Breasts, work and play

JAMBO!!!


Hope this update finds everyone just fine and dandy... As with previous update I’ve been doing a half decent job of occupying my free time with non internet/computer related activities and also just think highlights/lowlights is the way forward rather than boring the life out of you guys with day-by-day plays especially when I’ve gotten into a routine of seeing some clients on a regular basis.

Funny/interesting stuff from today (there was so much today I thought it would suffice!)
Soooo to start off with today, Monday, I managed to get myself onto a 3-day early childhood feeding course at the hospital and along with an entire day of learning about the world of breast-feeding were some absolute crackers harked out by the presenters/staff present:

Presenter: If there is only one small bed in the house not big enough to accommodate all 3 child, mother and father who should sleep in it?
Staff member: The child and mother should sleep together, for bonding and breast-feeding. On the floor.

Presenter (about 30 times in the space of 2 hours): If Obama can do it, why can’t you? Say yes we can. (I’m not quite up to date on my politics but I don’t think Barack has been trained/giving out breast-feeding advice)

Presenter: (every time when giving an example difficulty with breast feeding): So will you help this woman? (probably the most ridiculous question I have ever heard considering the staff present (Mostly paeds, midwives, obs/gyn) and it is never rhetorical.

Presenter: What colour should baby poo be? Yes, yellow. Like scrambled eggs. (there goes my appetite for one of my staple meals here)

Some fairly interesting facts that no doubt you will never need to know but are pretty interesting regardless:
0 out of 16 public hospital facilities in Nyanza province (where I live and work) are considered “baby-friendly” according to UNICEF / WHO guidelines

A common belief here is that witches at marketplaces (yes, it’s oddly that specific) bewitch new mother’s breasts which causes the clearer, more watery milk (“foremilk”) that is at the beginning of every feed. Due to this many mothers get rid of it even though it is nutritionally great for a kid just not as good as the dense white, nutritionally higher milk that follows (“hind milk”)

In some tribes/cultures the baby cannot be breast-fed until the baby has been named. This priviledge falls to the father and sometimes does not take place for days or weeks after birth. In these cases the child is fed salty and sugary water instead.

In some tribes/cultures once a Kenyan becomes a mother and produces milk, one breast’s produce is strictly for the father and one breast for the child.

60% of all Kenyan mothers are anaemic

Calcium and Iron are not pals. In the presence of calcium, Iron’s nutrients cannot efficiently absorb into the bloodstream and body. The presenter stated if you drank a glass of milk with dinner every night for 6 months your Iron content would reduce by around 25% (not sure how accurate this statement is mind!)

Highlights:
The child who I took to the epilepsy clinic as she was being dosed up to the eyeballs with drugs has been changing her intake and after never seeing her awake (even when O.T’s are going to school on her), she has been eyes open the last 3 times I’ve seen her!! :)  The dosages are still being altered but I hope to start to observe and give advice to mum in the next few weeks.

Training has continued to go great, especially at the two schools I previously mentioned where I delivered an Autism specific workshop. Disciples of Mercy have been great and responded to my request to have as many of the parents and relevant staff be there one morning so that I could not only give a brief hour long information session on Autism but also introduce some strategies that I could show to both parents and staff and they could then practice whilst I was there :) It was kinda a bit hectic but at least it’s a start and the most functional, easy way I could give information to a number of people whilst getting parents introduced to each other for some good old fashioned support. The tentative plan (though I’m not sure if time’s gonna make it possible!) is to home visit all 8 kids in the autism unit before I dissapear for Christmas to follow-up the session and take photos of things around the home to use in communication books and visual timetables.

I delivered pretty much the same workshop at Lutheran which could only happen on a day kids weren’t in (so teachers were free) but therefore couldn’t get parents along. However, the lovely headmistress was trying to organise a load of parents to come in tomorrow for me to mention the importance of attending the epileptic clinic  and give an autism workshop to relevant parents! Why can’t all heads be like this! Unfortunately this had to be nixed as I managed to get onto this early childhood feeding course which was an opportunity to good to miss really.

