Ica the End of the Campaign

 Photo: The plaque at the Casa Girasoles in Ica.

 Photo: Our home away from home in the desert.

 Photo: Pepe - the team mascot. Boy did Pepe and I bond . . . 

 Photo: Team breakfast before our departure.

Photo: Our bus ride back to Lima.

Once again, off we go. This time we are on our way back to Lima. Our two days in Ica at the Casa Girasoles have been very fruitful. Yesterday was spent seeing all of the boys at the house and helping to develop a record keeping system for the health and social care needs.

Our clinic started around 9 a.m. and ended just after 7 p.m. Needless-to-say, it was a long day. The challenge for our project is the fact that there is a strong needs to document a “holistic” history and evaluation on each boy – as mandated by a Government law established in 2010. The exact requirements of the new law (although the law was established in 2010, it was not operationalized and required until this year) are still being sorted out. We figure it will take a couple of years for the Peruvian Government to fully require compliance with the details of the mandate. For now, we are hoping to develop a model that can be rolled out to all of the Casa Girasoles.

At present, we have completed a trial of our record keeping and evaluation project at three houses; and, we have run into challenges at each location. We have also established some amazing relationships with the boys in the Girasoles houses and the staff working at each location.

One little boy I had the pleasure of serving yesterday was a short stature 8-year old by the name of Sanchez. He has a deep, raspy voice that seems more appropriately vocalized from the body of a person five decades his senior. He is absolutely adorable – constantly in motion and forever questioning everything. Sanchez has lived at the Girasoels house in Ica for 4-years. He comes from a very economically impoverished background. At one point when we were seeing him he mentioned that he had a hard time hearing. A quick otoscopic exam definitely diagnosed the etiology of his decreased hearing. He had more sand in his years than may be physically possible.

Karen helped to lavage his ears with a special large gauge syringe infused with warm water and hydrogen peroxide. He was not that happy with our procedure. In fact, it took more than a few folks to coax him through the procedure. Later last night at dinner Sanchez was sitting a few chairs away from me. I asked him if he left better. He looked at me with a puzzled appearance, not quite understand the intent of my inquiry. I rephrased my question and asked him if he could hear well. He responded with one word – “bastante” (lots)!

I love the work we are doing. I love the fact that the goal of our work is to connect the pieces together to create a bigger whole. Collaboration is built through relationships and trust. Each day we strive to create deeper relationships and establish more trust through the merits of our work and the compassion of our service.

Ica - Casa Girasoles

Today was a transfer day. We left Lima this morning and boarded another bus – this time heading south along the Pan American highway for 6+ hours. Our destination – the city of Ica.

Ica is a coastal community just North of the driest desert in the world. Ica is best know for a massive earthquake that decimated parts of the community in 2007. HBI has worked with our Peruvian partner Union Biblica in this area for a few years now. The city is just now recovering from the devastating effects of the earthquake.

We will be working here for two days. Once again, seeing all the boys at the Casa Girasoles is our main priority. Our goal for this project and campaign continues to be documenting the needs of the children and helping to develop a formal medical and social record keeping system. We are so fortunate to be working with Union Biblica and their fantastic team (Billy and Kate are two of the best people anyone could ever wish to meet and have the pleasure of working with).

Tonight at dinner one of the house parents was telling me that our dental team was going to be very busy. Thank goodness we have two dentists and the amazing energy and extreme talents of our team (Karen, HBI’s Director of Nursing – does the work of three people). Mike Dotten has been a real trooper acting as the dentists assistant. His poor back has got to be killing me – but Mike is never one to complain!

On our trip to Ica we took a slight divergence and visited one of Peru’s most famous winery. It was a fun filled visit to a former convent turned winery. We really enjoyed getting to see a window into the past of this ancient colonial city.

Lunch on the Continetal Divide

Today was a bit of sightseeing and planning for our project that begins tomorrow.

We drove up to Lago Llanganuco and then kept driving all the way to 16,800 feet above sea level where we took pictures, played with a snowball and then had a wonderful lunch overlooking the dividing line of the watershed to the east and west. It was amazing to look out from the continental divide at the seemingly never ending expanse of the Andes Mountains.

