Two things are indelibly etched in my mind as symbolic of the city of Lima. The sepia tone lights of the pueblos jovenes and the polished concrete sidewalks. The soft yellow glow of the sepia lights is quickly being replaced by energy efficient LED. The polished side walks that were the winter equivalent to an urban ice-rink, are also getting a makeover. Although rather insignificant in the bigger global changes occurring all around us, they are changes I find myself mourning.

As an organization we know change. We witness the changes that happen in the children we work with as they grow and mature toward emancipation. We see the bureaucratic shifts that occur within our parter organizations as they move toward new elected leadership. We embrace the dynamic learning we witness as healthcare professionals encounter new knowledge and gain new skills. We watch the ebb and flow of time as it etches a new reality in all our lives.

There is a lot of change happening. All this change brings a sense of uncertainty. Change is not, however, a shift toward doom or gloom. It is not a resignation of hope. It is simply change – like the sun and the moon, the leaves on the trees or the hair on our head.

Knowing that change is inevitably, we embrace change. We invite the opportunities – and the challenges – that come with newness. We look forward to chance to grow with the changes around us.

We are not naive to the fact that change is hard. We know that change will force us to move out of what is comfortable and known, and into a space of new experiences. More than anything, we know that are big part of the way we embrace change is through our grounding in the collaborations, the communities, that we are a part of.

Now, perhaps more than ever, we need bridges. We need collaboration. We need community. As change unfolds, we know that bridges of safety and support will allow us to remain focused on our mission as we transition through the phases and stages of what will unfold.

As a dear friend told me just the other day, “change is the only thing we can be certain will not change.”

Beneficence is the act of doing good through charitable kindness or gifts. It is a central component of medical practice and critical to caring for others. However, the practice of beneficence is not enough. We owe ourselves a broader way of connecting with others.

Miguel (not his real name) is an incredibly talented cyclist. He is always the ride leader for the Girasoles Sanos Team. Miguel is brilliant, kind, and blessed with a balance of keen intellect and profound emotional intelligence. He is an amazing young man with unlimited potential. He dreams of one day becoming an engineer and working in the agricultural businesses.

Miguel comes from a biological family of origin marked by violence, neglect, and substance abuse. He came to live at the Casa Girasoles after spending time in a state-run orphanage and living on the streets. Miguel has had contact with his family in the child welfare system. The pain of knowing his family could not take care of him – and having frequent contact with them has been very hard on him.

At 18, Miguel is ready to leave the Casa Girasoles Program. His family has been contacting him more and more. They want him to come and live at their home in Lima. They want him to work and support their aging mother. This is a typical scenario. At the time of emancipation from child-welfare services, families like Miguel’s seek to reunite with their sons – often not to heal wounds or build new relationships. Still, it is more important to have a young, healthy member of the family who can work and gain income. Time and time again, the family promises to help the adolescents finish their schooling or pursue a career. Time and time again, the young men who exit orphanages, state-run homes, or care facilities find themselves living as indentured servants . . . caught in a dysfunctional web as their futures become hostage to the same trauma that trapped them in their childhood.

Perú is going through a tremendous time of challenge. The social and political unrest quickly pushes the country into an economic spiral. The events that led to the current situation are not unprecedented. The struggles of Perú are deep-seated and multifactorial. One thing is, however, ever-present – people living in the experience of extreme poverty are disproportionately impacted in times of economic, political, and social upheaval. Families like Miguel’s, who were previously teetering on the edge – are now falling into the abyss.

Miguel has gained so much from his time at Casa Girasoles. Yet he faces many challenges and limited opportunities in a world of tremendous inequalities. The future of this bright, capable young man is now uncertain.

Our commitment to helping him build the resilience and connection that will support his future has led him to a place where he is ready to push the boundaries of what is possible. But is this enough? What will happen to Miguel if his family falls further and further into extreme poverty? Will kindness and beneficence help Miguel overcome his new challenges and find the life he deserves?

