And that was the week that was

Hey hey hey, here’s another bit of chicken scratch as one of my friends calls my beautifully awful handwriting…

Funniest things from the week

Me: I’ve got to go soon. Thought the match was meant to statt at 9am and it’s almost 10 now.

Jim: What time is it?

Me: 9.55

Jim: So it’s still 9.

When giving a poster for International Stammering Awareness Day to a new local establishment run by the local representative I was asked if I got permission from the government for giving out info…. My reply: “errrrr, no” . . “You could get arrested you know…. (cue awkward silence) … but I’ll cover for you this time”

Was told that a few weeks ago at the meeting in Uganda as I was busy shovelling food down at lunchtime a lady opposite me told a colleague: “I like him… He eats like a Kenyan man”.

Last Sunday when having a kick-about at half-time during a tournament I was goaded into having a pop at goal. Struck it beautifully, came off the underside of the bar and the makeshift goal proceeded to collapse in comedy-like fashion: bar came crashing down, then the right post flopped down and the left followed suit.

Twice now there has been some odd kinda witchcraft like chanting just outside my house at stupid o’clock in the morning… Very tempted to grab a look but probably not the best idea as 1. The front gate gets padlocked at night (fire safety hazard woo-hoo) and 2. They may be chanting about me.

Picked up a huge snail (about the length of my tiny girl-like palms) for a photo. It proceeded to pee/slime everywhere.

Monday - School canvassing

After a lovely morning at the hospital seeing some clients new and old I spent the afternoon trooping around some of the major schools in Kisumu explaining what I do, giving information regarding Saturday’s stammering awareness event and encouraging the principals as much as I possibly could to pass on the information to relevant pupils and parents and all staff. The response I got was very mixed, which in my humble opinion is pretty representative of that seen in the majority of teachers/school staff. One principal looked like he hadn’t been to sleep in 3 days and would rather have been having his fingernails pulled out than listen to my speil, whereas 2 principals in particular were incredibly lovely and receptive, asking questions regarding my work and immediately flagging up a few students/families who they will contact. Come Saturday, students from both of these schools turned-up :)

Tuesday - Home visit

My first proper home visit was today and it is hopefully going to be a sign of things to come as I have started to clear by Tuesday’s for home/school observation purposes (previously Tuesday was a mish-mash day and as home visits are not as efficient time and money-wise as school visits I hardly had any). One of the reasons for this home visit is that the parent has been looking for a SLT for a long-time, she is extremely passionate, receptive and motivated for her child (age 5) and is also the head of the parents committee at Disciples of Mercy School where I will be doing some training in the next month. On a slightly selfish note, it is also really nice to be able to see a child on a regular basis and work across environments on specific short-term and long-term goals. 

This first visit was explained to the mum as an observation to get to know the child better (the referral information/diagnosis merely says “intellectualy challenged” , see how he plays with mum and sister (if there is opportunity to play in the house) and to do an informal assessment of his receptive and productive communication ability. Like many of the kids I see the child has fairly significant sensory issues and during the hour or so I was at the house he only sat/stood still for a maximum of 30 seconds or so and each of these longer periods were due to noises outside the window which he had to go and see/hear/explore. One of the major discoveries from the session was  the child’s receptive language skills (I.e: understanding of spoken language) were far below that reported by the mother. It can be a little difficult at times to explain things like this to family, especially when she believes he understands basic commands and many basic words but when observed, non-verbal cues (such as following others actions, understanding through gesture) was how the child was understanding and a basic assessment showed his understanding of basic nouns was the equivalent of guessing. In addition to this I also breached the subject of potentially using a non-verbal means of communication for her child. At his age, with good tongue movement, an encouraging motivating environment but still very little spoken language (only screaming/crying/open vowel sounds and mama, baba and tuk-tuk - but the words are not used for any particular purpose/intent)  plus a good set of non-verbal communication skills (both understanding and use of gesture, facial expresion, passing and taking objects) a non-verbal way of communicating is likely the way forward. Considering the amount of information I gave mum, strategies for her to use of the coming week and the possible emotional distress of the news given (early in the session she said “I can’t wait to hear my baby speak”) she was incredibly understanding of everything and extremely thankful for the service I am providing. Again, like other times I always feel really quite humbled and embarrassed considering the amount of time and effort she has spent raising her son in an environment with likely little support or information and yet she is praising me for doing something I’ve been trained for and have come out here to do as a job… Maybe I’m just bad at taken compliments but still find it weird to be thanked for stuff!

