First week of work!!

29th: FIRST DAY OF WORK! 

Was told to meet Silas, the co-ordinator of the EARC (Education, Assessment and Resource Centre) where I'll be based at 10am. Got a call in the morning saying the roads were flooded cos of last night's storm so we met in town instead. After calling him at 10 on the dot to let him know I'd arrived, he said he'd be there shortly - 45 minutes later a Stephen K Amos look-a-like turns up and introduces himself as Silas with a hearty friendly hug :) I was warned that everything runs "pole pole" (slowly slowly) here and people are always late but didnt it extended to anyone and everyone! Just will have to get used to it and as recommended only book appointments with clients for the a.m or p.m with no set time.

We walked the 20 mins through slippery muddy roads to Joylands School, the biggest special needs school in Western Kenya, where the EARC is based (within it's grounds even though it's a seperate entity). Silas thoroughly and very passionately explained the work the EARC do, their weekly timetable and current projects. Each EARC (there are 3 in Western Kenya, all of which have a Yellow House volunteer!) is supposed to have a specialist in:

1. Visual Impairment

2. Hearing Impairment

3. Physical Impairment

4. Intellectual Impairment / Mental Health

And now a worker (don't exactly think I can call myself a specialist!) in speech and language :)

They provide resources, assessment, training and therapy programs to the local area and in the case of Kisumu EARC, further afield when funds allow as we are the most centrally located. Funding is a huge problem here on it's own but also as corruption is so rife throughout all aspects of the government/people in government paid positions e.g. police that funds/grants obtained from overseas charities need to go through improper channels to be used in it's entirety as it was meant to, otherwise the EARC will kindly turn down money they need as any amount would and could be taken from the charity given money if done through official government channels. This is what is currently happening with a brand new sound-proof audiology room that is being built on-site - Silas had to explain to the dutch charity funding the project that he would rather turn down the money than let it go through government channels - and thus on my first day having a tour of Joylands some of the staff members friends who work in construction rocked up with the foundations for the new room :) Couldn't have a proper look at the resources/assessment room as it was flooded!

Although there has not been a SLT here for 4 years and I'll be working alongside Silas and the EARC in attempting to re-start a service (which may take a fair amount of time in itself) the tentative timetable I'll be working with is:

Mon/Fri: Joylands School work and admin

Tues: Home Visits

Weds: Open assessment day/clinic

Thurs: Local School (and hospital if we can get permission) visits for training/obs/assessment

But as the schoolgrounds do not re-open until the 5th this week I'll be joining the Vihiga EARC (about 30 minutes north) twice this week for a Cerebral Palsy clinic run by an OT and a hospital visit. The Vihiga EARC has 2 SLT's - David from Uganda who is being funded by Yellow House to live and work in Kenya for a year and Rachael from England who will be acting in part as my supervisor as she had been working as an SLT for 3.5 years.

In the evening I was introduced by my landlady Veronica to a Masaii from Tanzania who acts as a kinda local neighbourhood watchman at night and we exchanged numbers so that if I'm not back by dark to call him if I need protection to walk with/someone to be there when the tuk-tuk drops me off if out at night. Veronica introduced me as her son and then started chatting to me in full blown Swahili for a few seconds before apologising! It's lovely how welcoming and part of her family she has made me feel considering I've been here less than a week. I don't think I merit being part of the family yet (!) but have started studying a bit of kiswahili and on the whole eat with my hands, especially after being told by a local on my first day in Kisumu: "take your food seriously man, eat with your hands, eat, eat, eat" !! No-one tells me I don't take my food seriously!..

