Such a difference...

I’ve been staying with Isis (another SLT volunteer) in Mumias this last week. Not only has it been lovely because of the company in the evenings, but also, the joint working (I’ve missed that) and how much of a team the staff at the EARC there are.

It’s made me realise that at the moment, there is no MDT working at the Vihiga EARC, especially between the SLT’s and the assessment teachers. This definitely needs to change asap because I have seen how much of a difference effective collaborative working can make here...

The EARC in Mumias is more established than Vihiga, especially when it comes to SLT work, and this is because there have been a flow of SLT volunteers there for the past couple of years. As a result, everyday a child came in for SLT assessment, there was very little ‘thumb twiddling’ time and in one week Isis ran two training sessions. Working there for a week has definitely made me much more focused in my ideas on what I want to achieve in Vihiga when all returns to normal in September.

Things that have shocked/surprised me this week:

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•             During some training Isis ran for staff at Butere Hospital, one of the doctors stood to comment about a husband and wife who were deaf (and dumb – as they continue to be called here...) who had a child. That child was not deaf, so the doctor felt it was best to remove the child from the family in order to prevent him from becoming ‘’dumb’’ too...

• ·        A child who has Autism is being ‘treated’ with an adapted diet, which basically means the parent has to cut out all wheat, dairy, sugary, some fruit and veg and animal based fats/oils from their child’s diet. This is being recommended by the Kenyan Autism Society who has a whole load of foods that a child with Autism should and shouldn’t eat to help moderate their behaviours. I’ve read their hand-out about it... It’s all contradicted by itself and is clearly sponsored by a cooking oil company, which is ridiculous. I asked the mother if the diet had had a positive effect on their child’s behaviours etc. unsurprisingly there had been none!!

• ·         Caning is illegal here. Yet, I was told that 10year old Andrew is repeatedly caned by his teacher because he is struggling in class. Andrew was brought to the EARC by his father, he attends an academy school (one that you have to pay a lot of fees to attend) that’s on the site of the Mumias Sugar Factory. For the first time in what feels like forever, Isis and I carried out a language assessment (my first one here) to look at his expressive and receptive language skills. Andrew is a really bright boy, he’s 10 and we were giving him all of the instructions in English and he understood all the directions. We concluded that Andrew has significant word finding difficulties, which are made considerably worse when he is put under pressure. He is coming last in his class, a class of 43 with 1 teacher – you’d think that because it’s such an expensive school, there would either be smaller classes or teaching assistants... – and he told this on a daily basis, and caned to add emphasis to the point.

We met with his class teacher and I had to bite my tongue to not say anything inappropriate/rude to him about his treatment of Andrew. It’s just really bad timing now because the schools are shut for a month so no further input can happen until September.

Things that have been amazing this week:

·         Working with Isis to support a little boy in developing the use of PECs and observing him request for things consistently throughout our session, as well as making eye-contact with all of his communication partners... including his father.

·         Helping Isis persuade a mother of a 7year old girl with Cerebral Palsy, who has excellent understanding, that developing a communication board would be beneficial to her daughter. This was the fourth time Isis had spoken to the mother about the option of AAC, and we think (hopefully) she is starting to come round to the idea.

·         Meeting even more wonderful people who are determined to help and support children with special needs, even though they are faced with challenges unlike any we see at home everyday...

I am going to Kampala, Uganda for a meeting this week (as you do – just popping to Uganda for a meeting!!! Haha, love it!!) to help set up an association for Speech and Language Therapists in East Africa. There are about 10 speechies in Kenya, all are international. 13 qualified from university in Kampala last year, and about the same will be qualifying again this year. There is no organisation to moderate and support the profession here yet, so that is the aim of the meeting. I’m sure it’ll be interesting, and a great excuse to visit Uganda...

five weeks in....