Wednesday - Supervision!

My supervisor/best friend in Kenya (!) came to clinic to observe my work to make sure I wasn’t doing anything horrendously badly. It was also an opportunity for me to continue my ongoing training in oro-motor exercises as a lot of children I see require this to increase stability, movement and control of the jaw, lips and ultimately tongue and having Rachael down allowed for me to see her giving advice to parents. Afterwards we went through the day with some lovely positive feedback J and some things to improve on which is lovely to know when out here on my own most of the time! We also went through the Royal College of Speech and Language Therapists Competencies which is something expected to complete afterr graduating within a year of your first job. As Rachael is RCSLT qualified and has the experience, I’m lucky enough that if she thinks I have the competency of certain points in the guidelines (there are loads!) they can be signed off whilst I am out here working. All require evidence and some simply aren’t possible due to the work I’m doing here but the good news is I have already has 2 signed off! Woooo hooooo! We also discussed some of the others I hope to achieve once Rachael sees more of my work and I can provide solid evidence to the RCSLT. A lovely day finished off with a lovely drink :)

Thursday - Prep for Saturday, Ultimate

Today was all about prepping for Saturday so I won’t bore you about making things and how great I’ve become at using a photocopier. In the afternoon I met up with some fellow mzungus to play a bit of ultimate (a cross between netball and american football played with a Frisbee. I’ve just read that back and it sounds both mental and a pretty bad explanation of the game but as I type away without deleting stuff it’s staying in!). Was real nice to meet a few new folks and have a bit of a stretch out of the legs - will hopefully be playing weekly and seeing some of these guys regularly (the main man with the discs has a birthday tomorrow evening that I’ve been invited to).

Friday and Saturday - Drinking, walking and stammering.

Finally the weekend has come around and Friday evening myself, Leigh (my newish neighbour / person who will get bored of seeing me in approximately 3 weeks), 2 of her mates and Rachael all went out for a buffet-tastic Indian where we joined up with a couple of the guys from Ultimate and their friends. Following eating until I felt almost ill we headed to Josh’s (American Frisbee throwing birthday boy). 60” T.V plus Rock Band and beers = where am I cos it’s not Kenya. A palace of a house which is nicer than any I have ever been in anywhere in the world filled with a nice gathering of mzungus was a bit weird but the homebrewed beer, passion fruit vodka and home-baked cupcakes and pies made me relax a wee bit! Got home at 2am before dashing through some sleep and waking before 7am for a cancer charity/awareness walk which I roped the aforementioned group of folks who I went to the Indian with along to. Arrived on time as wanted to get cracking, head home for food, shower and stuff before zooming across town for the stammering event. Don’t even know why I thought it might kick-off on time cos nothing does here… the guest of honour arrived an hour and a half late so we picked up a massive sweat whilst doing an extended warm up with a crazy mr motivator type (non brits - look him up) and the ever increasing hotness of Mr.sun. Luckily the walk itself was only about 6 km I reckon rather than the “10km” it was meant to be so had plenty of time to get home, sorted and worried about the stammering event!

Special thanks go to Leigh, Rachael and Stella who came to help out at the stammering event aswell as Josh, Jen and Sam who came to learn a bit about stammering and entertain the kids J So with these guys at my back the event went well with about 60 adults and children turning up to collect information (which I encouraged them to read on the spot so they could ask speech therapists any questions whilst there), come to brief presentations I did on stammering and listen to a few adult stammerers speak of their experiences. The adult stammerers were the big hit of the day with their presence provoking a lot of questions and discussions which was great as it is so important for the kids, parents and teachers (though was a little disappointed with the turnout of this group of people from Joel Omino School itself :( ) to see that stammering should not affect your ability to get through school, get a good job, get married and do all the other mundane things we achieve before passing into the next life! The people who came heard about the event through different means including some who heard about it on the radio (!), but the thing that probably made me smile most, bar some lovely feedback from folks, was approximately 20 children from a school I visited coming by school bus, half of which were stammerers and half of which wanted to know more. It’s always nice to know some of the people you chat to are this receptive and motivated to take on board the information I gave out, encourage their students to come along and provide transport. Fan-blooming-tastic! :)

And on that smiley note I’m off! As mentioned apologies for lack of photos (for the moment) and I hope no-one is being driven nuts by early Christmas paraphernalia and songs on the radio yet.