As I’ve mentioned previously a very high percentage of children I see at the hospital have swallowing difficulties, and along with this (for nearly all of them) one of the factors, if not the main factor, is oro-motor difficulties - difficulties with movement and or co-ordination of head/neck/jaw/lips/tongue. These difficulties also account for a number of non-verbal children I see within the O.T department. Therefore I was very thankful to have arranged for my supervisor to come down to attend to some of my clients, whilst I got a chance to learn a load about oro-motor activites and exercises that can begin to support children with the aforementioned difficulties. One of the most difficult things out here is probably the amount of children I see with sensory issues or oro-motor difficulties, neither of which I’m specifically trained for (being newly qualified) and it can be a bit intimidating/difficult when I don’t have much information or activites to do with these clients especially when it is their main difficulty/priority.

Over the past week I’ve had a number of clients referred to me from all areas of the hospital which is simply brilliant. It makes me think that at least some people have knowledge not only that I am here, but more importantly what I do and the types of clients I work with. An O.T who only works out in the field brought a non-verbal 7 year old to see me from their home a few hours away and from various other personnel I had 2 very different adult stroke referrals this past week with one being a lovely young man (32) who is exhibiting global aphasia (difficulties with both receptive and productive language) with very common characteristics such as word-finding difficulties (causing non-fluent speech) and some fluent unintelligible jargon-like speech. He has an unbelievable brother who is looking after him and takes notes at all meetings and is using all the word-finding strategies I introduced them to on my first meeting (examples such as talking around the word e.g: what category is it in? What size is it? What colour? What is it’s function? And giving a phonemic prompt - the first sound of the word). The client is great because even though he is obviously struggling with the impact of the stroke, he has a really good sense of humour and realises (at times) when he has made a mistake/when sounds don’t come out right and can laugh at himself. Something which I think is incredibly important when something as life-changing as a stroke happens. As a side note it’s also great to work with adults too as this is an area which I always thought I would go into and although I love working with kids, in my heart of hearts I still think adults is where I want to be.

Playtime :)
A couple of weeks back I bustled off to a place called lake baringo for the weekend with a motley crue of americans and brits (some of which are in a pic below). Although we only stayed for a single night, the 7 hour journey there and back was an absolute joy made awesome by getting to know each other (a number of people I’d never met before), drinking beer (don’t worry, the rental van came equipped with driver!) and playing games such as Kenyan road bingo (e.g: spot 4 people on a motorbike, an entire living room of furniture on a tuk-tuk etc.), The place we stayed was absolute heaven, the communal food was mind-blowing and drinking into the night on our pier overlooking the lake was beautiful. Even gotta see a hippo about 15 ft from our pier munching away for a good few hours :) The day we left we went on a little hike taking in some breathtaking landscapes and a couple of scorpions, rock hyrax and a snake. Good times.

Continuing weekend fun, this past one, on the Friday went out for some live traditional music and even got a little dance on (yes, I did have a number of tuskers) before Saturday was a day of afternoon drinks and games. About 15 people joined in am afternoon of corn hole (thank you America for introducing me - look it up before you assume it’s something rude), Stickcup (thank you Canada for introducing me) and a quiz hosted by yours truly (Thank you England for being the country I grew up in). Absolutely lovely stuff.


Lowlights

The only real lowlight was me being a bit on the ill side for the good part of a week which meant having to cancel on clients, appointments and rearrange my already frantic schedule! Oh and I’ve been writing this in the dark cos there’s something really weird going on with the power and the lights have been on then dimming then switching off every 45 seconds or so constantly for the past 3 hours. It’s even more annoying then having no power. And it’s taking me about 3 times as long going back over all the spelling errors. Effort!


Plan for the week is looking pretty eventful as am on this childhood feeding course until Wednesday, doing 2 or 3 school visits on Thursday if possible as nearly all the schools close up this week until January followed by a thanksgiving dinner (!) before Friday to Sunday going to a national park called hells gate for a bit of camping and wildlife. Woooooooooooooooooooo.

PS: Reached 1000 views!! Thank you all for continuing to be interested in my word vomit and work!

Huge hugs to all,

Jon x


Top 3 songs on Itunes shuffle whilst writing:

1. American Slang - The Gaslight Anthem
2. Love Is Rare - Morcheeba
3. Here I Dreamt I Was An Architect - The Decemberists