Stammerers, Uganda and prayers

Quotes of the week:
"So if a person is caught cheating in England do they get executed or put in prison?"
"Why do you people have such low opinions of Africans?"...
"Dearest son-in-law, you know here you will have to pay a dowry for my daughter yes?".. this was consquently followed by "have you told your mother/girlfriend that there is a woman harassing you to marry her daughter"

Sooo, starting at the backend of last week I had a very interesting Thursday and pretty standard Friday before heading off to Uganda..

Thursday - Some very interesting school visits
First up on the agenda was the visit to a special unit affixed to a fairly new mainstream school (open around 5 years). The person in charge of the unit was the deputy head, which is awesome as it allows for a lot of change/meetings/training to happen potentially quickly, however on the flipside he doesn’t have any training in special needs whatsoever and is the sole person responsible for anything and everything within the unit. On arrival, the effect of this was immediately clear with the children on the whole being left to their own devices for a good hour or so, after which the deputy head came to spend a bit of individual time with each student whilst the others just got on with… well nothing on the whole L Apart from the lack of staff (the school has 23 staff for 1600 pupils) and special educational needs knowledge the biggest problem I saw within the unit which I couldn’t help but voice straight away was why approximately half of the 15 pupils were there. It was explained that when they started the unit, all teachers were informed if there were any kids that did not understand/listen or had behavioural of physical problems to be referred to the unit. Many of the children I saw were perfectly capable of being within a mainstream class (with extra support in the areas that they struggle in) with some purely being placed there as the teacher did not want to deal with/handle a cheeky/talkative etc.. child. After bringing this up and having a quick discussion, it was decided there and then that a number of those children would return to their mainstream classes :) with me supplying  training for the teachers to use strategies to aid and support any difficulties they have. I will also be speaking to the EARC to try and get them to speak to the Department of Education to provide a teacher who knows about special educational needs and has experience in it!

Second up was a school where a child I saw for assessment a few weeks ago attends. He is a stammerer and is having huge difficulties in one particular teacher who was not being especially helpful/supportive (as reported by a very concerned mother). I briefly visited the school earlier in the week for an intro with the head to explain what I do and what I was hoping to do come Thursday (observe the child in class and give the teacher and parents information relevant to their roles in intervention) and asked if there were any other pupils that they would like me to see please send them over my way when I come in… So I wasn’t exactly expecting the 14 kids lined up waiting for me when I arrived! I managed to have a chat and deliver information to the intital client but couldn’t observe as he finished at midday, however the teacher in question came to see me in the afternoon which was really helpful as I think she really needed someone talking her through some of the strategies and why it is so important to use these to be supportive of the child. The other 14 kids were ALL stammerers and I was told these were the only ones they could round up that day! Alongside a staff member who interpreted when necessary I briefly explained stammering, how it can present and that as there is no known cause there is no known direct “cure” but some strategies working with parents, staff and some therapy techniques may be of help. I tried to explain as simply as possible and did a lot of hands up so the children were comfortable expressing there feelings about their stammer (e.g: hands up if your stammer makes things in the classroom difficult). I then individually spoke to each of them for a few minutes about their stammer, including their feelings and if different emotions/situations make it worse before giving them some information to share with their parents. I hope, and have already confirmed with the head that this would be possible, to have a huge meeting of all students, their parents and as many of the teachers and staff involved to have a training session on stammering and for all to discuss their difficulties and things that can help all parties within the classroom environment! Off the back of this I intend to create a monthly stammering group for anyone in Kisumu (I already have a 20 yr old stammered pegged to take on a lead type role and be a role model for others as he is very confident and sociable even though he has a fairly severe stammer) which would be the first of it’s kind in Western Kenya I believe! Fingers crossed!

Sunday - Tuesday - to Uganda and some creature comforts
After an 8 hourish coach ride which wasn’t too horrific we arrived in Kampala, dropped off our things and went straight out for a sterling southern Indian curry - A sign of things to come in more ways than one; We ended up eating a tremendous amount of worldwide food and western comforts (decent coffee!) but 2 out of the 3 of us were pretty ill for the following days possibly cos of the curry (garbage guts here had no problems whatsoever!). Most of Monday was spent enjoying the creature comforts mentioned above, swanning around town and the arts/crafts market and living/sleeping in luxury (Hot showers! No mozzie net required! A fan!). Tuesday was Rachael’s birthday and we had a lovely day out including going to our nearest working cinema (8 hours away in another country!) and having a p-retty authentic and tasty Chinese for dinner where the folks sang Happy birthday and presented her with the oddest cake I’ve ever seen. Pineapple and watermelon slices with a candle in. Oh yeh, before I forget - I’ve never been the biggest fan of birds as an animal but the maribou stork, of which there are hundreds perched around the city, moving around like a cross between an evil superhero villain and an old hunchbacked miser, are the ugliest and biggest birds I have ever seen out in the open. Freaky.

A very unscientific study of the main differences between Kenya and Uganda‘s capitals:

1. Kampala feels far more westernised than Nairobi both in terms of the shopping centres/restaurants but also the sheer number of expats living there.

2. Matatus (minibus taxis) are not deathtraps in Kampala. Strict rules/respect for the government/coppers means only one person per seat (madness!) compared to an all out bundle as many people as you can into any space going in Kenya.

3. Kampala is safer at nights, with no-one warning us of being out come nightfall and the following hours (up until 10 or 11pm is generally thought/said to be safe) and many people swanning around carefree. Nairobi is nicknamed nairobbery with many Kenyans and westerners alike not walking around after dark (this applies to Kisumu and other areas too).

4. Ugandans do not hassle you nearly as much for taxis/motorbikes or in the art/craft markets. Which was nice :)

5. Seemed to be hardly any mozzies in Kampala which meant I got to actually jump into a bed and fall asleep without a care in the world instead of faffing with mozzie nets for an age.



Wednesday - ASaLTEA (Association of Speech and Language Therapists in East Africa) meeting
The main reason for the trip to Kampala was for this little beauty. A meeting of some of the main SLT players in Uganda (Including the SLT course co-ordinator at the only university in Western Kenya delivering SLT training, current students and recent graduates) alongside all 4 yellow house volunteers took part in discussions and voting to further the progress of establishing an association of speech therapists in East Africa. Although it may sound pretty boring it was actually pretty interesting to see what hoops, monetary requirements one has to go through to become a professional, official body and ideas regarding membership fees/aims for setting-up the association and website and election of roles were some of the key issues at the meeting. I felt very honoured to be part of the process and also felt like I actually contributed a little towards the meeiting aswell rather than just create problems with any silly thoughts/comments!

