PFM and HIV -- An Update

India, with an estimated 2.4 million people living with HIV (as of January 1, 2012), is home to the world's third-largest population suffering from the condition (after South Africa and Nigeria). In India, when a parent contracts HIV, children are often forced to provide for the family by working or begging. When a parent dies, his or her children may be left with no one to care for them. 

Through Project Food & More, Operation Shanti provides support to  those affected by HIV in a couple of ways. PFM provides a monthly care package to destitute HIV+ children who have lost one or both parents and who are now living with a poor relative (usually a grandmother or aunt) who must feed another mouth. Today, the care package is valued at about $20, of which 56 HIV+ children benefit.

PFM also supports destitute women who have been abandoned by their families for being HIV+ with a monthly care package and assistance for medical expenses. This month, Saraswati (name has been changed to protect her privacy) was admitted to the HIV clinic, emaciated and nearly unconscious. Although medical care for HIV+ patients has improved significantly over the years, she was not given the second-line ART medication when she needed it last year after her CD4 count declined, and she subsequently fell very ill. Mom is now in the ICU ward at the clinic, literally fighting for her life. We are assisting her two children, aged 16 and 18, with the medical bills and some difficult-to-obtain ART medication. 

Saraswati's two teenage children have stopped attending school to care for mom -- one stays with mom at the hospital and the other works to earn some money for food and other basics. They have no other family available to help them. 

Your donation to Operation Shanti's PFM program will help us continue to assist women like Saraswati and children who continue to experience stigma and abandonment by their families. On this auspicious day in India, Maha Shivaratri, we hope and pray for Saraswati's recovery.

For more on PFM, please see http://operationshanti.org/project_food.html.

Great doctors

Finding a good doctor is sometimes a challenge, especially when the preference is for a good and caring doctor for a child or poor woman with a disease that still has significant stigma attached to it.

Our kids and moms are really lucky to have a couple of good doctors near us who care for our kids with no prejudice or bias, regardless of their socio-economic background and/or health condition.

A few years ago, when we worked on the streets, finding a doctor to treat an HIV+ woman was a huge endeavor. Many times, these women were turned away or told to go elsewhere. Several died.

Now, the amazing doctors at Asha Kirana Hospital in Mysore provide excellent care to HIV+ adults and kids. Kids -- ours and others -- love Dr. Mothi and Dr. Swamy at Asha Kirana, and many of these kids have been under their watchful eye for several years now.

An eight-minute walk from Karunya Mane is the Amrita Kripa Hospital, where Dr. Vikas Modi and others have been caring for our kids for three years, treating them for everything from coughs and colds to appendicitis and, recently, a very dangerous case of fungal pneumonia in one of our HIV+ kids.

This past month, one of our kids contracted PCP, sometimes fatal in immunocompromised patients. Dr. Modi and Dr. Swamy coordinated the medical care for the child, who fortunately pulled through after spending a few days in ICU at Amrita Kripa and another week at Asha Kirana. The child is back at Karunya Mane and has completely recovered, thanks to these great doctors.

Only the sincerest of thanks to these doctors for caring as much about our kids as we do.

Vaccinations and poor children

Umesh!

In India, although immunizations are provided for free in government health facilities, vaccination rates remain low because of a lack of proper healthcare providers (especially in rural areas) and unreliability in the supply of vaccines. Moreover, many poor people do not understand the benefits of vaccines.

According to the Center for Disease Dynamics, Economics & Policy, "Approximately 27 million children are born in India each year – the largest birth cohort in the world – but less than 44% receive a full schedule of vaccinations." Moreover, Indian researchers stated, "Although India is a leading producer and exporter of vaccines, the country is home to one-third of the world’s unimmunized children... India’s vaccine deficit has several causes: little investment by the government; a focus on polio eradication at the expense of other immunizations; and low demand as a consequence of a poorly educated population and the presence of anti-vaccine advocates."

Our own staff members sometimes talk about their young relatives in villages who died of a "fever" of unknown origin. Measles? Hepatitis? Don't know.

Although vaccinations can be controversial, they save lives and prevent the spread of potentially life-threatening diseases. The Gates Foundation stated, "Vaccines save millions of lives a year and are among the most cost-effective health interventions ever developed. Immunization has led to the eradication of smallpox, a 74 percent reduction in childhood deaths from measles over the past decade, and the near-eradication of polio. Despite these great strides, there remains an urgent need to reach all children with life-saving vaccines." 

