By Jac Connell, Acting Country Director, Tiny Tim & Friends: 
A few weeks ago one of the social work team came to my office with a small child, Rachel (aged 2), who had been identified at the Clinic that day as HIV+ and at risk of TB. Weighing only 7.1kgs (15lbs), our counselor, Mwenda, was concerned about malnutrition and wanted to include Rachel on the list of patients who would benefit from our crowd funding campaign, should we be successful. 

She was incredibly tiny and I could tell from holding her that she had breathing problems and a persistent cough, a symptom we see often at the clinic and a primary indicator of TB. 

As with all of the patients we are considering supporting with nutrition the team usually sit with the family or undertake a home visit to assess what the household is like, how many people the individual lives with and what the income for the household is. 

As soon as we asked Elina, Rachel's mother, about food for the family she broke down in tears. She admitted that there was no food at home, as her husband was bedridden with TB and therefore had lost his job. They were totally reliant on her mother in law to provide food and often would survive on only one meal a day. 

Sadly, their story isn't particularly unique to us. They live in a two room house, sharing a pit latrine with their neighbors (17 people in total). Elina had never been to school as a child because her family couldn't afford it and therefore had never been able to get a job herself. Rachel's father is unable to work so they pay their rentals (approx $30 per month) through support from other family members.

Rachel has an older sister, who is 7 and in good health, but who has had to stop going to school after they could no longer pay the school fees. 

Rachel has been diagnosed with TB, but without food, both her and her father will struggle to take their medicine, recover and risk passing the disease to her mother. Having only recently started on HIV treatment, Rachel is in a vulnerable situation. Being underweight puts her at risk of picking up any number of illnesses which could prove to be fatal. 

We need all of our donors and supporters around the world to come together to support children like Rachel through our crowd funding campaign - by donating you will change a child's life: 

 Sadly, sometimes patients come to TTF and from their appearance you immediately you know there is a major health problem. This was the case for 19 year old Panji when he was brought to the TTF Clinic earlier this year. Panji is 1.73m (5ft 8) and weighs only 42Kgs (92lbs). He is significantly malnourished and currently undergoing tests to see if he is suffering from Tuberculosis. 

His malnutrition, alongside HIV and suspected TB puts his health at significant risk, and without boosting his immune system just a small infection could prove fatal. 

Panji's parents died when he was just a child and he now lives in a one room house with 6 other people (his sister (pictured below), brother in law, and four nieces and nephews),  sharing a pit latrine with 20 other people. Whilst food in the home is provided by Panji's brother in law, there isn't enough to support Panji in his current state and he is in desperate need of nutritional support. He needs your help to ensure he can go on to finish his education and lead a healthy, successful life. 

Panji, was identified in the community by one of our teen mentors. He had previously been tested for HIV but wasn't yet ready to accept his status. Our staff have been working closely with him to provide him with medical advice and emotional counselling to prepare him to start on medication. But because of his late access to treatment he is incredibly sick and because of his poor health, he has been unable to attend school for the past 6 months. He desperately wants to complete his education so he can make something of his life and help others. 

With the right medical, social and nutritional support Panji can go onto lead a healthy life, but we need your donations to support him and 49 other children and adolescents like him to reach our crowdfunding goal. So please consider pledging today and changing Panjis life around for the better!
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Esther is a single mother to three small children, living in one of the most urbanely dense compounds in Lusaka. Having not finished school, her employment prospects are limited. She came to our attention when her youngest child, 3 year old Samson, was brought into the clinic suffering with various health issues, he was incredibly underweight for his age. Without a job or a source of income Esther was struggling to feed her children this is her story: 

Last week we successfully graduated 8 children out of our nutrition programme after just 3 months. All 8 of these children had gained such a great amount of weight and grown in height that they are now well within the healthy weight range on the BMI index.

Through our nutrition programme, not only have we been able to support these vulnerable children to gain weight and become healthy, but we have also provided their families and caregivers with nutritional support and education needed to ensure that can help their children to have a well balanced diet. The weekly food packages have also allowed families to make small savings in their weekly outgoings to support several of them in investing into their small businesses or paying for school fees. 

Thanks to the support of 34 donors who funded our CARINGCROWD CrowdFunding programe at the end of last year. Please stay posted for individual stories on each of these children. 

For more information about our nutrition programme and how you can get involved in us helping even more malnourished, vulnerable children to get healthy and get the education they need check out our programme page: Nutrition programme. 

 We want to share with you the story of just one of the children, whose life has been changed thanks to everyone who donated, through CARINGCROWD, to our Nutrition programme. Gladys is 6 years old and was brought to the Tiny Tim & Friends Clinic last year by her grandmother who was concerned with a persistent cough and considerable weight loss. Upon testing it was discovered she was HIV+. Gladys weighed just 12kgs (26lbs) putting her below the 1st percentile on the BMI index and classifying her as considerably underweight.

Thanks to the donations of 34 people through CARINGCROWD, we were able to enroll Gladys into our Nutrition programme. After only one month on the programme Gladys had gained 4kgs (almost 9lbs) and now is considered as a very healthy weight (at the 78th percentile on the BMI index).