We must be pushing beyond simple acts of charity and kindness. There needs to be more than just providing food, shelter, education, and access to healthcare. We must push for structural changes, allowing the young adults transitioning from care homes to build on support and compassion and manifest their desired futures. Only when we can say there are pathways to success for all the children in the Casa Girasoles and child welfare in Perú – is our work finished.

Now, more than ever, your support is helping us build futures. Thank you.

Can we really change the world? I think about this question a lot.

I don’t wake up with an unbridled sense of pure optimism every morning—although I wish I did—instead, most mornings, I wake up feeling a bit stressed and overwhelmed. The one thing I don’t do is allow these feelings to paralyze me.  Instead of letting this overwhelm consume me, I start each day with a simple reminder to myself—a reminder of what is most important to me. I remember what an incredible privilege it is to be in the work of empowering people to the futures they deserve. I am reminded that the greatest gift I can offer is myself.  This reminder galvanizes me to take action. It keeps me going.

The key to all of this optimistic wishing is the reminder that we – the collective, the power of our combined efforts, are what will change the world. In my own efforts, I can change myself, but the impact will rarely cascade beyond my immediate efforts. But I know I am not alone. I know that when we work together and see the others in our lives as just people trying to do the best they can on this wild ride we call life, that is when anything and everything is possible.

It requires that we come together, share—of ourselves, our resources, our time, and our energies—and connect with one another. It is only in relationship with others that we can truly heal. So I guess that is it . . . This all starts with knowing we can change the world . . . with each other. So, let’s keep coming together. Let’s keep building bridges. Let’s not forget that a world where every child can access a life built on health, hope, home, and purpose is not only possible, it is entirely attainable . . . when we work together.

Can we really change the world? You bet we can. We already are.

We have long known that collaboration and building bridges are our most effective organizational methodologies. Creating and sustaining critical partnerships allows us to expand our impact significantly. In fact, collaboration is the foundation of everything we do. Whether we are building communities of practice to advance knowledge, as with our newborn resuscitation training program, or structuring key alliances to reimagine the child welfare system in Perú, we know that when we build on the sum of all parts, we are more effective. Our goal is simple: to create a compelling and dynamic continuum of services and support for children and families living in the experience of economic poverty and low-resource settings.

This week, we are excited to host a team from the University of Maryland School of Social Work and Artemis Consulting. This event is significant as we have received a small grant from the university to adapt an ecological screening tool for at-risk children and families. The Neurodevelopmental Ecological Screening Tool, or NEST, is the product of years of research and work by Dr. Carmela DeCandia and Dr. Katie Volk. Along with their colleague Dr. Jay Unick at the University of Maryland, Drs. DeCandia and Volk envisioned a resource that could be used to screen children and families in high-risk settings like homeless shelters to better access neurodevelopmentally appropriate care and resources.

Our focus is adapting the NEST tool for Perú, a huge task that we are just starting to imagine. Over the next week, we are meeting with key partners—the Universidad Catolica Santa Maria and the Peruvian College of Nurses—to chart a pathway for collaborating on the modification, translation, and cultural adaptation of NEST for use in Perú. This is a super exciting project that complements our work in child welfare settings by providing a mechanism to screen families before children are separated from their biological parents.

In this pilot research project, we are partnering with Peruvian nurses to consider how to implement the NEST screening instrument in the well-child examinations within the Ministry of Health (MINSA) health posts. Our goal is to embed an instrument that can be used to identify early children – aged 3 to 5 – who are at risk of developmental and social challenges. The scientific evidence is clear: early recognition and expedited intervention lead to much better life course outcomes for children and families living in the experience of poverty in low-resource settings.

We are committed to creating a world where every child can access a life built around health, hope, home, and purpose. Collaboration with key partners allows us to tap into the brightest and best’s skills, talents, and resources. We may not change the world for child welfare serving agencies and providers alone, but we certainly can through solid collaborations with key partners.