Most of our kids at Karunya Mane, who are all from the streets and slums, were not vaccinated during their early months and years of life. Even if they may have been, their moms (if they have a mom) have no immunization records. Part of effort to provide our kids with the basic needs is to ensure that they are all properly vaccinated. 

We've tried to take our kids to the government children's hospital for free vaccinations but to no avail -- possibly because our kids may be older than tiny-tot age so don't qualify. Vaccines in India are less expensive than in the Western world, but still cost a bit, especially when vaccinating 40+ kids, and we estimate that it costs around $200 to fully vaccinate a child. 

little Jyothi and mom Lakshmi in early 2008

Most of our kids cry a bit when they see the needle, but not too much. Two of our tough little ones, Jyothi and Umesh, don't even react when getting their shots! 

Volunteer doctors and nurses generously donate their time to vaccinate our kids at Karunya Mane, such as Dr. Miguel Valenzuela, who gave his time when he was in Mysore for yoga classes. We're almost complete with catch-up vaccinations for most of our kids, but if you'd like to make a donation to help cover these costs, please do so at http://operation-shanti.org/donate.html.

Thanks!

Sources:

Center for Disease Dynamics, Economics & Policy (see http://www.cddep.org/blog/posts/india’s_vaccination_problem_cddep_director_weighs_nature_and_health_affairs); Ramanan Laxminarayan and Nirmal Kumar Ganguly (see http://content.healthaffairs.org/content/30/6/1096.abstract); Gates Foundation (see http://www.gatesfoundation.org/What-We-Do/Global-Development/Vaccine-Delivery).

Helping Krutika

Operation Shanti's Project Street has worked on the streets of Mysore for years, helping the women and kids who live there, particularly near the government hospital in the city. Since 2005, we've gotten to know well many of the kids who used to live on the streets, most of whom now stay with us at our children's home, Karunya Mane.

Today, Project Street continues to help our kids' moms and other destitute kids and women who need assistance. Krutika, one of our new friends, is a 15-year-old girl from a very poor family in Chamarajnagar (about an hour from Mysore). She was diagnosed with childhood (Type 1) diabetes a few years ago and needs daily insulin shots.

Krutika

Krutika's dad is a day laborer. Insulin injections cost about $12 a month (Rs. 600), not much for most people but a huge chunk of dad's monthly income.

Since November 2012, we've been providing Krutika with her monthly insulin injections to help ease the financial burden on her family.

If you'd like to make a donation to Operation Shanti so that we can help more kids like Krutika with life-saving medicines that they simply can't afford, you can do so here: http://www.operation-shanti.org/donate.html

Thanks so much!

Clean those ears!

A couple of weeks ago, the wonderful people from audiologyindia (www.audiologyindia.com) and AIISH (All India Speech and Hearing) came to KM to give all of the kids ear checkups.

Jyothi: Oh my god, THAT was in my ear? 

The ear doctor checking Lalitha's ears.

The checkups included a hearing test, an exam by an ear-nose-throat physician, and a speech test.

Vinuta being check out by the speech therapist

Thanks so much to Jayaprakash at audiologyindia and our dear friend Manjunath for doing such a nice job organizing everything.

The kids' friend Manjunath, who helps them with many health-related arrangements.

The Numbers

A recent article in a local paper talked about the problems that children in India and other countries face, and the staggering statistics.

Translation:

Increasing Evils towards Children

     In India, thousands (lakhs) of children are deprived of their fundamental rights. Everyday, they are exposed to exploitation, injustice, and evils. Many children are seen in cities working as scrap collectors, beggars, and coolies in hotels and factories, and at bus stands and railway stations.

     Around the world, more than 1 billion (100 crore, 1 crore = 10 million) children work on the streets. Children are used in criminal activities like begging, prostitution, and selling illegal substances, all of which are very harmful to a child’s psyche. Such children have to deal with fear, violence, insomnia, an inferiority complex, and suicidal tendencies.

     Our society is embarrassed because of the poverty-stricken parents who sell their children and because of the teachers who sexually, physically, and verbally abuse students. An alarming percentage of Indian girls below 18 years of age are sexually exploited. Pressure from family members and caregivers forces children to sacrifice their natural instincts and give up their innocent childhood.