We spoke to her Grandmother, Janet, about the impact the food support and nutritional advice is having for her family: 

"I have cared for Gladys for most of her life, as both of her parents have died. I own the family home but we live there with 15 other family members, selling vegetables to make money for food - usually making about 300 kwacha a week to feed the entire family (less than $30). 

I took Gladys to the TTF clinic as I was worried about her weight and after speaking to a woman in the community thought she may be HIV+. The food we have been getting from TTF helps so much. Before we could only feed Gladys at breakfast and in the evening and now she has 3 meals a day and snacks. The food is also helping with her taking her medication which was previously making her sick when she took it without eating. 

We have always tried to make her go to school but since she has become sicker she was missing more and more. Now she has gained weight and is managing on her medication better so is going back to school. 

The nutritional talks are also helping me in thinking about how to care for Gladys and prepare her meals - I have also been sharing this with my daughters and supporting my other grandchildren with this knowledge. 

I am too thankful to this support and I try and encourage the younger mothers in the programme to think about how they are using the food to help their children gain weight and become more healthy like Gladys."

Gladys is just one of the children we are seeing significant changes in due to the nutritional support and education their families are receiving. Without your donations this would not have been possible. So thank you and please watch out for more updates on the children you are helping.
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Sometimes you try your hardest to make a change in a child's life and are unsuccessful - but when you are successful that is definitely worth celebrating and sharing with the world! 

Many of you may remember Everson, a 13 year old child who was brought to us last year suffering with extreme malnutrition, neglect, and a variety of other health issues. His story stuck with the staff at Tiny Tim & Friends due to the fact that when he arrived at our Clinic many of our staff prepared themselves for the worst. We worked hard with our partners at Our Ladies Hospice, to provide him emergency palliative care,  found him a stable safe home at MacDonalds Farm, and have continued to treat him over the past 18 months to make sure he can lead a healthy, productive life. 
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Last week our social work team went to visit him at the Farm, to see how he was doing, and whilst he was showing them his vegetable garden he has been cultivating he said he would like to go back to Our Ladies Hospice, to thank the staff who helped him to recover over a year ago.

This week we went with Everson back to Our Ladies Hospice for an incredibly emotional and rewarding visit. None of this would have been possible if it wasn't for the hard work and dedication of the staff at Our Ladies Hospice; the nurturing environment and safe home he has at MacDonalds Farm; and  all of the TTF donors and supporters who enabled us  to provide 4 months of intensive palliative care and medical treatment at the TTF Clinic. 

So we want to share with you in this celebration and as a picture can say a thousand words - here are just some from our day: 

Thank you to everyone who made this transformation possible - we are eternally grateful for your support and donations - without working in partnership none of this would have been possible!

​THANK YOU! 

Joyce is a new patient at TTF. She is HIV+, weighs only 12kgs (26lbs), has TB and is suffering from an all over body rash. Her symptoms and illnesses are not uncommon for a malnourished HIV+ child. Joyce currently sits below the 5th percentile on the BMI index and her health is a great concern – her CD4 count is 261 - just above a critical level.

Joyce's family situation is complex, her mother has alcohol abuse issues, and upon visiting her family home we discovered here grandmother, Betty, was seriously ill with TB - weighing only 28kgs (61lbs). Due to malnutrition Joyce is always sick and unable to go to school. Her mother never went to school and so is unable to secure regular employment, meaning food is scarce. They are stuck in a cycle of poverty. 

Joyce needs significant medical and social support in order to help her to get healthy and lead a positive life. Tiny Tim & Friends is currently supporting her in the following ways:

• Providing nutritional support to help her gain weight, improve her general health and boost her immune system
• Providing medical assistance through the TTF Clinic to cure her other ilnesses
• Giving her mother adherence counselling and disclosure support so she can help tell Joyce about her HIV status and help Joyce to understand the importance of taking her medication on time
• Helping her Grandmother (who weighed only 28kgs (61lbs) when we met her) to recover from TB and stop passing this to Joyce through emergency palliative care. 
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​Joyce’s story is sadly not that unusual for the children we see at the Tiny Tim & Friends Clinic. Joyce’s mother, Miriam,  got pregnant when she was still a teenager and unfortunately, as she was not on Anti-Retroviral treatment passed HIV onto her newborn daughter.  Miriam’s siblings have passed away leaving her and her younger brother to care for their children and their own Mother, who as mentioned is also incredibly sick.

"Without improving nutrition, the world will fail to achieve many of the Sustainable Development Goals. There is an urgent moral and practical imperative for the world to make ambitious, measurable, and timebound commitments to equitably improve nutrition. In monitoring these commitments, the Global Nutrition Report will help us hold ourselves accountable. Lives depend on it."
Anthony Lake, Executive Director, UNICEF

Yesterday saw the launch of the Global Nutrition Report 2015, stating that good nutrition provides a foundation for human development and the scaffolding needed for people to fulfill their full potential. Good nutrition is an essential driver to human development. Without good nutrition human beings cannot fulfill their full potential.