J xxx

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

Top 3 Itunes songs on shuffle whilst writing this:

1. Dashboard - Modest Mouse

2. I won’t back down - Tom Petty and The Heartbreakers

3. Sunrise, Sunset- Bright Eyes

I can die a happy man! :)

Funniest soundbytes of the week
Classical music playing in a matatu. It tends to be rap, reggae or the occasional random western pop song (Gym Class Heroes, JLS and weirdly enough Phil Collins are big players at the moment)

Me: “Jim, why aren’t you dressed for football?”
Jim: “I’ve got typhoid”
Me: “Oh”

Head of a school: “This is X (he looked about 14 years old), best coffin maker in the school”

The different relationship titles I’ve been called since being here: Son, Son-In-Law, Brother, Husband, Boyfriend. Just to clarify to friends and family alike, none of these are correct in the true sense of the words and I have not become attached to anyone through dating, marriage or adoption.

Monday - Feeling unwell L!
For the first time since arriving I’ve been feeling a little off kilter. Not sure if it’s the malaria tablets side effects, the increasing hotness, something I ate or other but hot and cold sweats, feeling tired 24/7 and generally not feeling my normal (if that’s what you can call it) self… Writing this as of the weekend and I’m still having the weird sweats and having funky dreams but feeling right as rain on the whole J


Tuesday - Disciples of Mercy (not a horror movie viewing but a lovely private school)
Disciples of Mercy is a  mainstream private school a little bit out into the rural countryside, it has a special unit of almost 70 children. It is beautifully kept and is essentially a little town within itself with an attached vocational training centre, chemist, hospital and church. These children are split into specific classes (sensory/attentional difficulties, Cerebral Palsy, Autism and 3 classes of general special needs according to age/ability of those without severe enough difficulties to be placed in one of the aforementioned specific). All the children have been assessed at the Education and Resource Centre to be placed here (unlike Pandpiri) and all the staff I met were really enthusiastic and passionate about the work they do which is fantastic. The headmistress is really keen for me to do as much work as I can here and unlike other head s who welcome me and let me do what I want, she showed me around explaining some of the potential things I could do, difficulties they have, asked me what would be best for the kids and my timeframe - e.g. training or 1:1 etc… Really great to have someone so gung-ho and interested/enthusiastic in having special needs work be done. The plan is to go in next week to look through all the children’s records, observe some classes and then plan a training workshop for the staff members that is as relevant as possible to the clients at school. The headmistress has already asked if I would dish out a few full day training sessions at the end of November when school breaks up for December. Ideally she would like me to do this for all the staff (not just the special educators) and also some of the staff from the attached small hospital and church who may work with relevant clients.

Wednesday - CP feeding and a particularly interesting client at clinic
Managed after an age to see the CP class at Joylands Special School at Lunchtime for a feeding observation. Much to my delight when I got there half the class had beans and the other had veg and ugali (consistency a bit like a harder stodgy mash) and when I asked why this was it was because “those that can’t chew don’t eat beans”. Starting off on a positive note yippee. During observation all but one of the 14 kids could self feed (which is great as self-feeding compared to another person feeding reduces risk of coughing/choking/chest infection due to the child being able to control pace and size of food etc… but also I imagine it’s a lot more enjoyable to be independent as well!) with two having some difficulties through poor posture and/or eating too much food at too quick a pace. I pointed this out to the staff and that if possible could the person who feeds the one child who cannot self-feed keep an eye on and remind these 2 children to take small, slow mouthfuls and be sat upright. With the child being fed, he does not possess the fine motor or gross motor control to grip or feed himself and additionally has very reduced neck and head strength/control meaning he can only hold his head upright for a few seconds at a time. The lady feeding him started off with fairly large sized mouthfuls and putting more food into the clients mouth on request - when he opened his mouth, even when there was still food remaining that had yet to be swallowed. Within the first few mouthfuls he began aspirating (coughing due to food/drink going down the “wrong way” towards the lungs rather than the stomach) at which point I asked if I could interrupt and give a little advice. After giving my two cents, to which I’m very grateful the staff member was very receptive to, the child did not aspirate for the remainder of lunch J It is very difficult to attempt to totally change a lunch menu etc.. but many of the children struggle with certain types of consistency (one girl had huge problems with the strighy veg but no problems with the ugali) so I’m planning to ask the school if they may purchase a blender to be used for the certain children which hopefully wouldn’t take too much extra time/effort but yet would ensure safety and enjoyment of eating for the kids.