     India has more than four million (40 lakhs) child prostitutes. UNICEF reports state that 147.5 million (14.75 crores) children in India are homeless and stay in temples and public spaces. Thirty-three million (3.3 crores) children in India have never seen a school and 50,000 to 60,000 children are infected with HIV. According to the 2001 Karnataka census, the state has more than 350,000 (3.5 lakhs) child workers. The international publication Lancet stated that, in the past 20 years, one million (10 lakhs) female children have been killed because of female infanticide.

     Child marriages, child abuse, injustice, child labor, prostitution, criminal activities, and female infanticide have affected the lives of hundreds of thousands of children in India. We say that we have no actionable laws in place to solve children’s problems. However, child offenders must be tracked down and caught, and measures must be taken to prevent children from being involved in criminal activities. Programs must be put in place that constantly remind us of the problems that these children face, and we must help solve these problems. Governmental and non-governmental organizational involvement and cooperation is essential.

Original article:

Kumari's dilemma and your assistance

Kumari sells flowers near Bombay

Tiffany’s in the city during the

season (May to October); offseason

gets difficult, as she has to

sell vegetables on the street, which

is not as good a business.

We're doing an emergency fundraising drive for one of our long-time street moms, Kumari. Kumari has chronic lung damage (fibrosis) from past bouts of tuberculosis. Because of her lung damage, even at her young age of 33, she does not have adequate oxygen intake (blood oxygen level of around 90 when sitting, even lower when walking). Her pulmonologist highly recommended that we get her an oxygen concentrator machine for her house, so that she can use it as frequently as possible, giving her increased oxygen and basically enabling her to live longer.

Without the machine, she has only a handful of years remaining. With daily supplemental oxygen, because Kumari is otherwise healthy, she could live to see her youngest kid, Mohan (age 6 and who lives with us at our children's home), grow into a handsome young man. 

Kumari is a single mother whom we’ve known since 2005, when we met her on the street, where she lived with her kids. Her oldest daughter Prema (13), youngest daughter Sumitra (11), and youngest son Mohan (6) live with us at our children’s home and attend good schools. Her oldest son Venkatesh (15), lives with Kumari and helps her with household chores.

If you would like to make a donation to help defray the costs of the oxygen concentrator for Kumari, we'd really appreciate it! The machine costs Rs.45,000 (discounted price from Mysore Medical Systems), is an American-made model, and is quite reliable. It would be the first such machine installed in Kyathmanahalli (a slum area in Mysore) where Kumari now rents a house.

If you are an Indian taxpayer in India, you can contact Tracy at 99451-00945 / info@operationshanti.org for more information or to make a donation. We’ll provide you with a receipt for your donation that you can use for tax purposes (80G deduction).

(photo courtesy Janea Wiedmann)

When first diagnosed with her lung

condition, Kumari needed oxygen daily for

about one month. She recovered and was

fine for about a year, but now needs oxygen

again.

We just started soliciting donations today, and so far, Mr. Madhusudan Pattanaik, a friend of our kids who has helped us over the past two years, has managed to secure for us over 15% of the funds we need, in just two hours! Thank you, Mr. Pattanaik.

Cheques/DDs should be written to: Akhanda Seva for International Shanti

For NEFT transfer, use the following:

Name: Akhanda Seva for International Shanti

Bank: Canara Bank, NRI Branch, Nazarbad, Mysore

Account Number: 230910-100-1439

IFSC: CNRB0002309

Brush your teeth Canadian style

Earlier this year, our friends Tomasz and Tamara from Canada and their current group of travelers visited the kids at KM. This time, one of the younger women in the group showed the kids how to properly brush their teeth.

The guests first had lunch with our kids...

...then everyone played for a bit outside...

Adarsh and his new friend from Canada

Sreenivas having a chat...

Tamara and Shanti

then everyone went upstairs to learn about brushing teeth...

...and our kids even got new brushes!

Thanks again, Tomasz and Tamara and friends for a really great visit!

Project Food and More now supports women

Project Food and More, our effort to assist children orphaned by HIV/AIDS, now supports women with HIV who have been abandoned by their families. These women are often thrown out of their houses and/or after their husbands have died (from causes related to HIV), their in-laws with whom they lived refuse to help them and their children.

We currently have three such women in our program, and we endeavor to assist many more who are poor and struggle with the stigma of HIV/AIDS.

Improvement

Deepti, a homeless street woman who came to us a few months ago, needed significant medical attention. A few years ago, Deepti was kidnapped and taken to a brothel in Mumbai, where she was forced to service numerous men each night. She managed to run away late one night, and make her way to the police station. She spent a few years at a shelter in Mysore, but somehow ended up back on the street.

