Inonge and Mukubesa arrive....

Left to right: Precious, Mukubesa, Granny, Carol (Precious's sister who also has 4 year old twins and stays with the parents), Inonge, and Lillian - Kasensa staff) 

  This is a long story! 

January 3rd  Mukubesa (male) and Inonge (female) 10 week old twins arrived accompanied by their maternal grandmother, Cecelia and their dad, James. 

The twins' mother, Precious had been having mental health issues over the past several weeks which had led to neglect of the babies. 

Precious, the twins and the 5 year old daughter Faith had been staying with Precious's parents at Simakakata since the baby's birth and since Precious's psychosis had worsened the husband and granny felt the twins were no longer safe. Due to her deteriorating mental state of increasing auditory hallucinations resulting in pre-occupation ++ Precious had not been breastfeeding the babies regularly and on January 2 had thrown cold water on them. 

As has become the culture, the family brought the twins to stay at Kasensa before first being assessed by Social Welfare in Kalomo. 

But....over the past few months much work has been done to have the orphan homes in the Kalomo District work towards 100% compliance with the 2009 Child Care Facilities Minimum Standards document on the process of admissions. 

The process that is to be followed according to the Government document is

• a full social welfare investigation and report must be done
• a committal order from the courts
• a police report (when warranted) 
• and a birth certificate and under 5 health card must be produced

Our staff have all been instructed in what to do when a family comes with a baby, that is not to accept any baby unless ALL of this paper work is complete. So the family returned to SW office that afternoon. 

The paper work could not be completed at that time, due to a medical report that needed to be done to confirm the mental health issues of Precious and the committal order form could not be located. 

Therefore, since all the paper work was not done and since Precious had been a physical threat to the babies it was decided that the granny and the babies would stay at Kasensa until SW had completed the paper work. SW gave permission verbally for this to happen. 

Kasensa will only care for the babies independently once the paper work has been completed. A family member can remain at Kasensa if that is needed, but Kasensa staff does not care for the baby. 

The next day Precious was evaluated at Kalomo Hospital. The typed medical report noting the degree of psychosis and her inability to care safely for the babies was delivered to SW office. She returned to Simakakata with Haldol 2.5 mg to be taken once a day and was to return the next day to be further assessed by a Clinical Officer who had mental health expertise. 

I brought Precious to stay with us at Kasensa so I could further assess Precious. She was flouridly psychotic. She peered around corners, sometimes dashed here and there, was very pre-occupied most of the time, refused to take her meds, ate and drank only with encouragement, and with much hesitation, paid no attention to the babies, denied anything was wrong with her and at times laughed inappropriately. Other bizzare behavior was also noted. 

Next day we took her back to Kalomo Hospital. She was compliant with the evaluation but once back at SW she refused to get out of the vehicle. Once out of the vehicle she headed off running to the market instead of being further assessed by the SW worker. We were able to get her back into the vehicle with 3 people helping (reminds me of a few other memorable days at another job!) where I drove directly back to hospital for her to be admitted. Precious's brain needed some time for healing! 

Over the next week Precious was treated at the hospital with a good dosage of haldol and discharged back to her parents at Simakakata 4 days ago. 

Some of the development lags in the "majority world" as noted in this case is the inability or inefficiency of being able to follow through with expected Government requirements that are designed to protect the child and to assist families and communities to better care for their children. 

So in this case, we have a verbal agreement to have the twins stay here, the SW report is complete and the committal order process is partially complete. I am committed to seeing that the full processes are completed ASAP as all of us who are working in these jobs have committed to full compliance with the Government regulations. Its not about a crazy following of the letter of the law - its about caring enough for the children to see that the system is working for the children. A major role for CSO's or FBO's is to have relationship with government systems in order for systems to stay on track and even improve. 

Perhaps the next time this process needs to be followed the time will be halved. 

Precious is doing MUCH better! She is bright and attentive to the children. She's taking her meds willingly under her mother's supervision. (Her father is blind). 

Yesterday, we took the twins to Simakakata for a 2 hour visit. It went very well. Precious enjoyed ++ seeing them and was about 75% engaged with them. 

We'll take Precious for a review at Kalomo Hospital on January 28 and at that time make a plan for the twins to return home. 

We'll have Precious and the 5 year old daughter spend a night here late next week so we can evaluate her involvement at a closer level. 

In the past a baby from a mom with a mental disorder who was brought to Kasensa or any orphan home in the area would likely spend up to 2 years in care and likely the mom would not have received assessment and treatment to enable her to attempt to get well. 

But...that was then, this now and all of us need to keep the ball rolling in this direction.....for the babies, for the families, the community and the nation. 

Partnering, relationships and government working together towards better solutions! 

FYI - Mukubesa - Losi name meaning king; Inonge - Losi name meaning....(not sure!)