The aforementioned interesting client was a 3 year old who has excellent social skills (eye contact, appropriate smile, handshake etc..) but who from the single assessment session I did with him does not seem to have a concrete understanding of basic words (nouns) but the interesting thing about him is that his spoken language is complete jargon. Unlike babbling, he looks directly at you and has a conversation with you, complete with prosody, tone, different length “words” but all totally jumbled up word sounds, none of which make sense. Additionally he presents with echolalia - the process of hearing a sound and repeating it without processing meaning - however he copies the syllable structure/prosody/tone of the word but as with his natural spoken output the sounds are completely different to what was originally said. For example I said “aaahhh”, he said “mmmmm”, I said “baaaa”, he said “tuhhhh”, I said “mmmm”, he said “aaaahh”, I thought I’d repeat the sound “mmmm” to see if his output was the same again; he said “puuhhhh”. Positively, he uses basic gestures to communicate needs such as hunger/toilet and can understand through use of basic gestures also. As the family live directly in between Kisumu and Vihiga I have passed the case on to Racheal as she has 4 years experience over my next to none and makes sense!



Thursday - School visit and the first ever Stammering group in Western Kenya!
My plan for the day was to visit 2 schools - the first was Pandpiri a large school (1600 pupils) with a recently attached special unit. I visited a few weeks ago and the two biggest issues of the unit was that half the children shouldn’t be there - they should be in their normal mainstream class with extra support from teachers during or after class in the areas they are struggling in and that the person in charge of the unit was the deputy head who is not trained as a teacher, only 3 months into special education training and has other jobs to do as deputy and thus the kids do not really have much structure/learning in the class with long periods of time left alone. On my arrival I was delighted to see that the children I mentioned that I felt would benefit more being in mainstream had been moved out of the special unit :) ! Working with the Department of Education we are trying to get funding for a professional and appropriate full-time teacher to take the special unit rather than the situation in which the school currently finds itself in. The rest of the time there I wrote up an individual advice sheets for 3 children who would benefit most from specific strategies and support when the teacher is giving instructions (e.g: always show objects or gestures together with instructions, use slow simple language etc..) or when the children are attempting to answer questions (e.g: give time, choices, use phonological prompts) aswell as the level at which these particularly children have solid understanding and the level at which work should be done, that they are developing into.

The second school was where I had planned to hold a stammering training/group as I saw 14 children 2 weeks ago with stammers. This was the first ever meeting of it's kind in Western Kenya and I can die a happy man thinking I've actually achieved something pretty decent(!), the key is to carry it over month after month including after I leave! After getting all my resources printed I rushed across town on the back of a bike in the scorching hot sun, adding to the sweat already building from the nerves! When I arrived there were maybe 4 parents which I thought better than none but there were no teachers to be seen. This really worried me as the main crux of the training/meeting was support strategies for the children in class and for the kids, parents and teachers to discuss difficulties,.. After almost 45 minutes of rounding troops up we ended up with 15 pupils (of the reported 17 who stammer), 9 parents (7 of which were fathers which was a total surprise as 95% of the people I see are brought by mothers and mothers alone) and 6 teachers (all the form teachers of the stammers bar one child). I thought the session went quite well with some hands up points to show the teachers/parents things that could really help. There is a well-used model within the Speech and language profession of an iceberg to describe overt issues with stammering (those we can all see and hear - above the water) and those covert (the feelings of the people we cannot know - underneath the water). It is widely thought that the covert feelings as those that need working on to reduce the overt features (e.g: If the environment is accepting and knowledgeable of stammering and the student is supported in class they will feel less worried/fearful etc.. and will potentially speak more/stammer less. As icebergs aren’t exactly common in Africa I switched the model to a crocodile which one od the kids thankfully drew for me - whilst asking the students on a word to describe the feeling they have surrounding their stammer these are what came out: Ashamed, strangled/constricted, why am I different?, afraid of what others thing/teasing. Another quite powerful moment I thought was when I asked everyone to take a few minutes to read some poems written by some Kenyan stammerers - the information was provided by the Nairobi stammering group. Below is the one that I think holds the best impact/feeling -

I’ve not been me.

My heart beats faster,
My chest pounds with terror and worry,
As I hold up the phone,
To dial and stir up a conversation,
My lips swell, eyes close,
As I struggle through “Hallo”
Oh what a frustration!