Deepti has AIDS as well as tuberculosis, and a chronic infection in her cervix area. She is undergoing medication for her conditions.

Deepti takes her medicines regularly, and we're so excited because she is finally gaining weight! TB patients usually undergo significant weight loss before treatment, and HIV patients often experience wasting syndrome. Deepti was about 30 kg (66 lb) when she first came to us. After about a month on the TB meds, they begin to gain weight. For Deepti, that process took three months. She's just about finished with her TB treatment, and now weighs a much healthier 38 kg (84 lb).

Let's keep hoping that Deepti continues to improve and begins to enjoy a more peaceful and happy life at Karunya Mane.

Hope and improvement

Over the years, we have lost HIV+ women who had also contracted tuberculosis. HIV and tuberculosis is a difficult combination for many reasons, including the toxicity of the medications needed to treat each illness.

One of our street women, Deepti (her name has been changed to protect her privacy), was recently diagnosed with AIDS, and a few weeks later with tuberculosis. Like the other women who died, she was emaciated and could barely eat -- weighing a mere 30 kg (65 lbs). Like the other women we lost, she had a fever for weeks and frequent vomiting and diarrhea. Like the other women we lost, we admitted her to the local HIV clinic, where she started on antiretroviral therapy (ART).

Soon after starting on ART, she developed lumps in her lymph nodes. Testing revealed that she had tuberculosis, and she was started on anti-tuberculosis treatment (ATT). But, unlike the other women we lost, her ART medication was changed to accommodate her need for ATT.

Fortunately for Deepti, the doctors today know better how to treat patients with both AIDS and TB. A few years ago this was not the case, and doctors hesitated putting patients on ART when they were already taking ATT for their tuberculosis. Today, these patients have a better chance of survival.

Deepti was discharged from the hospital and, unlike the other women we lost, her health has improved dramatically -- she has gained a few pounds, can eat a full meal now, looks 100% healthier and happier, and is ready to get on with her life. She still has a long way to go, and we hope that she has many good years ahead of her. Since she has no home, does not want to live on the street, and her family has shut her out, she'll be living at Karunya Mane.

Oh my god, the... DENTIST!

We certainly lucked out when it comes to teeth care for our kids. A fabulous dentist just a few minutes from Karunya Mane has proven to be quite charitable and kind. Thank goodness, because ALL of our kids require some kind of work on their teeth, either fillings or extractions, or other nasty procedures that we all so love while at the dentist.

Dr. Mahesh also gives us monthly supplies of toothpaste for our kids, as well as toothbrushes. He's at the Mahesh Dental Clinic on Gaddige Main Road in Bogadi, Mysore.

Inspection!

On Saturday, our friend Anu went to Karuya Mane for the kids' first inspection. It's something that we are implementing to help the kids maintain proper hygienic habits, like brushing teeth, keeping nails short and clean, and keeping their personal areas clean.

Anu, as usual, made her visit a fun one for the kids. Earlier that day, the first graders dressed up as two Indian gods, Krishna and Radha, in honor of Krishna's birthday, and a couple of them won prizes for their costumes. So they all congratulated the winners, then Anu asked them if they like winning prizes. All of the kids screamed "yes!!!" She then asked them how they can become winners. They were quiet for a bit...

Lokesh came up with the answer and said, "If we work towards it!" They then talked about cleanliness and germs, and how germs find their way into our bodies and what they do to us, the importance of washing, bathing and keeping all their body parts clean.

Snot!
The kids stood in two lines while Anu looked at their hair, noses, ears, fingers and toes. They laughed and joked at some of the runny noses. She told them that she always had a runny nose as a kid and when the snot slid down, she tasted it (ugh! but come on, who didn't as a kid...???). It was salty -- yuck! They all laughed and many owned up that they had tasted it too!

Anu then told them why their noses run and why it is important to wash the gunk off and keep the nostrils clean -- when germs that cause colds enter our body, our body and the germs fight each other like a war or battle. Some germs die and some of our body soldiers die, and all of the dead ones are expelled with the snot. So it's good to blow and wash our noses -- and not lick it.

Worms!
She touched on the importance of washing hands, and keeping finger and toe nails short and clean by scrubbing with soap. She then discussed how worms enter the stomach. Anu asked who has had worms (very common in India) and several said yes. She then explained to them how they can avoid getting worms (not sticking their fingers in their mouths) and how the worms suck our blood when they lodge themselves in our intestines.

