It has now been six months since our first family entered the Saúde Criança Recontar programme.   

Given that the programme works with families in the most difficult of situations, over two years, I have steeled myself to seeing no clear results for quite a while.  Indeed, I have buried myself in the pursuit of a set of objective targets as sign-posts that we are on the right path – x number of families that we are supporting, x number attending regularly, x number falling out of the programme, x number of active Board members indicating rising organizational sustainability.

So when I stumbled across the first tentative impact in the life of our first family, I was caught unawares, assailed by a hefty onslaught of elation and overwhelming humility. 

Last week, I joined in one of the handicraft workshops that Recontar offers to the mothers.  Leticia and I sat opposite each-other, both bordering t-shirts with patchwork outlines of the little girl on the Recontar logo.  Over the years, I have come to accept that I have the heart of an artist and the talent of a four-year old.  So I sat there, trying to thread my needle, as Leiticia deftly threaded hers and set to work.

Leiticia* is the mother of the first child that entered the programme, whom I wrote about in my blog in March.  She, her husband and her 3 year old son have HIV.   Her 2 year old son tested negative recently, and her 10 year old son from a previous relationship also lives with them.  Her 14 year old son is involved with drug-trafficking and lives on the streets.   When they entered the programme, Leticia looked emaciated, while her two beautiful sons were pudgy and willful.  Leitica was treating herself for her illness, but often missed appointments and therefore her medication because of a lack of money to get to the adult hospital.  She was suffering from bronquitis, and her husband was in hospital with pneumonia and had therefore lost his job.  They lived in a damp one-bedroomed rat-infested basement, with her ten-year old son sleeping on an old couch.     The impression I had of her was of hardness and distrust and she asked forcefully for charity.  She wanted a new house, a mattress, more food.  At the end of the monthly meeting, she would rush outside, light up a cigarette and let out a sigh.

Leiticia held up her t-shirt for the handicraft instructor to have a look and beamed as her good work was praised.  Though just 37, her smile showed her one and only top-level tooth, rotten black, at the front of her mouth.  I smiled with her, as I tried to keep up with her embroidering and she began to talk. 

´You know´, she began, ´I have no reason to be unhappy now´.  Her words stopped me in my tracks and I put down my needle to listen.  She rethreaded a needle and continued.   ´We moved house last week´ she said, ´we are on the same road, but it is a good house, with a little yard for the boys to play outside and it is right next to the shop.  I have a neighbor and we´ve already started helping each-other with the kids.   I made my husband move from the basement, which belonged to his sister, because my bronquitis was not going away because of that damp.   I paid for the mover´s van with the money I made from the handicraft I make here.´   

´The rent is R$250 a month,´ she continued ´but my husband just got a new job, delivering bricks for construction.  He is making R$700 a month and he is on the books, so if he gets sick again, he won´t lose his job.´ 

´That´s great ,´ I smiled, looking firmly into her eyes.    

´Yes, and with the money I am getting from making handicraft, I can pay for the things my sons need.  What I need now is to get Paulo into a creche, so that he can mix with other kids and I can do more work.´     

I felt an overwhelming desire to whoop for joy but I pulled my attention back to my embroidering and tried to catch up.

Over a hot, black coffee, Leiticia told me she had been to the doctor with her son Paulo and that his tests had come back better than before.  She said that she was now taking her medication without fail, though her husband wouldn´t treat himself.   ´I was talking to Giseli last month´ she said   (Giseli is another mother who is also HIV and has two daughters with HIV), ´Giseli was saying that sometimes she feels like giving up and killing herself .. but I told her, that we have to look after ourselves or who will mind our children.´         

We sat back to our embroidery and a new mother joined us.  She is schizophrenic and is a single mother of three children, each of whom has health issues.  Her eldest son, who is 13 is slowly going blind. She talked nervously, impulsively.   She turned to Leiticia and asked what illness her son has.  With a slight hesitation, but a defiant voice, Leiticia told her that Paulo is HIV positive.   This silenced the woman´s nervous chatter.   ´I am not ashamed of saying it´ said Leiticia with a spark of vulnerability , ´look at my son, he is a healthy boy and I am doing a good job taking care of him.´   ´You´re right not to be ashamed´ I said to Leiticia, admiring her courage, ´in a way we all have HIV, none of us knows when we are going to die´.     

We continued to embroider the t-shirts and within me, my admiration for Leiticia grew.  The transformation of her life circumstances in these six months was startling.  And at the heart of this incredible change was a growing self-esteem.   She had embraced the handicraft programme wholeheartedly and quickly turned her hand to anything that the instructor introduced to her.  She had received a sewing machine as part of the programme and was starting to make handicraft at home.  Her dream was to have a little shop and she was eager to start selling handicrafts in the programme´s weekly market stall.  She was no longer asking for charity, but was running after opportunities.   She even spoke to our volunteer dentist about the chance of getting teeth implants. 

I cradled this information as I focused on the embroidery and amidst the sense of elation, a question came to mind ´to what extent was this transformation due to the programme?´   The programme had given food, and nappies, and nutritional advice and dental advice, had provided a mattress and a quilt for the family.  The programme had provided an opportunity to produce and sell handicraft products and had helped her regulate her working papers and had ensured that the children were vaccinated, attending school and that her son was attending doctor appointments.  We had encouraged her to treat herself too, providing busfare to the hospital and we had provided group and individual counseling support over these six months.  

But the transformation had come from her. 

´Do you think the programme helped your life to get better?´ I asked her.  This time, it was she who put down her needle.  ´This project is really important to me,´ she said.  ´The people treat me differently here.  I feel more comfortable here than I feel with my own in-laws or my own mother. I don´t like doing the art (art therapy) much, but I love the handicraft.  I know all of you can help me, but I know that I have to help myself too.´

I was overwhelmed with a sense of humility.  I had a huge desire to fall to the ground and kiss her feet.  I felt that she had given me the most beautiful present in the whole world.   To be part of this story, to be part of this change in her life and the life of her children is one of the greatest pearls I have ever been given in life.  And this pearl belongs to all of us involved in Recontar and ARCH.  

As I drove to pick up the boys from school that lunch-time, I felt a sense of peace and grace.

My incessant mind was of course sending out its usual doubting thoughts such as .. is this transformation going to last? Will other families have similar stories?  Are we creating a sense of dependency on the programme?   Would her life have improved anyway?   And those doubts have their place and longer-term, structured evaluation can provide at least a clearer answer to them ….

.. but for now I watched my doubts, as a wise old woman watches a child at play and I let the sense of admiration, grace and gratitude take centre-stage.

*all names changed in external communications to protect the family and children.