Thursday - travel and a lovely home visit
On the travel back (5.30am start was not the most relaxing end to our little trip!) I discovered one important skill I still have in my ever enlarging age - I’ve still got the aim. 6 years since living in China and I can still nail a hole in the ground no problems. That was probably a little bit too much information… I decided to book a home visit of a child who lives just round the corner from me as it would be the earliest and easiest time to see this client even though was a bit shattered! I assessed the client (7) last week and amongst a myriad of difficulties she has, the two most prominent difficulties were dysphagia (swallowing difficulties) and both understanding and production of language is far below where it should be. During the assessment I gave as much information as I could with examples but really needed to see her eating/drinking rather than just giving general advice which may reduced risk of choking/aspiration/infection. On arrival, I was led into a tiny one room house without electricity or any running water where the family including there 6 children live. The father informed me (although how true this is I’m not sure!) that the child has improved lots since I gave them advice and even teachers at school have asked what has happened as she is more receptive and vocal in the classroom! I was invited to eat dinner with the family alongside observation of the child eating of which the major issue was that the child was putting spoonful of food in her mouth and immediately washing it straight down with water. Moving the water away, the child although looking a little unsure proceeded to show the ability to use her tongue effectively and chew and swallow her food well and for the duration of dinner there were no signs of choking, heavy breathing or coughing. The family, as many are in Kenya, are religious and the father prayed before and after the meal - less for the food itself but for myself, my safe stay here and the work I am doing to which  he was very grateful. It was all very humbling and I was genuinely touched by his exceptionally powerful and heartfelt words directed towards his personal god.

And that’s another week down! Already 6 weeks in and although I am loving everything I’m already feeling a little rundown as am trying to do as much as I can in the shortish time I’m here.. As advised by not only my supervisor but my body and brain too, I may start to try to focus on certain schools, hospitals and clients rather than attempting to go and see as many people in as many locations as possible but we will see what pans out over the next few weeks!

For more information on the teeny charity I’m working under please check out: http://www.yellowhousechildrens.org/

PS: If anyone is considering visiting whilst I’m here the end of Nov/beginning of Dec or the end of my trip around February would be best! Just email me if you fancy it! - Jonathanmlfagan@gmail.com

Top 3 Itunes songs on shuffle whilst writing this:
1. Burn for you - John Farnham
2. You make my dreams - Hall & Oates
3. Life on mars - David Bowie

Some interesting clients, a mini rant and some lovely phone calls!

Some funny things that I forgot to mention:
- I literally had ants in my pants in my first week. An invasion in my clothes bag meant around 100 biting ants crawling everywhere. After I thought I’d deeted them all to the grave I proceeded to put on some boxers… 3 short seconds later and 3 bites around my inner thigh made for some very quick stripping and some uncomfortable sore spots.

- The one and only time I have and ever will enjoy someone calling me “mzungu” - last week a teeny tiny girl looked up at me with disney style wide doe-eyes and shrieked “mzungu” in a similar way a spoiled European kid might shriek “doggy” at Christmas.

- My co-coach at footy wearing wigan socks and a hull shirt. Anyone that knows anything about football would find that funny as they are both laughing stocks ;) (no offence intended any fans out there!)

Friday - Hospital
So due to the amount of clients in need (rather than me personally in demand!) I’m back in hospital for the 3rd time this week! The main reason for returning this week was to see some clients as soon as possible who were reported to be aspirating on their food and drink (coughing/rattly breathing/gurgly voice due to intake going “down the wrong way“ into the airway and lungs). Both of the clients I had penned in to see came back to my delight although I quickly realised it was because they had an appointment with the O.T anyway… I asked both child’s parent/primary caregiver to bring in a variety of textured foods and liquids they normally feed the child so I could observe firstly how they are being fed (posture, speed, size of spoonful can all contribute to aspiration) and how they are coping on the food/drink (I.e.: What they are doing to the food and drink in the mouth and in the swallow process). One of the parents scampered before I could see her which leads me to believe she might have forgot to bring stuff but the other brought everything I asked for AND carried out the advice/strategies I asked her to try during the week :) Absolutely delighted with it all, especially the feeding assessment which helped me to not only see her feeding and offer some advice but also to show/explain to mum the differences between textures and why her child was struggling on some but not others.
As I was already in the hospital and there were clearly some new children who were having communication difficulties and also likely swallowing difficulties due to reduced muscle tone/stability/co-ordination I ended up seeing a load more clients

Weekend - Football crazy
Cut a long story short my entire weekend was all about football as had my first matches watching/coaching the under 10’s and under 18’s. Saturday morning, 7am, up and at ‘em to meet some of the boys and the head coach, Antonas, at our field to walk the hour to the town park. The reason this happens is because for approximately half the kids, they cannot afford to spend 20 ksh (about 15p) to take a bus down and the team itself has no funding or anything. But who’s complaining when we had a bit of a laugh, a good chat and a one hour walking warm-up down to the park. Unfortunately for the under 10’s our opponents didn’t turn up (tho we had a little warm-up - see below) so although we bagged 3 points the kids were gutted that they didn’t get to play L As soon as that was done we walked all the way back to ours as the under 18’s had a friendly to which I got involved with a bit of refereeing in the 2nd half whilst looking like a right sore thumb (see pic of the team below). Team lost 3-0 but only 2 of the first team were playing as big last match of the season tomorrow.. Yes, they really take footy so seriously here that they rest players for a friendly. Next day, the big match looked like it was gonna turn into a mud bath with the heavens opening, gale force winds and thunder abound but luckily it held off for a pretty scrappy not too entertaining 1-1 which finishes us in 3rd for the season. The biggest piece of action actually came when two of our players who were not on the pitch got into a right barny - I stupidly suddenly became a coach and thought to myself, I’m not having any of this and got in between them trying to hold them apart. Whilst stuck in the middle of this violent tango one of the guys full on punched the other and then head butted him too before things were kinda broken up. In hindsight was a right silly thing of me to do but I had a proper “teammates don’t mess with each other” hat on!