Pearly White Teeth

Anu also spoke about brushing one's teeth properly, and that even the gums and the tongue should be cleaned thoroughly. The kids were told they should brush their teeth in the morning, as well as before going to bed. Incidentally, Nanjunda has a great set of pearly teeth. The kids applauded him and listened quite attentively (except for Manikanta, Sharath and Sumitra...). Some of them have crooked teeth and some have old stains, but overall, their teeth were not so bad, considering many never brushed consistently until they came to Karunya Mane.

Anu closed by telling the kids that they should keep their trunks clean, their clothes folded and that when she visits next, she will take a look at the trunks. Her "inspections" will be once a month, and after a couple more they'll become "surprise inspections"!

After 13 months...

This past week, one of our street dads finally agreed to be tested for HIV. His wife tested positive about a year ago, and although he's seen her health dramatically improve with proper care and guidance, he's refused to be tested, until now.

Dad recently got sick and suffered from vomiting, tiredness, fever, and other symptoms for over a week. Being so miserable finally got him to agree to go for testing and a checkup. When we took him, the doctor said, "finally, you caught him, yes?" "After a year..."

Unfortunately, dad tested positive. Fortunately, we now know, and he can be properly counseled and treated. Interestingly, wife told us that since finding out his status, he has stopped his drinking (let's hope that he's stopped for good).

Why the hesitation to be tested for so long? Fear, stigma, misinformation, as well as the sense that these young men have of being invincible.

Congratulations to Reeta!

Today was a great day for Reeta, as she was given a clean bill of health from the tuberculosis center! We met Reeta in January 2008; she was a young, destitute woman with no family. She came to us on the street, gravely ill---feet swollen, barely able to walk, and unable to keep anything down for days.

Our volunteers at the time, Jan and Maike, helped admit Reeta to the hospital, where she was diagnosed with tuberculosis---not pulmonary, but it had spread to her abdomen and heart.

We later learned that this was Reeta's third try at TB treatment. TB is easily cured but to do so, one must take the medicines consistently for at least six months. Being a destitute, Reeta had no home base and complying with treatment was nearly impossible for her. The government tuberculosis center, which distributes free TB medicine, allowed her into the program on the condition that we take responsibility for her treatment. After Reeta was discharged, we brought her to Karunya Mane, where we could be sure that she took her medicine properly---and stayed off the streets.

About a month after Reeta arrived at KM, we found her three-year-old daughter (who was taken in by hospital employees during Reeta's admission, who were reluctant to give her back and actually told the little one that her mom had died) and brought her to KM. Reeta and Sinchana have been with us since.

Now that she's healthy again, Reeta is thinking about continuing her education. She passed 10th grade a few years ago, but lost all of her documents after her husband left her and she became homeless. She is also learning how to sew during nightly lessons with Mary.

Operation Shanti's battle against TB:
Won: 6
Lost: 1
Lost (AIDS patients): 3

Home visit from Asha Kirana

On Thursday, a counselor from Asha Kirana Hospital, the charitable HIV/AIDS clinic where a few of our people are registered, came to Karunya Mane for a home visit. She wanted to stop in to see how our women are doing, and counsel them on taking their medicines properly, practicing good hygiene, and eating well.

Saroja, Ramesh, Ramana, and Asha Kirana counselor

While at KM, she talked with our staff and gave them a tutorial on HIV/AIDS, what it is, the ways that the virus can be transmitted, and equally importantly, how it is not transmitted, as there are many myths surrounding the disease in this country.

The counselor was quite pleased to hear that everyone at Karunya Mane---kids, women, and staff---enjoys the same high quality meals and clean drinking water.

Saroja, little Siri, and Asha Kirana counselor

Update on Yashwini

Yashwini was admitted to the hospital about a week ago, as her feet were completely swollen and she couldn't eat. The doctors said that her lack of activity led to edema. She normally isn't the best eater, and has been tired lately---a side effect of her ART. After staying in the hospital for about two days, she insisted on going to her house for a day, then, she promised, she'd come back to Karunya Mane. We encouraged her instead to come directly to KM, but she was quite adamant about going home, as supposedly her blind mother was visiting.

