What do I do?

I realized that I haven't really explained what I do, or what this job is that motivated us to move to Nicaragua. The short explanation is that I am the country director for an orphanage reform project.

The longer answer (get ready for me to dork out on this) is that we are a small NGO that has been working in Nicaragua for about 5 years funded by private donations. This year we were awarded funding from the Inter American Development Bank to continue our work, under the orphanage reform effort headed by the Ministry of the Family here in Nicaragua with whom we have a memorandum of understanding to implement our methodology in all of the Protection Centers (orphanages that are dedicated to abandon, abused or neglected children).

Our methodology is an evidenced based approach to improving the quality of life for these children by improving the quality of care given to them. We emphasize small groups of children with 1-3 primary care givers who consistently work with the children. The continuity of care (not moving children around, not moving caregivers around) is key to for children, especially in the 0-6 year range, to develop appropriately socially, emotionally, cognitively and physically (there is a really interesting study in Russia that proves this last point). Also essential is providing for freedom of movement -- not leaving children in cribs all day because it is easier for their caregivers. We advocate for mixed age groups, and maintaining of sibling groups.

A lot of our work focuses on how to make the time that caregivers can spend on one child really count -- making a diaper change an opportunity to connect with the child, communicate with them, encourage language development, develop a relationship.

We are currently working with 5 orphanages all in Managua, but hope to expand outside of the city within the next year and hope to eventually work with all 83 orphanages nation wide.

We begin by assessing the orphanage -- it's structure physically and logistically, the staff, and the children (using several different development assessment tools). Then we sit down with the directors and the technical staff of the orphanages to make a work plan -- in theory this should be easy because we have already presented to them our methodology and the Ministry has given us the go ahead to work with them, but in reality this is very complicated as I guess change always can be. Once the work plan is done then we get to work!

We provide training first to the directors and technical staff on the basics of our methodology, then we provide training to the caregivers (and anyone else who has direct contact with the children). The Caregiver training actually began this past week! The Caregiver training is given over 9 months -- we provide one lesson a month (the same lesson given three consecutive days so that all of the shifts can be covered) followed by direct mentoring of the caregivers during their work shifts by our staff. We have a course on Early Childhood Development that we also intend to provide to our local staff and the directors and technical staff as well Ministry staff and any other interested parties. The exciting news about this is that I'm working to get it accepted as a Post Graduate Certificate at a local very respected University.

We make structural improvements such as putting in child gates so that children can move freely in safe areas, creating different kinds of areas (soft play areas, elevated areas, quiet areas) as opposed to one giant room, and play areas (like a sandbox!). We also provide toys and books that encourage learning and age appropriate development and have worked with staff to make appropriate home made toys as well (ej: take a clear disposable water bottle, even better if it has a texture on it. Fill it half with oil - best is baby oil but cooking oil works fine - and half with colored water. Add some plastic or shiny confetti. Glue gun the lid on. = hours of fun).

The possibility for impact on the lives of the children in these Protection Centers is extreme. When we first began working in one of the orphanages, caregivers identified children only by the hospital style name bands they had on their wrists and children were in wards of 15 or more. There still is a lot of improvement to be done in the orphanage we originally began working with, as well as the other 4, but I am so excited about the possibilities of what we can do. If succeed in successfully working with the Ministry to implement our methodology Nicaragua would actually be a model orphanage system.

All this is not to say that I or even our NGO is in favor of orphanages, far from it, but the reality is that there are no large scale efforts being made to reform the orphanage system. Many large international organizations work with orphans but not orphanages with the idea that orphanages are not good places for children to grow up. It's true they are not -- but it doesn't mean that they can't be made better for the children that have no choice but to grow up there.

Further reading if you are interested:
www.wholechild.org
http://www.ocd.pitt.edu/Files/PDF/managuaorphanage.pdf
http://www.ocd.pitt.edu/Files/Publications/The%20Effects%20of%20Early%20Social-Emotional.pdf
http://www.aipl.org/