Monday - Hospital
The day started off similar to Friday with two returnees, carrying a load of foodstuffs ready to do some feeding! Yipppee!! J Following this I checked up on another few clients I saw the week before asking about how strategies are going etc,.. as well as seeing a number of new clients including two particular cases that are not particularly common to the work I will be carrying out here / clients I‘ll be seeing:

A young girl of 4.5 who seemed to have been burnt very badly from the middle of her forehead down to just below her bottom lip encompassing the central part of the face where all the features lay. Due to scarring/damage she had very little space to see through, in place of a nose was two flat against the face nostril holes and the majority of her top lip was missing. After taking a case-study (and seeing the behaviour of the child), the information given revealed the child has unbelievable sensory issues and had, for lack of a better word, scratched her face off. This started 3 years ago and seemingly it was the first time she had seen anyone. The plan (from my job viewpoint) is to first see her for a feeding assessment as mum reports many problems with feeding/coughing and then start to work with the O.T’s to reduce her sensory needs (they are specifically trained in this area here) as this combines with a lack of focus/attention which would prohibit any meaningful work upon a communication medium for her at the moment - as reported and under brief obs/attempted assessment the child can only an open mouth “aarrrggghh” type scream and doesn’t seem to be using it for any particular communicable intent. I also referred to the ENT (Ear, Nose and Throat) team as due to her lack of nose and missing top lip I wonder if this is having any effect on breathing and possibly a factor of difficulty with controlling breathing effectively when eating.

A man in his mid fifties who had a head injury (assault) approximately 2 weeks ago was referred to me by the adult O.T team. After taking a case history and discussing his condition with both himself, wife and son the two reported concerns were speech sounds and word-finding problems (not being able to recall words that are known to the client). I did a brief assessment using whatever I could find (book, spoon, doll, ball, pen, train, mobile phone) whereby I asked him in turn to name each item. Some of his speech sounds were jumbled but he could name 4 of the 6 without problem, however he could not name ball or train, even with facilitation. When I checked his understanding he could correctly point to all the objects named without difficulty. I also asked him to name as many animals as he could in 30 seconds to which he could name 5 and colours to which he could only name 2. As the client lives far away I urged them to come back and see me in 2 weeks so as to see how his speech and recall are as “time heals” - he could not say anything for a number of days following the assault - and the family could use the strategies I recommend over the next 2 weeks. These centred around the client and the family having time for him to speak, to talk around the object itself if cannot remember the name (I.e. what is it’s function, size, colour) and the formation of the name (e.g: what sound does it start with, how many syllables) as these factors are all interlinked in the complex web of brain structure that stores and recalls information thus solidifying and aiding the memory process. When reading or copying others the clients speech sounds were generally better so this was recommended as a practice strategy as was use of a mirror and breaking down longer words into syllables to produce each part slowly and correctly as longer words and joining together words were the most difficult things for the client to perform (as reported and observed). I am very much looking forward to seeing them again as they were a really nice amiable family that although cared a lot and supported the client, they also all had a good giggle when he couldn’t remember basic words or mispronounced things badly. That may sound a bit harsh but I think it’s so important to have a good sense of humour in these things and the client himself was the one leading the cacophony of laughter most of the time too!

In the evening ended up taking the football sesh alone and will do until Thursday as the other coach is away… wee bit daunting with around 25 kids between the age of 8 and 12 but they just bloody love training and kicking a football around so as long as I try and make sure we have a bit of a laugh and a game at the end of the session they are pretty much good as gold :) Therefore today we had some wheelbarrow and piggyback races as part of the warm-up hehe. Will rock british bulldog and stuck in the mud this week I think! I’ve also introduced 2 rules: If anyone calls me mzungu instead of my name - 10 press-ups, and if I catch anyone chucking rubbish on the floor the same. No harm trying to change a bit of the mentality out here bit by bit!
The only down point was one of the under 18’s got kicked out his house and is having problems with family issues and was really kinda angling to stay at mine and asked me what he should do - I gave the advice I’d give anyone/what would I do myself and explained why I simply couldn’t take him in for the evening to which I think he understood. Pretty tough on the old heartstrings especially after seeing some of the clients I saw today and then after saying bye to him being approached by a boy who gave his name, said he was an orphan with nowhere to stay and asked if I could help. Probably the toughest day emotionally so far.

Tuesday - Paper and Intros
Apart from seeing a client that was booked in to see me in the morning (4.5 year old, Cerebral Palsy, Speech delay) I spent over 2 hours pooling together resources, printing and photocopying in prep for tomorrow’s assessment day, school visits on Thursday and a client I’m seeing Friday. Following this, I was introduced to the CP class at the school I’m kinda based at (where I’m hoping to hit up lunchtimes/feeding as the first priority alongside classroom strategies to aid communication) and then 3 other local schools - one for the “mentally challenged”, one mainstream school with a special unit of 12 pupils attached (the school has 1600 students with only 24 teachers - MADNESS!) and a mainstream school where two kids I saw at assessment last week go (one stammered, one slow processing), both of whom were having trouble with staff due to their communication issues. I’ve bustled my way into almost immediately returning to 3 of the 4 places mentioned above on Thursday to observe the classroom environments, give out some information and set-up a date for training in the near future.

Wednesday - Assessment day
Similar to last week with a load of different clients from 9 til 2ish with one returnee who needed to be assessed further to be placed at a specific school or unit within a mainstream school most suitable for her. This child (8) is an absolute sweetheart with some tendencies that are commonly seen in autism (repetitive play, lack of imagination in play, lack of understanding others point of view/feelings, non-verbal, huge sensory issues) but also has a variety of behaviours that do not fall under the label of autism (excellent eye-contact, some social skills present through giving and receiving objects and hugging). Anyways, the reason I’m mentioning all this is two-fold. Firstly, people here are VERY quick to throw the label “autism” at many clients but in general the staff very much like to give labels to children and they do this bluntly in front of parents - “Jon - Autism yes?!”, “Jon - What is your thoughts on diagnosis?”. My second point is related to the first, whether they do this because of the job they are in or whether this would be done regardless, the EARC’s primary roll is to assess and place children accordingly and therefore, unfortunately, the diagnose (and label especially) is important to place within a unit for Autism, or a class for Cerebral Palsy etc.. I have three times in the past week and a half had a little 5 minute polite passionate rant about treating each child as an individual and not as a label. Even if they do happen to be under a label - Down’s Syndrome for example -  each client is different so the intervention put in place will be unique to that individual not a pro-forma plan that is given to any child with that label. Rant over.