My tummy fills with anxiety,
My name stuck in my throat again,
A flutter of desperation,
How do I introduce myself?
Switch words, avoid others, hand signals,
I silently whisper to self,
Wishing I didn’t have to do this.

Oh, I despise this thing!
This thing inside me,
That’s bound me with tight grips,
That’s made me its prisoner,
Silently, I wish it was easier,
To say my name, to say “Hallo”,
To speak my mind, to raise my voice.

Time alone, I spend,
Wishing I could control my speech,
To hold discussions in class,
To read aloud without panic,
To express my interests,
Without a sunken heart,
Without a desire to run,

By Everline Muthoni, 24

To finish off with each of the students got to sit down with their teacher and fill out a form which had different circumstances in class e.g: reading aloud, answering the register, answering questions and they could tell their teacher how best to support them, below are some pics of them filling out the information which will be shared across the whole schools staff hopefully:

As we were taking a photo for the record, I asked everyone to hold up a poster for “International Stammering Awareness Day” and an event held in Nairobi. Out of nowhere one of the teachers, in fact the teacher who was the original reason for me visiting the school exclaimed “we should have our own”… and thus next Saturday will be an informal picnic type affair and I’ll be doing my best to spread the news to schools in Kisumu where kids, parents and teachers who are affected or interested in stammering may come along. I’m even getting a shoutout on Kenya’s no.1 radio station on Wednesday courtesy of the Nairobi group who are being interviewed!

Friday - Kakemega training
Went to a lovely place a few hours away to watch the 2 SLT’s from just north of me do a training session to around 30 teachers from different schools. Was really helpful to see a full-day training session, different ways of presenting, giving examples etc.. which will all really help contribute to the training sessions and information I give our across the district.

In other news, I’ve been venturing out at night-time quite a lot with my little mobile phone torch to meet friends nearby… I feel much safer and comfortable after having done it a few times but I still make sure I’m in by 10 which I’ve been told is kinda the deadline for safety in the neighbourhood! Also it is just getting hotter and hotter. Got sunburnt today for the first time (which is a miracle considering how pasty I am) and it will get worse through til February. Hot hot hot.

Loads of love and hugs

J xxx

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

Top 3 Itunes songs on shuffle whilst writing this:
1. Fine - Alkaline Trio
2. If you got the money - Jamie T
3. The horizon is a beltway - The Low Anthem

My first training session! (and some other bits)

Only a shortish post to catch-up-to-date before I get lazy!...


Funniest sayings of the week

“My son-in-law, have you washed your hands before eating? . .  I am being serious - I want to see my grandchildren”

“We Kenyans, when it comes to taking a drink or food, we give you a “choice”, like tea or coffee. There is no choice in not taking something”

Places where people have thought I come from on first guess: U.S, Italy, France, Israel, Germany, Holland.


Thursday - First ever training session!
I carried out a 2-hour training session for 13 members of staff (11 O.Ts and 2 ENTs) at the hospital where I work. I found it really difficult to try and fit into 2 hours the most basic relevant things about speech and language therapy (developmental norms, things to look out for and also some specific client groups/difficulties I’ve seen a lot of in the hospital) but it went pretty well so was dead chuffed! There were a couple of things I definitely wanted to drill into the staff concerning facts that are widely believed here that have little to no evidence behind it. Firstly, that cutting a tongue-tie leads to improved speech (I did a true or false quiz and all 13 people thought this was true) and secondly that a very strict diet (cutting out all wheat, dairy, many many fruits, nuts amongst literally hundreds of foods) leads to a reduction in autisitc behaviours. It was nice being able to talk about these things and discuss them (there were a few questions et.c.) without feeling like I was insulting the way things are done here by clearly stating the facts/evidence and comparing for example the very limited research on the role of diet in children with autism in the U.K and Kenya (at times completely opposite!). At the end I asked for feedback as this was the first time I;ve done anything like this and whether true or not one lady said it seemed like I’d been doing training for years and another commended me and gave me some ideas for the next session which was awesome. The guy who helped organise the training, Wesley Snipes look-a-like Winston (see previous posts) is so keen and motivated for me to do as much as possible and stood up at the end to give thanks and that anytime I want to do training “we are in” before saying how important they feel it is given the lack of service and knowledge here. It’s so so so great to have someone like Winston in my camp, someone genuinely interested and passionate about not only my area but special needs in general and I am unbelievably thankful for that.

