Emergency Care: Meeting Chenda's Needs In the Unknown

Emergency Care: Meeting Chenda's Needs In the Unknown

Courtney Smith is an Occupational Therapist and a technical advisor to the ABLE Project at Children in Families. She shared with us her experience interacting with the Emergency Care project and why it is a crucial first step in helping children develop healthy attachments.

I recently worked with a child called Chenda in our Emergency Care project. Doing so, I learned so much from one of our foster mothers. She seemed to put into natural practice so many things that I had previously read as theory.

As Occupational Therapists, we are often most concerned with holistic wellness. That is, identifying how all the pieces of a person’s life play together to their advantage, or else limit their full potential. We are trained to “think” like an occupational therapist, more than we are trained in “doing” therapy. This skill-set has proven valuable while assessing the many complicated health needs of the children in CIF’s ABLE project.

Bridging Loss to New Beginnings

The Emergency Care project within Children in Families is often the bridge between a season of loss and a new beginning with a new family. Infants and children under 5 spend a range of 2 days to 3 months in the home of an Emergency Care family. Children in Emergency Care have been removed from families or situations. This is due to abandonment, abuse or neglect. Entering emergency care is often a quick and unsettling process. It requires a certain sensitivity to the diverse needs of the child as they enter a season of immeasurable unknowns.

Despite the season of transition, children’s needs remain the same as any other human’s. Psychology students all learn, early on, about Maslow’s Hierarchy of Needs. Maslow’s pyramid model explains how we need to have our basic needs met before we can feel safe to grow and know who we are. Our emergency care program aims to re-establish this critical foundation.

Emergency care requires committed and compassionate caregivers who carefully and thoughtfully respond to the needs of each child that enter their home. Their aim is to soothe the wounds of the past while preparing the child for what’s to come.

Ming Rachana

Khmer woman
Khmer woman in the local market. Photo Amy Higg.

Ming Rachana is a shining example of what it means to be a fully committed emergency care parent. She deeply invests in each child who enters her home whether it be for a few days, or several months. Recently, she was the emergency foster mother of Chenda who entered her home, after her own mother became too sick to care for her. I watched as Chenda became the darling of Ming Rachana’s home. Chenda often asked for reassurances calling out, “Mom, mom where are you going?” Each time Ming Rachana responded in a calm, quiet voice that she was just around the corner and would be right back.

While in emergency care Chenda received in-home therapy from Children in Families’ ABLE project. During several therapy sessions I assisted Chenda to learn to walk properly with her braces. Ming Rachana was there every step of the way. She reassured her, reminding that each practiced step was one more step toward her goal of attending school with her friends. While Chenda was in emergency care, I accompanied her to several overdue doctor’s appointments. Ming Rachana prepared her for each one. She explained the importance of prioritizing her health in words that were just right for nervous little ears, afraid of white coats and strange buildings. Ming Rachana responded with care right up until Chenda’s lasts days in her home. As she prepared to transition into life with her new family.

A few days before moving day, I was unsure of how to talk to Chenda about what was coming next, but Ming Rachana had already started to prepare Chenda for the future. She held her even tighter as Chenda cried remembering her many losses combined with her anxieties as to what was next. She helped Chenda picture life in a new house, new community, and new school. Chenda started to smile while talking about a foster home with cousins and friends to play with. She frequently discussed her excitement for starting school and learning to read and write with other students. Chenda was full of questions as the day grew closer and Ming Rachana lovingly answered each one, reassuring her that her new family would be a place of warmth and care.

The New Suitcase

While going through transition, CIF makes sure children are properly equipped with hygiene items and clothing.

When moving day arrived I practiced what I would say to Chenda during the car ride. I wanted her to feel as safe and protected as possible as she faced yet another transition. Ming Rachana, in all of her experience, was already 10 steps ahead. She packed a brand new suitcase, pink and red, Chenda’s favorite colors. Ming filled it with clean, well-fitting clothes, new bottles of hygiene products, relevant medications, and her favorite stuffed animal. Then, she packed a small bag with things that might make her feel safe as she made the 2-hour car ride: her favorite strawberry milk, a few bags of snacks, and some pocket money she could spend however she liked.

For two months in Ming Rachana’s care, Chenda had her physical needs addressed. But, it was Ming Rachana’s love and support that truly prepared her for her moving day. Chenda had experienced the benefits of consistent care in a home and community not so different from the one she would be going to. She had experienced an environment that had promoted attachment.

Trust and Attachment

It’s almost impossible to overstate the importance of attachment in a child’s life. As an occupational therapist working in foster care, it is one piece of the puzzle that I am always evaluating. Dr. Diane Benoit is a psychologist and attachment researcher. She is the author of the foundational book, Pediatrics and Child Health, and defines attachment this way:

“[Attachment is] one specific and circumscribed aspect of the relationship between a child and caregiver that is involved with making the child safe, secure and protected. Attachment is where the child uses the primary caregiver as a secure base from which to explore and, when necessary, as a haven of safety and a source of comfort.”

Ming Rachana had consistently reinforced trust between her and Chenda – quickly responding to calls for help and tears of sadness; frequently offering hugs and back rubs as she remembered the past and anticipated the future; relentlessly reminding Chenda that she was smart and capable; encouraging her to try new things on her own. Ming Rachana was teaching Chenda that some adults can be reliable and safe to seek help from. This relationship almost certainly eased the transition into her new family. Ming Rachana’s efforts to prove herself dependable to Chenda were paving the road for relationships with her permanent family.

From One Home to the Next

The day she left, Chenda got in the taxi with her social worker and myself. While waving goodbye to Ming Rachana, she still brimmed with questions about her new home and school. She shared her questions with the social worker. As the car grew closer, she asked for her favorite teddy bear. The social worker, unsure of what had been packed, looked apprehensively through her luggage and quickly found a small teddy bear, tucked away with her perfectly folded clothes. Ming Rachana had considered Chenda’s needs on the deepest level, down to the simplest but most crucial of items: her favourite stuffed animal.

Emergency Care is often a season of ambiguity for many children. Ming Rachana acknowledges the many losses that these children have faced by prioritizing their physical, mental, and emotional needs. Her home is a place where adults can be depended on. Often, home is a training ground for the children in her care to learn to trust once more. Ming Rachana shows in word and deed that each child is uniquely made, and deserving of dignity, acceptance, and a real place in a family. Even for a short time, Ming Rachana, exemplifies what it means to be a mother to a child in transition. She is a loving bridge between the loss of one family and the gain of another.

Emergency Care: Meeting Chenda's Needs In the Unknown