Had 2 lovely call’s this evening (which makes a change from being hassled by random call me-all-the-time-man):
- a father who I contacted earlier to let him know I’ll be visiting his son’s (stammerer , 7) school tomorrow to observe and speak to staff called me back to tell me his son is excited to see me and go to school tomorrow. He than said his son wanted to speak to me to which he said a few words to me and I asked if it was o.k to see him tomorrow to which he gave a lovely smily sounded yes :)

- had a random lady from a university call me to ask if I could help set-up a speech and language therapy course there! It would be the first course in the whole of Kenya and would take a LOT of effort, funding, promotion and especially resources (there are no Kenyan national SLT’s here and not so many in Kenya full-stop - possibly less than 20 in total - so to have the skilled staff to lecture will be a major issue). However it’s absolutely amazing that a uni is interested in getting something up and running and that the work SLT’s in Kenya are doing is being recognised woop woop!!!

The next week
So tomorrow I’m off to visit two schools for observations, offering advice to staff and hopefully book a training session and recommend any children (with the need) to come to assessment day with parents. Then Friday I’ve got hospital in the a.m and then seeing two clients in the afternoon, a stammerer (20) who I met on a minibus who lives round the corner from me and another client (7) reported to have problems with muddling up word order in sentences, also very close to me. Then break phheewwww, off to Uganda :) from Sunday til Thursday for a meeting of the East African Speech and Language Therapy Committee (which is just getting started essentially) and a bit of a travel and celebration of Rachael’s birthday! Can’t wait.

So shall be giving bloggin a break for about a week as won’t be bored as sin in the evenings ;)

Tutaonana (see you later) xxxxxxxx

Top 3 Itunes songs on shuffle whilst writing this:
1. Remember me - British Sea Power
2. Kisses and thugs - Super Mash Bros.
3. Inner meet me - The Beta Band

Some totally non-work what it's like living here ramblings

Sooo, I realise I’ve banged on a lot about work and some aspects of play but haven’t really chatted about what it’s actually like to live out here!

In all honesty the first things that pop into my mind are the following - the friendliness of the folk (sometimes overly friendly), my daily living being a little slice of the times gone by, the religiousness of the country and safety issues - and therefore I’m gonna give a little insight into each of these…

Friendliness
So, Kenyans on the whole are extremely welcoming (literally - You hear “karibu” / “welcome” everywhere you go) with some people being unbelievably nice and going out of their way to bring you something or give you a lift etc. However, whether it be that I’m a white guy here (although slowly on the turn to tan ;) ) or the general way things work here people are VERY forward in asking for your number or giving you their number and telling you to drop call them immediately - the way this is asked is “flash me” which always makes me giggle like a schoolgirl. Some people then act as you expect them to and use the phone number when and if necessary, but there have been more than a few occasions where people have phoned me not long after I’ve “flashed them” (stop laughing) just to tell me the latest football score, or in one particular case I have had someone phone me a number of times this week before 7am to ask what I’m doing and where I’ll be that day (the same person than proceeded to phone me in the afternoon to try and arrange a meet-up and then the evening quite late to which I didn’t pick up). It’s difficult when I feel like I have to give out my number to clients in case of emergencies/major worries and I can’t really say no to neighbours friends/the under 18 football boys as I’ll see them a lot so it’s a bit of a lose-lose situation. Especially when I get woken up from my golden slumbers at stupid o’ clock even before the cockrel gets crankin.
So as I’m writing this the freaking calling me 24/7 guy calls me.. I say I’m going out in 10 minutes (which is true!) and he says he has a  problem he has been faced with he wants to share with me and is coming round now to talk to me… Am really not looking forward to seeing this guy. Hmmmmppphh. Will tell you what happens at the end of the blog…. CLIFFHANGER!!!

Daily living
On average since I’ve been here I would say the electricity has been off approximately 1/3 of the time either due to power saving in the neighbourhood or the storms cocking everything up. These storms pretty much solely happen in the evening so being sat with a candle illuminating a dark room, a torch to navigate the house or pages of a book and a camping stove to cook with is a bit of a hassle/change from the norm! Because of the power I have to make a concerted effort to charge things when I can so I’m not left without my trusty technological buddies for company in evenings (laptop, ipod, mobile). The other two big changes I’m actually really enjoying - no fridge and no hot water. No fridge means I can’t really buy dairy or meat unless I eat it right away and similarly not keeping anything in the fridge + hot weather means things don’t last too long which means I buy almost solely from the small local stalls near me on a daily basis which is all a bit old school and nice plus it aids and abets my fixation on shopping and food hehe. Cold showers - sometimes I’m really not in the mood but in general, it’s good for the circluation, fairly welcoming after the initial shock of freezing my (enter body part here) off and always feel pretty awesome after J

Religiousness
People in Kenya are very religious, with the vast majority from where I am being Christian. In the month or so I have been here I reckon I have been asked approximately every 1.3 days “Are you Christian/religious?”. People who have asked me range from random tuk-tuk drivers - “Are you saved or born again?” to staff at workplaces (my personal fave: “I‘m Christian“ - No that wasn‘t her name, just the way she introduces herself when meeting someone new) and people in the neighbourhood. It’s gotten to the point where I almost feel bad for not being Christian and actually blurted out yesterday “No, I’m not Christian…. (awkward pause) Sorry!” To which the roomful of woman laughed jovially and most said “it’s o.k/no problem” with a few sneery glares in the far corners. This was my landlady/neighbour/Kenyan mama’s Christian group that meet every week for a get together. I don’t find it a hassle/awkward/difficult and in fact have had some really nice open conversations with people about the differences between England and Kenya with attitudes towards religion but I’m not gonna lie by saying I cringe a little every time Sunday comes round as undoubtedly there will be the calls of “Are you going to church today?,,, Why not? Is something wrong?” or “There is still time for you to decide and find God”.
Safety Issues
This is probably the thing that has the biggest overall effect on me as locals, other westerners and guidebooks all constantly say to be inside by nightfall or to take door-to-door transport from a reputable/trustworthy person. Due to this I am constantly making a mad dash back to mine by dark and the few occasions where I have been walking by myself at nighttime there is an eerie feeling that I can’t explain that is constantly in the air making me feel unsafe and always being watched (which in all fairness I probably am because at night time I’m pretty much luminous compared to the locals). I’ve never had this feeling before, even when in more dodgy countries/places. It’s almost certainly a culmination of stories I’ve heard (a friend has been robbed 3 times, once at knifepoint, a couple were killed/kidnapped from a secure safari compound recently etc..), the fact a lot of locals are back by dark or call on the local neighbourhood watch to walk with them and the widespread poverty present that truly makes you feel that someone wouldn’t think twice of hurting you for very little money/reward. This need to be secure and safe at nighttime prevents me from going out for a drink, going for a stroll/run in the evening and imprisons me to lonely evening of long hours.

