Medical Care in the Orphanage

When 2-year-old Kashvi came into orphanage care in India, she quickly presented with several health issues — including a heart condition that required surgery. But with support from Holt donors, she received the heart surgery and medical care she needed to become healthy and strong.

Two-year-old Kashvi was sick when she first came into care at our partner orphanage in India.

She was small for her age due to malnutrition and was behind in development when it came to talking and walking. But she was soon diagnosed with something even more serious, something that would require lifesaving care…

When Children Come to the Orphanage

Kashvi and her sister first came to our partner organization in Pune, Bharatiya Samaj Seva Kendra (BSSK), because their mother has an intellectual disability that made her unable to safely care for them and meet their basic needs. Children come into orphanage care for a myriad of reasons, each reason heartbreaking. While Holt and Holt’s partner organizations always strive to first keep a child in the care of their birth family, this is sometimes not possible — as was the case for Kashvi and her sister.

Many children are sick when they first enter orphanage care. Sometime this has to do with underlying medical conditions or special needs. Sometimes it has to do with the impoverished conditions they lived in before coming into care. Sometimes it’s because they routinely experienced hunger. Often, it’s a combination of all three. 

“We see that upwards of 40% of children are malnourished when children come into care,” says Emily DeLacey, Holt’s director of nutrition and health services, “with an even higher prevalence of malnutrition among the 25% of children who come into care with a medical need or disability.”

“Many children are sick when they first enter orphanage care. Sometime this has to do with underlying medical conditions or special needs. Sometimes it has to do with the impoverished conditions they lived in before coming into care. Sometimes it’s because they routinely experienced hunger. Often, it’s a combination of all three.” 

This was true for Kashvi. But thanks to Holt sponsors and donors, there was a place ready to provide her with the medical care, nutritious food and therapies she needed to become healthy again.

High-Standard Medical Care for Orphaned Children in India

BSSK has cared for children for more than 44 years and has high standards of care for the children at their facility. Donors help make it possible for BSSK to maintain a low caregiver-to-child ratio, ensuring that children’s individual needs are noticed and met. Trained cooks prepare nutritious meals. Orphanage staff track children’s nutrition and growth through Holt’s Child Nutrition Program, providing interventions when needed. Safe indoor and outdoor play areas give children a fun place to play and develop. And each child regularly meets with occupational therapists who assess their needs and help them work toward their physical, emotional and developmental goals. There’s even an intensive neonatal care unit on site for the smallest, most fragile babies.

With this attentive care, Kashvi’s health began to improve.

“She not only gained weight, but also started to thrive socially and emotionally,” says Prajakta, BSSK’s childcare program director. “Her integration into age-appropriate activities and interactions with other children reflect her growing confidence and comfort in her surroundings.”

But she still seemed easily tired and out of breath when she played with the other children. Her caregivers took these concerns to Kashvi’s doctor, who quickly found out what was wrong — Kashvi had a hole in her heart.

It’s not uncommon for children to be born with a small hole in their heart, although it often resolves itself within a couple of years. But Kashvi’s heart defect was large, and would need surgery to repair.

Kashvi’s Heart Condition

Kashvi’s heart condition also likely played a large role in why she was malnourished. Her heart was having to work harder than it should – increasing her metabolism and energy requirements. The reduced blood flow can also slow gut motility and decrease stomach size. Her heart’s inefficient pumping also causes fluid to back up into other organs. Often children with heart issues will need specialized diets (such as low fluid or salt), which can also make it hard to ensure a child receives adequate intake.

Because of her heart condition, Kashvi was more at risk for decreased food intake, frequent illnesses, infections, impaired nutrient absorption and increased energy and protein needs. If her condition was not treated early, she would be permanently impacted from malnutrition and poor growth…

But thankfully, with support from generous Holt sponsors and donors, the resources were available to help Kashvi right away.

“Our team, supported by Holt’s generosity, immediately sprang into action,” Prajakta says, “ensuring she received the necessary medical attention and support.”

Medical Resources, Nurturing Care

In order to have a successful surgery, Kashvi needed specialized medical care in the days leading up to the procedure. She had a cardiac catheter that helped determine exactly what was going on in her heart, as well as daily four-hour-long oxygen treatments. But her dedicated orphanage caregivers were there with her every step of the way.

Kashvi received open heart surgery to repair the hole in her heart, and it was successful! Her caregivers say she was strong and in good spirits throughout the whole process. Although her journey was not yet over.

“None of this would have been possible without the steadfast support of Holt [donors]. Their generosity has enabled us to provide Kashvi with the love, care and support she deserves.”

Next came 15 days of intensive post-operative care in the hospital, as Kashvi’s doctors strived to ensure she recovered well. Her caregivers remained at her side while she recovered, and then helped her adjust back to life in the orphanage as soon as she was able to return.

Today, Kashvi is 4 years old and doing so well. Her caregivers and doctors keep close watch on her health, and ensure that she receives the care she needs to continue to recover and grow. She and her sister are both matched with adoptive families, and will unite with them as soon as the adoption process is complete.

“None of this would have been possible without the steadfast support of Holt [donors],” Prajakta says. “Their generosity has enabled us to provide Kashvi with the love, care and support she deserves.”