style, to give a sense of play and they would leap forward to bash the instrument and go back again.

One child sat on my lap facing me and held my head between his hands, gazing into my eyes as I sang. He sat there for several minutes with this incredible eye contact. He would look at my mouth then the rest of my body, deciphering where the sound was coming from. He quietly mouthed words, as if to sing himself, and smiled and interacted. Another boy came out from hiding behind his mother, drawn to the hypnotic beat of a song and lay on the floor, rocking in time to the music, his movement becoming slower until he lay still, listening and gently squeezing my fingers to the still quiet beat of the tablac and the soft melody.

At one point, I just sang, and the children listened. Their attention was phenomenal. I sang a whole Italian operatic aria, at full pelt and they were completely held by the music, and watched and listened and when I sang the final note, they knew that the song was finished and suddenly bounced and smiled filled with happiness!

Well supported

The sessions were so well supported by the staff in the centres and the mothers really took part and were supportive and keen to see their child’s development and interaction through the sessions. They intuitively understood the purpose of the sessions and were delighted by their child’s interaction. The sessions for me were a wonderful experience, to play and sing with the children, to help bring out their own creative energies and accompany them in their dancing, singing and expression. To be supported by such compassionate helpers, mothers and staff was inspiring and such a joy.

I look forward to returning and building on the work and more importantly, to help encourage and train others to lead such workshops to build sustainable workshops for children’s creativity that can be enjoyed on a more regular basis.

Written by: Lynsey Docherty, professional singer

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Mark and I worked together and separately with Saida, Nazira and the rest of the team. Our busy programme covered six days. Our work included direct work with children and parents, meetings with family groups and with local doctors, visits to EC offices, ministries and NGOs.

Visiting the new Autism Centre

We visited the new Autism Centre that grew out of the work of Kishti and opened six months ago. Lola and the parents she works with have created a valuable place for community support and child development.

Delivering teaching, advice and support

Mark conducted teaching sessions in Kishti with doctors and students. It is good that doctors come to Kishti to see the services that we offer. Mark also worked together with the Kishti team to offer advice and support on direct work with children and families.  He visisted the adjacent Baby Home and remarked that the children there are visibly happier and better cared for than a year ago, thanks to a large part to the continuing work of Ricardo from the Kishti team.

Child protection is an integral part of our work; Mark ensured that the Kishti team know what to do when a child appears to have suffered harm.

Zuchra is working to develop a crisis team as a new initiative based in the second Kishti building. She and Jonathan spent time planning how this service should operate.

Working with the government to bring about change

Notwithstanding the two coming years of funding secured from the British Government, Kishti is still not locally commissioned by the Tajik State. This has been an area of intensive work over several years that continued in this visit through meetings with the EC. The Ministry of Labour allows for partnerships with and funding of NGOs and we will be taking part in their commissioning process in the coming months.

At the end of our visit we took part in a strategy meeting about Early Years Support chaired by the Ministry of Health. This is the beginning of a process where the MoH sets and agenda and coordinates the work of the various NGOs and ministries that all contribute to the welfare of children under 5 and their families. The challenge remains of working across administrative and organisational boundaries in Tajikistan for the benefit of this vulnerable group.

Ambassador Trevor Moore kindly welcomed us in the British Embassy and offered helpful insights to guide our continuing negotiations with the Tajik government and the municipality of Dushanbe.

Mark and I thank all those who supported us through our visit.

Written by: Jonathan Watkins, HealthProm consultant social worker. 

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