Friday -  Oromotor stuff and Hospital tea
As mentioned, working with swallowing difficulties is something I’m doing a lot of here and for some unknown reason to me I’m massively fascinated and drawn to this area of speech therapy. Whether it’s the fact that there is a risk to life involved which makes it seemingly more important, whether it’s because it’s fairly medical based or whether it’s due to the fact I love food so much that I have a passion for people to enjoy and be safe when eating/drinking food it’s definitely an area that at the moment I want to train further in. Many of the children I see have limited tongue movement so oro-motor stimulation/movement is something that may be of use both for the act of eating but also making a variety of speech sounds and this week I saw a child of 7 who had no difficulties receptively, excellent non-verbal communication (gestures, pointing, facial expression) but could only make bilabial sounds (b, m, p) and vowels. Although there is nothing in the case history I took that would account for this lack of movement, it seems likely to be one of, if not the reason the child cannot say any words other than mama, baba, pi (water). As I’m newly qualified and not specifically trained in any areas yet, I gave my supervisor a ring as this is an area she has lots of training and experience in and rather than giving some generic ideas to promote tongue stimulation and movement I was given some straight forward basics that are part of an entire oro-motor program which hopefully we will follow through with the client and fingers crossed maybe see some results :)

After a fairly normal day at the hospital I took tea (that’s how everyone says it here and it’s rubbing off on me!) with a few of the staff and talked about life in general. Similar to above, one of the O.T’s, David is so passionate about his job and special needs that he has a stipend for travel and lunch but essentially volunteers EVERYDAY at the hospital, leaving his house (which is miles away) at about 5am to start by 7.30. Winston on the other hand has a paid job at the hospital but as he is supporting a family of 3 (fairly small considering we are in Kenya) he works most of the time at the weekend doing private work to earn more money - as Winston put it “Kenyan’s don’t relax when it come to the weekend, they hustle”. After hearing from my supervisor at the EARC that many teachers in special needs are not passionate/bothered/care about the area but have just trained in it because the pay is better it really is lovely and encouraging to find people such as those who I work with at the hospital who care about their clients and genuinely enjoy working with them.

Weekend - Properly relaxing!, a night out and surprise surprise footy!
For most of this weekend I have been a bit of a lazy bugger but doing a lot of needed chilling out, reading (1984 is pretty awesome - who would’ve known non-comic reading could be fun haha) and spending more than my normal measly budget on some delicious western foods including one of the nicest chocolate milkshakes I have ever had which I practically inhaled. Saturday a.m awake and at 'em by 7am to meet the kids and walk to town for our final game of the season - ended up a pretty fair 0-0 which makes us finish 3rd for the season. As I've said everyone takes footy so seriously here and I subbed off 3 kids in the second half so as many of the kids as possible could play in our final game. I wasn't quite expecting a little backlash by a couple of sulky kids who were taken off even though I explained to them why I was taken them off - not cos they were playing badly but because we are a team and everyone should take a part in the last game of the season. Children need to be children out here I feel sometimes and many are grown-up before their time due to the amount of independence they have or responsibilities they have at home/within the family. In addition to all of this, the seriousness that people take football makes matches a bit of a pressure cooker where I think fair enough we want to win etc.. but these kids are under-10 and should be enjoying it first and foremost rather than anything else! Saturday night I was invited out with my new best mate - who am I kidding, my only mate in Kisumu - to meet a load of peace corps volunteers who were in town for a night out. Was slightly taking aback when stepping into a room full of white people(!) but after a few drinks and being the only non-american/peace corps person it was pretty easy to regain all the social skills that have run away from me over the past 2 months - ended up going to a bar/club til 2am chilling with beers and chatting the night away - only my second time out since getting here pretty much so was real nice to do something a bit different J Annnndd up-to-date today, Sunday, been continuing my new found love of reading non-comic material, watching a bit of footy, embarrassing myself by thinking I saw the biggest avocado in the world which was actually a papaya and writing this! Looking forward to a skype with the Fagan clan tonight as it’s been a while! Just hope electricity continues it’s good form for the evening!

Have a wonderful week everyone and thank you for continuing to be bored enough to read my ramblings,

J xxx

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

Top 3 Itunes songs on shuffle whilst writing this:
1. The same old innocence- Architecture In Helsinki
2. La - Old Man River
3. Don’t stand so close to me - The Police

Kenyaisms, Role models and Stigma

My Favourite Kenyaisms (so far)


“Pole” pronounce po-lay - which means sorry. People say it to you when you fall over or drop something even though it is not there fault whatsoever!