We took her to her village but there was no mother, an apparent misunderstanding or miscommunication. She insisted then on staying home until Sunday, three days away, after which time she would return to KM. She lives with her sister and next to her brother and his family, but nobody is willing to take care of her, insisting that we take her with us. But it's hard to take someone when they're not willing to go. Her daughter went with her husband to Bangalore, for how long nobody knows. As Yashwini can barely walk, someone has to be near her at all times.

We returned on Sunday, at which point she cried and insisted on staying home for two weeks, until the 22nd of this month. There wasn't much we could do, even though, again, her family insisted we take her. We reminded her to continue to take her ART (which she is doing) and to eat healthy and practice good hygiene.

Often, the poor are difficult to help when they are sick, not only because they often don't take their medicine properly. The family is often unwilling to help, the patient lives in squalid conditions yet insists on staying there, and he or she may not have the knowledge or capacity to understand how bad his her her health condition really is.

Two more women on antiretrovirals

This month, two more of our women began taking antiretrovirals (ART) as treatment for HIV. One woman, Yashwini (named changed to protect her identity) had her CD4 test done at the government clinic in late March, and the results showed a 303 count. After she had gotten sick, she was referred to the private HIV clinic in the area that had the facilities to admit her and care for her as an inpatient. While there, the doctors suspected that her CD4 count of 303 was incorrect and ordered another test. That test came back at 44 (people with healthy immune systems register CD4 counts between 1000 and 1500), dramatically different from the first test and a bit upsetting.

The doctor recommended that she start on ART, but since Yashwini had been discharged, we could not find her very easily---the street women sometimes wander around the city, or go back to their village for a couple of days.

In mid-May, Yashwini finally reappeared and was quite ill, with a fever and severe dehydration and fatigue. We admitted her to the HIV clinic, where they treated her, and she finally started on ART.

Our second woman recently found out that she is positive, but the government clinic did not do a CD4 count that day and told her to return in two weeks. As she was moving into Karunya Mane, we took her to the private HIV clinic for a checkup and requested a CD4 test, as she seemed quite weak and frail, weighing at most 25 kg (55 pounds). Her test results showed a CD4 count of 26, and she immediately started on ART.

The ART has some side effects, such as dizziness, nausea, and fatigue. Encouraging the women to continue taking their medicine even while experiencing these side effects is very important, as once the drugs "kick in" (after about a month), we have seen tremendous improvement in their health status, which is then their encouragement to take good care of themselves and to properly take their medicine.

Back-to-school health checkups and school bags

Since school started on the 26th for the kids, Saturday the 24th was our back-to-school health checkups for the kids. On that day, members from SWARG also arrived to pass out school bags to all of our kids.

Dr. G (our fabulous doctor on our board in India) brought a couple of pediatricians, including Dr. Umesh, head pediatrician at JSS Medical Hospital, to see our kids for free. Here's Surya getting his weight checked, and Dr. Umesh checking Anand's throat.

Everyone got their height and weight measured, Dr. Umesh was pleasantly surprised to see that most of our kids are very healthy and well nourished.

SWARG (which in Hindi means "the heaven we desire") is a charitable organization started by young, proactive, open-minded individuals from Infosys who want to give back to their society, particularly by harnessing the minds of deprived children, identifying the children who cannot afford education, focusing on innovative methods of preventing poverty, providing health care throughout the year, prohibiting child labor. We also make sure that all the benefits directly reach these children and transparency is maintained (from the SWARG What we do statement).


From SWARG's Who we are statement: The greatest stumbling block of a human mind is to think that 'No one is there to take care of me.' If we can make these children feel that "WE" are there to take care of them, their lives would change. So WE, a continuously expanding group, have set out on a mission to change this world. And if not change it, try to change it. In a country where religion dominates every nook and cranny of life, SWARG's religion is humanity.

SWARG accomplishes their objectives by working with organizations such as Operation Shanti.

On this same Saturday, four members from SWARG passed out school bags to all of our kids.

It's safe to say that everyone had a great time on Saturday and the kids made some great new friends in the members of SWARG. Top two and last photos courtesy of SWARG.

Prema's second ear operation

Prema was discharged today from the hospital, after a four-day stay to have her right ear operated on. She had the same surgery a few months ago on her left ear, as she suffered chronic ear infections since birth. She lost some hearing in her left ear and can later be fitted for a hearing aid, but the doctor thought her right ear would function almost normally, having suffered less damage.

Prema is recovering quite nicely back at Karunya Mane, and she's enjoying the arrival of her friend Amita.