Tomorrow starts bright and early and we will have a full day of activities. Stay tuned for more updates. Thanks for all of your support!

Kusi 2012

After an almost 10-hour bus ride and a 2-hour taxi ride, we made it to Kusi late last night. It is so great to be back here. The sheer splendor and beauty of the area (along with the 11,000 feet) take your breath away.

Today is a planning and sight-seeing day. We are headed to Lake Llanganuco and then on a small hike to the Campo Santo in the old city of Yungay. We also have a bit of planning and preparation before we start a clinic for the boys of the Casa Girasoles. The focus of this trip is to continue the work we have been doing for Union Biblica del Peru.

The work we are doing in Kusi over the next three days is a part of a program we are calling  Ayuda Girasoles Project. We will be working in collaboration with Union Biblica del Peru, helping to develop a monitoring and record keeping system for children living-in group homes around Peru. HBI will work Union Biblica to develop a system for collecting health and psychosocial data on children living in the Girasoles homes in accordance to the requirements (resolution number 080-2012-MIMP) of the Peruvian Ministry of Health (MINSA).

The project will be administered in three phases and include continuous collaboration with the Union Biblica administration and staff to assure the accuracy and relevance of data collection.  The goal of the project is to help with routine data collection as mandated by the Peruvian Government for children under the care and protection of Union Biblica and to identify youth who are at greater risk for health and social complications as they age out of services eligibility with Union Biblica and move toward emancipation.

We leave Kusi on Tuesday night and take an overnight bus back to Lima. Wednesday is a full day of meetings and preparations for the next phase of this project – which is departing for another Union Biblica Girasoles home on Thursday morning. We will be in the desert town of Ica from Thursday to Saturday collecting the same data on the boys living in this home.

In addition to the data collection and evaluation work we are doing for the Ayuda Girasoles Project, we also have two Peruvian dentists, a Peruvian nurse, and a Peruvian physician with our team. We will be providing medical and dental care to the boys during our visits to the homes.

All and all, this promises to be a very full week. We will be posting pictures and providing updates when the Internet will allow. A big thank you for all of your ongoing support.

Trauma and the Developing Brain

Last night we gave a talk at a local University (http://www.ulasalle.edu.pe). The talk was around the influence of stress and early childhood trauma on the developing brain.

Given that the talk was scheduled for a Friday night on a holiday weekend – the Peruvian government decided that Monday and Tuesday next week are “holidays” and all those in the formal sector of employement have the days off – I did not hold-out a lot of hope that there would be more than a handful of people in attendance. I was partly right – there were  about 25 people in attendance; and, everyone of the attendees was extremely interested in the subject.

Today is our day long conference on Trauma Informed Care at La Salle University. We are expected a group of some 60 service providers from accross the homeless and abandon youth fields. Our goal is to help them “scale” trauma-informed services to their agencies and across programs in the Arequipa area. Robina Bhasin, adult education specialist from the Center for Social Innovation, has graciously donated her time and talents to help develop a model for scaling new knowledge acqusition with the group in attendance at the conference.

Stay tuned for more updates on the conference and our work in scaling a trauma-informed effort in Arequipa.

Lima Street Youth Conference - Big Success

 Photo: Small group exercises on coalition building.

Photo: Talking next steps for the meeting and the coalition with Carmen and Robina.

 

Yesterday was our first Street Youth Conference in Lima. It was a smashing success. We had over 50 participants from 17 different organizations that work with youth and vulnerable young adults. We spent 5-hours talking about opportunities for collaboration, best practices in serving youth and young adults, and ways that they (the assembled group of very different organizations) may want to build a coalition.

It may be too soon to fully define the next steps of our work, but there was a palpable enthusiasm from everyone in attendance. We asked every attendee to complete a final evaluation. From the information in the evaluations we will strategize around next steps. These next steps may include helping to set-up a collation, providing focused training and skills development around best practices in serving homeless and underserved youth, and working to form an on-going “community of practice” (e.g. learning community) for the organizations that were in attendance.