CLIFFHANGER!!:
Turns out the call was from one of the under-18 footy boys whose problem was that he was kicked out of his house today and has nowhere to stay. It was really difficult for me as he was obviously pretty down/cut up about it and has nowhere to go but also either didn’t have an idea of who to talk to OR was purely angling to stay at mine. I gave him the advice I would to anyone/told him what I would do and his footy mates said they would ask their parents but would tell him tomorrow and the main coach who would be ideal to talk to (he’s training to be a social worker and is a really caring friendly guy) is away for a few days so I’m not exactly sure what he’ll do this evening. It was really hard but I had to flat out say I couldn’t take him in as this compound/house does not belong to me and due to security issues I have to respect my landlady (and common sense) who wouldn’t want me to invite anyone back here unless I had known them a long time and really trusted them. But also, crazy call guy called again this evening. Great.


Next blog will catch-up on the back-end of last week’s work, a football-orientated weekend and this week’s doings… Before I’m off to Uganda (Kampala) from Sunday through Thursday for a work meeting (oooooo fancy!), a bit of a look around and a celebration of Rachael’s birthday (she’s planning an old school bowlarama and cinematic experience!).

Love you byeeeeeeeeeeeeeeeeeeeeee xxxxxxxx

Top 3 Itunes songs whilst writing this:
1. Close call - Rilo Kiley
2. Paperback writer - The Beatles
3. Cancel on me - Bombay Bicycle Club

Busy as a bee. Speaking of which, they have fully black ones here. Weird.

Funniest/oddest sayings from the week:
Me: “How many children do you have?”
Toby (see later): “ummmm, 5. I think.” Cue raucous laughter.

Silas: “I only go down here in the day, don’t go at night” Cue Silas smiling ear to ear while pretending to choke himself to death.
Me: “Sooo why do so many people get murdered around here, is it a gang thing?”
Silas: “Many people rob. If they rob me at night and see/recognise my face, then they will kill me” Cue shaking of head in disbelief whilst laughing his face off.

Dorothy: (every time she sees me): “Hello, my future son in law” 

Dorothy (currently training in the area of mental health): Scribbles something on a piece of paper, then hands it to me. It says “Mentally challenged. Behind you”. She looks at me nods behind me and declares “have you seen?!”

Random: “What’s up my nigga?”. Makes a nice change-up from the constant Mzungu (white person) calls.


Friday - Big day out
Went to the Kenyan Youth Football Association (KYFA) for a meeting with the head honcho there, an American lady by the name of Rachelle. In passing during the week I mentioned to my work supervisor that I was hoping to find somewhere to play footy on a regular basis and before you know it he gets the lady on the phone to book an appointment. KYFA organise a disability football tournament once a year which is how my super Silas (sounds like a crap superhero that!) knows her. On the phone it turns out her child has some hearing impairment and speech delay/disorder so a lovely mix of business and pleasure was in order. Rachelle was lovely, explained that KYFA was set-up with a grant in 2004 to give more opportunities for social interaction, play and enjoyment in life, particular to those from poor areas/backgrounds. There are currently 150 teams of under 10’s, 12’s, 14’s, 16’s and 18’s in Kisumu with an organised football calendar of matches/leagues. She gave me the number of the nearest club to me which needed/would appreciate extra help which I proceeded to phone and agreed to join that afternoons practice at 4.30... After discussion about her child I’m planning to do an assessment as soon as possible with the child whose main difficulty seems to be word order difficulties.


4.30 rocks around and I walked the 15 mins from mine to the “pitch” - it’s essentially a patch of dusty earth with some sticks either end for goals. I meet Antonas, a lovely guy who works as a social worker, studies AND trains the team everyday (!) from 5 - 6.30. He was immensely grateful I wanted to get involved and so I got introduced to around 25 kids from around 8 to 11 years old… this proceeded into Antonas running me through the usual warm-up which almost freaking killed me - I was pretty red faced, out of breath and sweaty at the end of it - and then some drills before a quick match to finish up with. The match was played in the worst storm I’ve been in for a while and the pitch quickly turned into a mud bath/swimming pool with everyone comicly falling over, sliding and then literally diving into the massive pools that had formed everywhere. Wish I had a camera with me at the time but considering my phone didn’t work for days afterwards it was probably a good thing!


Friday night was the first night I’ve properly been out in Kisumu - Met up with Rachael and a friend from home, Rosie and her gang, who were in their final week here after a 3 month stint doing some project work. Hit up an amazing Indian buffet that is pretty well known in Kisumu before heading on to a club where we had a few beers, threw some shapes and generally (me anyway) made idiots of ourselves trying to contend against the hip thrusting, groin gyrating, booty shaking that was going on all around us.


Saturday & Sunday - Tropical rain/hail forest
Rachael and I met with Stella and Carolyn (an American SLT undergrad who was just about to finish a 2 week stint) from Mumias on the Saturday morning in Kakemega to hit up a bit of walking and wildlife in Kenya’s only tropical rainforest. After a bit of a roundabout way of getting there (minibus - wrong minibus that we sat on for a while - back of a motorbike - walk) as soon as we arrived pretty much it started raining crazily heavily. Rain was joined by gale force winds for a bit of fun in pounded us with rain pellets whilst we waited idly outside our cottage for the key master to arrive. To finish off the madness, hail decided to show up and join in the festivites. In Africa… What the…?!?! We had a really nice, informative 2 hour walk with a guide/sound machine (imagine motor mouth jones off police academy if he could only make a variety of monkey sounds) seeing some pretty awesome trees, vines, flowers but wildlife wise was kinda relegated to some monkeys and butterflies.. If we got lucky/had different weather etc… we may have seen a load more different mammals, birds etc but it wasn’t to be. Sunday we plodded up to the viewpoint which was really really stunning - it’s been a good while where I’ve been at a viewpoint and could see pretty much nothing apart from dense lush green treelife. Beautiful stuff. PS: Had my first hot shower for 3 weeks and it was glllooorrrioouussssss!! :)