“Flash me” - Phrase that is used for someone to drop call you. Not show your genitalia.


“Can I ride you?” - Motorcycle drivers asking to take you somewhere. Not the bedroom.


To “Xerox” - Slang for when someone copies off another person in class/exams etc..


Friday - Frustration
Alongside seeing 2 clients in the morning who were both booked in and both turned up :) My main aim for the day was to assess swallowing difficulties in the CP class at the school where I’m kind of based. There is “drinking” timetabled for 10.30am and then lunchtime where, although I’m expecting very little staff and support ,was told “home mothers” come to help at mealtimes. I arrived at the CP class at approximately 10.32am to which I was told drinking had already finished. Hmm. Then come lunchtime, the CP class do not sit together so it was difficult to try to establish who I was potentially meant to be observing, however good news was I did not hear much coughing at all (a big indicator of food “going down the wrong way” into the lungs instead of stomach) but on the bad side the “home mothers” solely helped out in the kitchen serving and giving food out. Not a single staff member was present to help support any children, which is a little crap to be honest as it is the biggest special school in Western Kenya and many of the children have physical and or mental difficulties prohibiting them from (I imagine) self-feeding efficiently/safely. So the lack of coughing may have been more to do with children not eating food, or silently aspirating on food which would only really be discovered through either chest infections or loss of weight present and can only really be checked as far as I know via technological means which are not available here. I booked in for me to watch “drinking” on Tuesday with a view to getting all the kids together at lunch to observe feeding and give training to staff who may be encouraged or even forced to help out as I seriously doubt that the entire school’s children can self-feed efficiently and safely.


Weekend - Chilling out and footballing
So the weekend (as most are here for me) was mainly football but something I wanted to say was that I didn’t realise how much people in the media in general, as a point footballers, influence children and are all role models having a huge impact on children not just from their country but all over the world. Some of the kids I coach dive around trying to get fouls and one of the loveliest kids who got sent off today (mark my words, if he continues to play he will be in the Kenyan team one day - a phenomenal defender) acted exactly like something seen at a world cup final. Looked around in dismay for a bit, hands on head, shirt over face and skulked off the pitch. We drew 0-0 which was good considering we were a man down for most of the second half. 3rd in the league with one game left. On the Sunday I went to a local field where out of nowhere a sponsored tournament had been set-up with a DJ - tune of the day -
http://www.youtube.com/watch?v=9fV5VdFcWLU, 
a live crazy commentator, professional refs, the full lot. It’ll run every Sunday til December. First game = huge 22 man brawl. I cannot understate how seriously people take football here and how obsessed the nation as a whole are with it. Kinda lucky it isn’t something that I don’t like or couldn’t get involved in, like brussel sprout eating.
Only other notable points of the weekend were finding a place that does proper good coffee - was heaven on earth. Yes, you heard me right, Kenya, which grows some of the world’s best coffee beans cannot do coffee at all on the whole. What is the world coming to. Also I met a local mzungu who by default must now become my best friend, a North Carolinan (Carolinian?) who only arrived a few days ago she lives right wrong the corner from me, is involved in healthcare (malaria projects) and likes beer. Score.


Monday - Sensory issues
A fairly bog standard busy day at the hospital, seeing a fair number of clients who I have previously seen and a few new ones. The biggest issue of work at the hospital for me is that a vast number of the children I see have HUGE sensory issues nearly all of which are hyposensitive meaning they are constantly in the need of touching, smelling and/or tasting things. Due to this they have either an inability or a very reduced ability to be still and focus their attention on anything. Focus and attention are the basics when it comes to communication - these need to be in place to learn through looking and listening which leads to understanding then vocalizing and ultimately pronunciation (in the normal development of a child). Without this in place the children whose parents have come to me about improving their communication (verbal or non-verbal) will not be able to learn effectively. Thus for these children I can offer little help other than general strategies/activities for focus and language development until their sensory issues have been reduced which is an area that the O.T’s deal with here and an area I have no training in :(