30th: Cerebral Palsy Clinic
The 2 SLT's in Vihiga have been working very closely with an Occupational Therapist at a weekly CP clinic mostly in part to assess those with eating and drinking or communication difficulties but also to introduce the idea of what a speech and language therapist does to encourage parents to come to the clinic not solely for the purposes of the OT. There were approximately 7 children who attended from ages of around 1 (many parents do not know the accurate date of birth/age of their child) up to 10 with a huge array of difficulties/severity. As mentioned, the majority come for the OT but Rachael and David make it a priority to try and take a case history and arrange a feeding assessment if there are concerns before attempting to work on any communication strategies. On the whole the cases seen today, and those I would see on Thursday, are far more severe than those seen in the U.K, probably in some part due to lack of money for medication/transport to medical facilities or a lack of knowledge that services exist to help. I thought I'd give a couple of examples of the different kids I saw today. Victor who is around 7 years of age has severe palsy of all limbs but is very cognitively and physically able to be independent in moving around on the floor, picking up/giving/recieving objects and speaking (it's difficult to tell whether he is within normal limits for his age as am not sure about Kenyan "norms"! But also he spoke mostly in swahili). The hope is for him to be put in a mainstream primary school with support and Rachael will go to the local school this week to discuss options. Newton, 8, was a fully functioning school going child until he got meningitis and currently has little function of his lower limbs and has lost all abilities of speech although he has some understanding of basic comms (e.g: follows pointing), strong eye contact, has the ability to produce sound (he almost constantly made a single sound throughout) and can show expression through facial movement. 

1st:: Mbele Hospital

Working closely with the OT again, Rachael and David have been joining his clinic to, where needed, assess and pass on strategies of feeding and communication to parents. The day had 2 main aims - firstly to take part in the clinic, where we saw a number of children with feeding / speech needs and secondly to discuss and introduce ourselves to hospital administrators/staff as Rachael and David are planning to run training sessions for the staff in the basics of speech and language therapy - primarily indicators/symptoms/causes so they can identify and refer on those that need to be seen. Compared to the CP clinic today had a wider variety of patients, from those with the most severe CP I am likely to ever see (a girl of 10 who had only been seen by anyone for the first time today, she was also incredibly malnourished so we referred her to the nutritionist (to speak to mum) and for a feeding assessment next week), to down's syndrome (a beautiful 2.5 year old with the most gorgeous smile by the name of brake) to malaria/meningitis/brain asphyxiation at birth.

In the afternoon we was introduced to the children's ward where we briefly met the lady in charge and strolled around the unit (32 beds) which was fairly spacious and child-friendly (paintings on walls etc.) although the ward sister said it was particularly quiet that day and at times they sometimes are overrun and have 2 children in a single bed. The ward is roughly split into 3 sections- burns, fractures/breaks and other.

As mentioned earlier, meeting of the adminstrators for training plans was an aim for the day and the meeting overall went very well with the woman in charge being very encouraging and helpful. The only part of awkwardness, as per usual in Kenya, was over money. In Kenya it is the norm for the people delivering training to pay those who will be trained! (Madness if you ask me) and when told that we would have to be 6500 Ksh per person per day (about £40 - which is an incredibly amount compared to living costs here) we had to explain we were volunteers, have no money, offering the knowledge we have learnt from our countries to offer people here to allow for better opportunities for patients quality of life. After some chat, it was decided that we would hold the training within the hospital (thus cutting costs of booking somewhere/travel), we would introduce ourselves at a big weekly meeting the entire staff has before embarking on training and we would provide refreshments and keep the training to 2 hours maximum (again to appease people, cut costs) but continue training on a weekly basis for a set group of staff before moving on to another group. I will almost certainly be facing the same problems when going into local hospitals and schools to offer training :( !

O.k, think that's more than enough rambling and me up-to-date! Next week is my first proper week at the EARC and am looking forward to getting a better knowledge of the running of it - if I need to buy things (paper, pens, photocopy/print stuff) is there any money for it? Are there any resources?! etc...

Strangest things seen so far:

1. A Zebra at the side of the road coming from the airport

2. A shop sign in the countryside hills: "rap advisors"

Unwanted visitors found in my house so far:

Mosquitos, Cockroaches, Spiders, a chicken!, a cat

Top 3 songs on Itunes shuffle whilst writing:

1. Heart of gold - Neil Young

2. Have love, will travel - The Sonics

3. Shake your rump - The Beaste boys