Monday - hospital
I joined the Occupation Therapy team for the first time (they work like physios back home - working on gross and fine motor movement), this particular area of hospital care is where the highest percentage of clients are most likely to need SLT intervention I think/feel. I was kinda meant to be observing for the day but I wanted to get stuck in and as there were a few kids who I knew would need some form of strategies put in place with the parents (either feeding or communication advice) I started going round informally introducing myself, what I do and if they were concerned/if their child does x, y or z.
The majority of kids I saw had a diagnosis of Cerebral Palsy (CP) or brain damage due to encephalitis/malaria/meningitis/birth complications. The four families I specifically made a beeline for and saw are all (hopefully) penned in to come back and see me on Friday or Monday as it’s really important for me to do an eating and drinking assessment as all the children were reported to be aspirating on intake (coughing/noisy breathing through food or drink being taken down the windpipe into the lungs instead of the oesophagus into the stomach). The OT in charge, Wesley Snipes look-alike Wilson (see below!),  has given me my own clinic room and also told me he would be arranging a folder/notes etc… AMAZING!!! Met Esther, the lovely secretary of the Association for the Physically Disabled of Kenya (APDK), who have an office base at the hospital. She gave me a Luo name (the tribe/language of the area) - Jonathan Omondi (meaning born in the morning - which I think* I am!) and as I was leaving she insisted that I should return tomorrow for a special clinic that is held once every few months - a paediatric neuro team from Kijabe Children’s hospital near Nairobi visit for assessments and referrals.. soooo tomorrow I’m expected at the hospital ready to get stuck in at 8am!

In  the evening I took footy training by myself for the first time and all the kids were good as gold, listening to me and seeming to enjoy me acting like a bit of an idiot half the time! I’m hoping to co-coach everyday as long as I can get back in time from work J I’m also planning to introduce some warm-up games based on classic English school ground games i.e: stuck in the mud, british bulldog etc.. maybe even throw in a bit of Kabaddi to boot (check it out on youtube if you have never had the pleasure).


Tuesday - hospital
During the day (8am til about 3pm) the team saw over 40 kids (4 months - 6 years) with almost all showing symptoms/diagnosed with hydrocephalus (swelling of the brain due to an abnormal amount of fluid our brains are cased within going into the various nooks and crannys). Five of the children were specifically referred to me - others were too young to gauge eating/drinking/comm difficulties or had non present. Of those referred, those living close by will return to see me (touch wood) for a proper assessment (prioritising feeding) and one family who live far away I gave a comprehensive written eating and drinking/ speech development stratagies for the parents to use at home and plan to ring them in a few weeks to see how things are going. Of the children I did not see, one particular case stands out - an 8 month year old who was painfully thin (imagine the charity adverts you see highlighting famine), had not only hydrocephalus but looked like her skull had not formed properly with a large soft downward dip in the centre and had a shunt malfunction (the drainage system they use to sort out hydrocephalus - the shunt drains the excess brain fluid redirecting it back into the body to absorb) which was causing seeping sores. Even though it wasn’t my place to say I nipped in to ask if she was being referred to a nutritionalist which she was.
Didn’t have a break til we finished at 3 which I wouldn’t be too bothered by but was absolutely famished as my “long-life” no need to fridge milk was off/lumpy this morning so pretty much had nothing all day! The entire team goes for a fish lunch down by Lake Victoria after these special Kijabe children’s day so we all headed down - me on the back of a motorbike ridden by a lovely funny bloke called Toby who is an orthopaedic technologist (making splints/orthopaedics as well as prosthetics). No chapati or rice was on offer so had to man-up and hit the ugali (a difficult to describe really heavy, stodgy maize and water mix)…it actually tasted half decent in comparison to the only other time I’ve had it and I pretty much had an entire serving which felt like the equivalent of 5 bowls of heavy stodgy mashed potato although that doesn’t even do it justice. The big boss also came over as I was finishing up - he looked at me, looked at my plate and then said in a pretty funny wild eyed way “EAT THE HEAD… EAAATTT ITTTTTT”.


Briefly after I got home straight to footy - game on - one of the kids who lives on the way to mine took me back to his to show the mzungu off to his family I guess. It’s been a long time since I’ve been so humbled - the kid, Marcos (striker for the under 10’s!) lives with his 2 sisters - aged 3 and 1 - and his grandmother (his mother passed away fairly recently and no father was also no longer alive). I was invited in to a tiny mud hut with no electricity (and I imagine no running water) and a single candle illuminating a tiny passageway from the front door to the only room, where the entire family were sitting. Marcos is immensely clever and has probably the best English out of the entire ratpack of kids I coach (including the 12 year olds) so acted like an interpreter between myself and his gran who was obviously very taken aback to see a big white guy enter the house. She humbly invited me in, apologised for them being poor, praised the lord for being lucky enough to look after the children (I gather many of the religious people I have met believe that everything happens for specific reasons) and then thanked me for the work I was doing. I felt totally blown away and not really sure what to say by it all..

Wednesday - Assessment day at clinic
Bloomin ‘eck, talk about getting chucked into the deep end! Through the non-stop 9am - 3pm session I saw a right smorgasbord of clients, both in terms of ages ( up to 14), abilities (from mild to severe impact upon communication/quality of life) and diagnoses; hearing impairment, stammering, learning difficulties, dysphagia (swallowing difficulties), speech delay, cerebral palsy, down’s syndrome and unknown conditions. I thought I’d quickly mention one client whose issues with staff at school is something that cropped up a lot today and is something that is within the underlying nature of people’s attitudes towards disability in this country unfortunately:
Tabitha, 14, has severe sensorineural hearing loss in both ears according to the audiology report with the audiologist reporting that hearing aids may not be of much help to her (I’m planning to follow-up this to double-check the results however) and cochlear implants do not exist as a realistic option here. Tabitha’s hearing loss has come on fairly recently and she has not told anyone until very recently and therefore her grades have been slipping at school and teachers, one in particular, are not being very helpful/receptive to her need with her even in some cases being punished for not being able to answer questions due to her not being able to hear. Tabitha was visibly very shaken (she cried a number of times) by the way she is being treated at school and straight away we gave strategies to Tabitha (she has to sit at the front of all classes, to not be afraid to ask for repetition or check her notes with teachers after class) and the teacher she came with , to give information to the school’s staff (make them aware of Tabitha’s hearing impairment, make sure they are facing the class whilst talking, be happy to answer Tabitha’s questions and check she is understanding). Rachael lives closer and will visit the school as soon as possible to give a training session and to ensure these strategies are being put in place.