Tuesday - CP drinking class
Apart from seeing two clients booked in for me by other members of the EARC and doing general admin stuff the main aim for the day was the aforementioned class which I’ve been trying to see for an age! I realise I have to be very tactful for anything I see as things are different out here overall and taking advice from a white westerner may not go down so well if I butt in or try and change things there and then etc.. So I started by explaining why I wanted to watch and what I was looking for and for the teacher to do the class as she normally would, ignoring me (which some people do anyways!). Much to my delight, all but 1 of the children could self-feed and out of 14 children, only 3 showed outwardly obvious signs of difficulty (coughing). One child has an exceptionally bad position/posture whilst drinking, another has positional difficulties also (possible spina bifida) but absolutely chugged her drink, whilst the 3rd was the child who the teacher was feeding. This child has very little head/neck control which is a major cause for concern when it comes to feeding - the teacher was doing an awesome job keeping his head straight whilst he took drink from the cup but as soon as it was in his mouth she would let go off his head and it would either flop forward or yank backward. The only other thing I advised her on (along with the individual stragies for the other kids) was to use a spoon towards the end of the porridge as the child can’t take the porridge into his mouth from that angle, she is pouring it down his throat somewhat. The teacher was absolutely lovely, understand why I was advising these things and I plan to ask the guys who make supports etc.. to come up with something for these individuals and come back to observe next week. It was planned for next Wednesday the CP class all be together for lunch for me to observe and advise.


Wednesday - Stigma
A fairly quiet day for me at the clinic with many of the children who came in specifically for visuals, follow-ups for something else etc. Which I was a bit thankful for as tomorrow I am delivering my first training session eeeekk.
Stigma isn’t something I’ve faced massively here although it is rife throughout the whole of Kenya and Africa when it comes to disability, however today there was a 16 year-old child who came (with his grandmother) to the clinic for placement in a place of educational learning. He had stopped going to school due to the way he is being treated by staff and peers and does not want to return to the school and at the time of writing had no interest in going to a mainstream school of any kind. The child’s disability is solely a problem with one of his legs and he walks with a limp. The stigma that has been pinned onto his disability has made him totally drop out of school and have no interest in returning to education unless it is a special school where chances are he may not be challenged to learn as many units/schools have moderate to severely disabled children mentally as well as physically. It really saddens me to see this tiny slice of stigmatism and the work we as well as other healthcare professionals are doing out here aims to address this - acceptance, knowledge and understanding.


Have been trying to catch-up on it all as been a bit lazy so have been writing this from my laptop at a rooftop bar with wi-fi place (the only one in Kisumu) overlooking the town and Lake Victoria. Not bad eh?! So next on the agenda my training (which didn’t go horribly yippee), hospital and weekend (and breathe)..


J xxx


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


Top 3 Itunes songs on shuffle whilst writing this:
1. Fortunate Son - Creedance Clearwater Revival
2. Peace & Quiet - The Rifles
3. Anymore - The Car Empire

A little story I wrote..

This was a little story I wrote for an English readers and writers club thing I went to a while back (when living in Japan and not yet applied to train to be a Speech and Language Therapist) and is pretty much the first (and last) thing I have written since school.. Anyways, we were given the topic of "birthday" and this is what I came up with. I'm kinda proud of it cos it's not absolutely terrible, but also I hope it gives the merest sense of feeling as to what someone with a communication problem feels like. Hope you like it.


Arthur

A single candle lit his haggard face. It was his birthday. As I gazed upon him, wrinkled wise like the spine of a book, yet with softness like the folds of a duvet, I realised this was no cause for celebration.


It has been almost exactly a year since I was brought into this hospital. I cannot communicate properly or express myself. I am bed-ridden... Trapped in my own world, the lines between reality and make-believe are becoming increasingly blurry. I am a stranger both unto others as well as unto myself.
Who is this man staring at me?


As I stared deep into his weary eyes, I wondered what was going on behind them. “Happy Birthday Arthur..”, the words came out as if I were a depressed robot. I could not even bring myself to say it with feeling. It was meant to be a celebration of his birthday whereas in fact it was the exact opposite. Life was ebbing away from him and there was nothing that could be done.
I dab at the corners of his mouth to put a temporary stop to the seemingly never-ending flow of saliva. I stroke the wisps of white hair emanating from his scalp. I do everything I can to comfort him. How did he end up this way? Was there anything I could have done?


He is still there.


As his frail curled hands clasped to my fingers, any semblance of happiness left in me disappeared. My heart skipped a beat. As I looked at him through blurry eyes, for some reason I just knew, this was it. “Make a wish...”


365 days, 8760 hours, 525600 minutes. Death could not come one second too soon.


He passed away that evening,
Arthur. My son.