As for our next steps on this trip - We are headed to Arequipa tomorrow for a day long “phase II” conference on Saturday at La Salle University. You may remember that we organized a street youth conference in May in Arequipa with La Salle University. The participants at the first conference asked us to come back and help them build the steps necessary to grow a coalition. They also asked us to facilitate a day long training around trauma informed care. We will be doing just that on Saturday.

On Friday night we will be presenting a general discussion a La Salle University on the influence of trauma in the developing brain. The University has asked us to make this presentation open to the general public. Who knows how many people will be in attendance? Check out their website at: http://www.ulasalle.edu.pe/index.php/btn-eventos/btn-trauma

I will be writing to give you another update on Saturday. Until then, please know how much of an impact our work is making in Peru. At the end of our conference today a young psychologist came up to me and said, “this has been really great. We rarely get the opportunity to come together and talk about these types of issues. I really appreciate the fact that your organization is dedicated to doing this for us You just don’t know how much a difference it means for our work.”

Thanks for all of your support – and please know that we are making a difference . . . one organization at a time.

Collaboration

I am on my way home from spending a couple of days in beautiful sunny San Diego, California. I was speaking at the Region IX Health Care for the Homeless Conference.  The conference is an extension of the ongoing homelessness advocacy work of the National HCH Council - an absolutely fantastic organization based out of Nashville, TN.

I enjoy speaking at these conferences. There are such amazing people working in homelessness services delivery and attending the conferences is a great place to reconnect with old friends and inspiring thought leaders and change agents. The people who work in homeless health clinics, supportive housing programs and mental health and substance use treatment programs around the country are some of the most amazing people I have ever met.

I spoke at this conference with my esteemed colleague Steven Samra. Steven and I talked about our work on a new model of outreach we are calling "Housing-Focused Outreach" (HFO). Steven and I (along with the amazing intellectual Kenneth Kraybill) have been incubating the ideas of HFO for a few years. Our ideas are not unique. They are born from the work of Dr. Sam Tsemberis and the 100,000 Homes Project. Our ideas are also born from our years of experience in serving people experiencing homelessness and the work we have all been doing over the past two years in visiting supportive housing programs around the U.S.

Our talk is about shifting the paradigm of services delviery and considering the ways that a new model can be developed and operationalized to agency level activities. You could really sum up our talk into a couple of pithy statements: (1) in order to truly end chronic homelessness, we [homeless service providers and advocates] need to lead with housing and build effective bridges to supportive services; and (2) the only way to assure adequate access to housing and supportive services is to build bridges of collaboration with a number of organizations and resources. We talk about the fact that most communities around the country have the "pieces" to put together a really effective model to end chronic homelessness. The issue, however, is that these pieces are fractured and disjointed. Our main predicate for the HFO model is training service providers to be experts in building partnerships.

What is most striking to me whenever I give this talk, is the fact that people are struck by how little collaboration actually occurs in services delivery. I hear over and over again at talks like this - "oh that [collaborating with partner agencies] won't work . . . we are all fighting for the same pot of money and we can't really collaborate or we will loose our agency level effectiveness."

Don't get me wrong, I totally understand the "no money, no mission" paradigm. I also know that without collaboration and resource sharing - true, lasting change is not possible. I am not sure how we can get more people invested in the idea that collaboration is one of greatest underutilized tools. I know that it will take some serious ego slaying and a strong commitment to service.

At the end of our talk today I had an opportunity to speak with a service provider. He told me about her efforts to get organizations to build a coalition in his community. He told me about the 6-months it took him to schedule the first meeting of the various homelessness services agencies in his area. He told me that he had not given up hope that the coalition will pay off with great dividends. I complimented him on his efforts and reassured him that his efforts would indeed pay-off. I told him that he may never know how much of an impact his efforts will have - but, I told him, if his efforts led to ending the experience of chronic homelessness for one person . . . his efforts were very worthwhile.