On the way back, a 20 yr old came and sat next to me on the minibus saying he knew me from the area I live in (as in he has seen me about) and introduced himself. Oliver, proceeded to ask me what I do here whilst coping with a fairly severe stammer to which I replied I work with people who have swallowing, communication and speech problems. Immediately he asked what can help “cure” him and I briefly explained the nature of stammering and some strategies that have/can work for people but have the opposite effect on others. We exchanged numbers and I’m planning to give him a load of printed information about stammering and maybe meet with him every few weeks for an informal session.


Thursday - A quiet day (phew!)
Silas booked in a client for me to see in the morning who was travelling  from really far away for his child (hearing impairment, non-verbal, age 3) to be assessed and advice to be given. The dad and kid travelled for 6 hours (though think there was a load of transport problems and should’ve taken less) and ended up arriving at 12.30ish. Unfortunately, this booking system is how things work in Kenya - you tell someone to come in the morning or afternoon as people in general never turn up on time for anything so you don’t give appointment times. The bad thing is you end up sometimes waiting around while you could be doing other things :( ! After seeing the very lovely kid and receptive dad I headed straight over to my supervisors (about an 45 mins away door to door)  for a 2 hour supervision session that I was immensely grateful for. We chatted through the plethora of clients I have seen this week and the things I did with them while Rach gave  me a few pointers/pieces of advice aswell as being very supportive that everything I’m doing sounds good! :)


                                                                                              J xxx
Top 3 Itunes songs whilst writing this:
1. All my fiends - LCD soundsystem
2. Is this love? - Clap your hands say yeah
3. Against the grain - City and colour


My address!:
Joylands School, EARC Kisumu District, Kisumu, P.O: 1790-40100, Kenya

And we are off and running... kinda.

Sooo, weekend came and went pretty quick including a lovely meal out with the newest volunteer to the yellow house crew, Stella (who was on my uni course!) who will be in Mumias for approximately 3 months.


Thought I’d kick things off with the funny stuff from the week before work takes over!


Funniest things saw this week!
1. “Sex and drugs and sausage rolls” T-shirt
2. A cow scratching behind it’s ear with it’s back leg and licking it’s arse (how are they even possible).
3. The “homestretch hearse” - one of the many minivan hearses located near the hospital


Funniest things heard this week!
1. “Don’t tell anyone you only have 2 in the family (referring to me and my sis), they will pity and laugh at you”
2. “If you take (as in eat) the brown ugali, you will be very sorry and when you go to the toilet it will be paaainnnfulll” (complete with gestures and facial expressions)
3. After being asked if I was married (still no by the way) I was immediately offered a daughter as a bride.


Monday - Intro’s and hospital visit
All three of the funny things said above were courtesy of Damien (the hearing impairment specialist) and Dorothy (the mental health specialist) who along with Silas (see prev. post) make up the unit where I am based out of. I was introduced to them both on the Monday and we had a good ol fashioned chinwag about all sorts of things (as you can see above) but also each of our roles and how we can work together effectively. 


First thing that happened in the morning when introduced to Dorothy was for her to rush off to grab a boda-boda driver (taxi motorbike) to whom I was introduced. Not quite understanding what was going on, it quickly became clear that this guy was just about to whiz off after having stopped by to speak to someone but no-one was around relevant to his concern. His child, 3, is profoundly Deaf ( as reported by dad) and not speaking so he popped in to find out some info. After a brief chat, it was decided for  himself, the mother and the child (it’s rare for both parents to come so here was hoping!) to come in the following morning for an appointment with myself and the audiologist. My first assessment! Eeek.


Following this Silas and I went to Nyanza Hospital (known as Russia by everyone as the Russians funded it!), the largest in the district, if not Western Kenya to be introduced to the Kisumu headquarters of the Assocation of the Physically Disabled of Kenya (APDK)and the Occupational Therapist crew (whose clients are most in need of SLT’s out of the hospital) in the hope that I can do some work there. Easy as that after being introduced to an O.T called Elvis and a dude who looked like Wesley Snipes (complete with dodgy ‘tache), I’m now working every Monday at the hosptial alongside the O.T’s and plan to try and do some basic SLT training with various staff members (e.g: nurses on the paeds ward) so they know I’m around and can refer to me when needed. On route Silas gave me a very dad-like chat about being careful not to be tempted by women here (anywhere in Kenya is this true but more so in Kisumu which is said to have the highest prevalence of HIV - 1 in 5).. A little awkward to say the least but very lovely of him to care so much!


Sooo, this week was meant to be the week all schools in Kenya re-open which would mean me getting stuck into some introductions at local schools (before organising training) and see how Joylands is run itself, especially certain class groups (the cerebral palsy group/teachers have been pegged as one area they would specifically like me to work within). HOWEVER, there is a dispute between school staff and the government over pay so no schools opened this week which put not only a halt to the start of a lot of work but also meant come Wednesday, assessment day, hardly anyone would turn up as the unit is based with the school grounds but not part of the school itself and thus people think it’s not open L


Tuesday - First assessment!
As we had the time available I spent around an hour with the family from yesterday (both parents came woohoo!!). A case history was taken assisted by the Audiologist who interpreted at times when needed - as the official languages here are both Kiswahili and English (as well as the 42 different in-country languages!) the majority of people can understand and speak English fairly well. It turns out the child had some sort of operation on her ears which they think made her go Deaf at an early age. As the child is not of the age where the audiologist can conduct proper testing (5) his informal assumption was that she may have cochlear damage and therefore hearing aids would not support her. The child had excellent non-verbal communication skills and although did not make any noise throughout the session, the parents said she babbles a lot at home and makes lots of noise and uses pointing/gesture to communicate her needs. I advised the parents on some basic strategies to encourage more babbling and speech development and am finding some Kenyan Sign Language information for the parents so that using official signs that are used throughout Kenya would benefit the child in the future rather than home-made signs/gestures. I intend to contact them for a follow-up to see how the strategies are going.


Wednesday - Assessment day
As mentioned, as people assumed the school grounds were closed we only had 2 people arrive today - a mother who was enquiring about potential placement for her child in a local school; Silas said that this child is someone who I shall be house-visiting next week so I quickly asked a few informal questions so that I could prepare.  The child, Joy, is almost 7 and had a pretty rough 1st year of life to say the least that impacted upon her physical, mental and communicative abilities. At 6 months she contracted T.B and then whilst in hospital at 8 months got cerebral malaria which presented as meningitis at which point she fell into a coma for 10 days. The mother says that after many years of O.T work, they stopped in July as she is at the point where she can self-feed and can walk. “She understands but cannot reply” and is able to say names and a few nouns. I will be seeing them next Tuesday morning.


The other child was a very similar case to the child I saw yesterday (profoundly Deaf, non-verbal) but was of a much older age - he was born sometime in 2005 according to his uncle who brought him in. Whilst asking the uncle some background history information it became clear that the Uncle was not entirely sure about many of the questions and thus we asked them to come back with the child’s Auntie who looks after him and his brothers; the child’s mother was kidnapped from the house and murdered and the father died in 2009. Asking whether Dominic has ever spoken/made noise (traumatic events can lead to selective mutism) the uncle seemed pretty certain that he has never made noise/sound - even when I asked he cries/screams when hurt or unhappy. During play with Dominic, he came across as a really smart kid with no motor difficulties, excellent non-verbal skills (nodding/facial expressions/pointing) and was incredibly receptive/found it fun to imitate. After I showed him how to use a pull-back toy, he copied, as he did with a few other objects… so I figured why not get a fake phone and show him me making noise whilst getting him to feel my throat for the vibrations, I handed him the phone and gestured to him to do the same whilst placing my fingers on his throat - Dominic to my surpise (and delight!) copied me by babbling into a phone, he also mimicked my lip movements for baby and made some really nice long “aaaarrrrrgghhh” sounds. I’ll see him again next week where I will meet his primary carer (auntie) and am really hopeful that I can see him on a weekly basis as he shows so much potential/ability.


So tomorrow (Friday) I’m meeting up with an American lady who is in charge of the Kenyan Youth Football Association. I mentioned to Silas that I was hoping to get involved in a bit of footy out here and straight off he contacted this organisation. After speaking to the lady she said it would be great if I got involved with some training or refereeing (who would be a ref eh?!) and alos by chance her daughter has language delay and a hearing impairment and they have not been able to continue the therapy she was receiving after moving here so I’ll be talking to her about that aswell! Work and pleasure - lovely stuff.


Off to Kakemega - a national park/forest - for most of the weekend which should be lovely as long as it doesn’t absolutely piss down. It’s rained pretty hard here every evening this week causing long periods of no electricity which doesn’t make living alone with an electric cooker (I’ve got a little gas one as back-up tho) and the majority of your entertainment being on your laptop too much fun.


Byyyeeeeeeeeeeeeee!!! xxx


Top 3 Itunes songs on shuffle whilst I wrote this:
1. Ain't got no... I got life - Nina simone
2. Mountains - Biffy Clyro
3. Ain’t no rest for the wicked - Cage the elephant 

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

My new home!

Soooo I left the last blog as I arrived in Kisumu, which is a "city" though feels far more like a town as it's pretty small and is located on Lake Victoria. My place is about 15 minutes from town on a matatu (taxi minibus/deathtrap) so in a small local area which backs out onto an amazing green landscape of fields and hills and has enough small stalls to feed all my needs and has a couple of places to go for food/a beer :)


26th: Arrived at my new place where I was welcomed by groundsman willie (his actual name's oscar) and my landlady's sister's daughter (think I've got that right). The house itself is really lovely and far too big for just little ol me! It has a medium sized living room (with some brand new handmade chairs, sofa and table), 2 good sized bedrooms - one kitted out with a new big mattress :), a large kitchen and a indoor flushing toilet! In the week leading up to my arrival the landlady put a tap in the kitchen sink, a sink/tap outside the bathroom and a shower in!!! Without these little things I would've been retrieving water from the tap outside in buckets for everything so feel very lucky :) The biggest things of change compared to the other places I've lived (not including the obvious mosquitos etc..) is no tv (a good thing!), no hot water (not so bad especially considering how hot it is here!), no drinking from taps (lots of boiling and filling bottles!) and no fridge (will be shopping from locals daily and not eating much meat/dairy :(! ). My place is attached to the landlady's house where she lives with some family -  we also have 3 cows, a dog, a tiny kitten and there are constantly chickens running around but these belong to the neighbours. They also own a goat that sounds like a bloke going "mate, mate, mate, mate, maaate".

27 - 28th:Thunderstorms ahoy - in the evenings so far the weather has turned into something out of a dodgy american tv series called "stormchasers" or something. The lightning (which at times hits nonstop every few seconds for a good while), thunder and rain is amazingly intense. If you're caught in it it's a bit liked being pelted by hailstones whilst listening to white noise. Powercuts are pretty common, mostly due to the weather although I found out at the weekend the power goes off all day on sat or sunday for some reason as well.

Made myself try and feel like a bit more like a local by going to the nearest bar - "the estate" (classy) and having a few beers whilst watching the footy. They are football MAD here (the electricity was off in the area allday so they wound up the generator just for the match!) and it's an easy way to get into conversations with the locals, especially when watching Man U trounce Arsenal 8 - 2. The majority of people here support one or the other so the pub was absolutely rammed and rowdy and as per usual the locals were pretty interested in the Mzungu (white person) being as there has not been a white person in the area for at least 4 years (since the last volunteer) and some may never have interacted with a foreigner before but regardless I was treated like a local by many of them with only a few quizzical looks. Also - never have "extra foreign guiness" - it's foul.


Met my landlady Veronica who is an absolute sweetheart and an ex special needs teacher so is well clued up on the work I'll be doing which is lovely!

First day being introduced to work stuff tomorrow! Excited but a little nervous!!

Top 3 songs on Itunes shuffle whilst writing:

1. Young american - David Bowie

2. Cigarettes in the theatre - Two door cinema club

3. The greatest man that ever lived - Weezer