I cannot believe I am at the end of my 5th week already!! Time is flying by, and in a way, I am kind of glad it is. Means there's less time to dwell on things..
It's strange, I spoke to a friend this week and was telling her the story of a little boy I had seen that day. Normally, I just deal with the immense poverty I see here and the fact that it's just 'not fair' for the children I meet, but telling someone about it, that's not experiencing it too, made me cry about what I am seeing for the first time.
It's been a busy week this week (although not today, because Wellington and David have disappeared on respective holidays, so it's just me... and because my Swahili has not reached beyond basics yet, I decided to have some of today off too!!!) Thankfully we've finished all the sorting of the grants, so now we can focus properly on meeting people and introducing ourselves to everyone.
Last Friday was meant to be the day of handing out school uniforms to children and teachers from across the county. The chair of the company, Safaricom, who was meant to distribute the uniforms didn't turn up. This meant nothing could be given out!!! SO frustrating!! However, a man from the Red Cross came and discussed with all the teachers opportunities for them to apply for grants from the Red Cross. This is a new thing from the Red Cross to donate to people with disabilties... Hopefully lots of children and schools will benefit from this proposal..

I visited 3 new schools this week. Madzu, Moki and Inyanza.
Moki is an inclusive school which means the children with special educational needs are integrated into the mainstream school. We had a meeting with the headteacher and the SEN teachers, I tried to find out how they supported the children's learning needs within their teaching, and it is clear that they don't. However, they were all genuinely very keen to attend our training and were fine when we told them we wouldn't be paying anyone to attend the course. The headteacher called into the office a group of children with actual speech problems. When I say actual I mean children with dysfluency, lisps, phonological delays... I have never been so excited to meet a child with a phonological delay!! Normally the teachers aren't aware that as an SLT I work with children/adults with speech difficulties, who are cognitively able, rather than just introducing the children with CP and learning disabilities to me!! A novelty!!
It was quite cute when we were taken around to be introduced to all the classes - the children all welcomed me by standing up and clapping. A couple of the classes sang to me.... I was also introduced as Rachael, from England. Not the 'mzungu' Rachael... If only that happened everywhere...

Inyanza school has a very new unit attached to it. There are 2 teachers for the unit, which is amazing in itself!! However, due to the school being in the interior (really remote) the teachers have had to fight to set up the school. The discrimination against children with disabilities is rife here, there are meant to be 7 attending the unit, however only 3 come. The other 4 children's parent's don't bring them to school because they don't want their communities to know they have children with disabilities, as they all believe the children are cursed. This is the first time I've heard someone properly say the word 'cursed'.. I was shocked! The 3 children who attend have to be escorted home, this is because they are at a high risk of being raped or attacked. They leave before lunchtime incase any parents of the 'normal' children come to shout abuse at them and their teachers. It's just horrendus to hear about. Thankfully the teachers are AMAZING!!! So dedicated to the children and to teaching them. I will be working a lot with them as of September and I can't wait..

I observed an end of term assessment in a CP class as part of Joylands Special School which is where the EARC in Kisumu is based. The child I observed being assessed was called Brian. He's 8 years old, very bright with very severe CP. Brian looks like one of the children you're seeing on the news at the moment. His thighs are thinner than my wrists, he is so malnourished, has a nasty chest infection due to aspirating on most of the food/drink he is given, he had wet himself and none of the teachers were cleaning him up (I was there for almost an hour, and no one cleaned him up, in the end, I had to tell the teachers to do it! - in fact, most of the children were sitting in their own urine..), his face was covered in dried dibble and snot and flies were all over him. Crawling on his lips, his eyes, ears and up his nose... No amount of waving them off would get rid of them..!! Due to the way he was being assessed: by getting him to say the answers, he was getting most of them incorrect. Mainly because he couldn't say them... So, I told the teacher to get him to point to the target picture. He then got them all correct!!
Thankfully there will be a full time SLT in Kisumu as of September and I know that having a constant presence there will make all the difference...

As much as there are difficulties here, I am loving the work I am getting to do... It's the biggest challenge of my working life, but I am learning lots. September will be a good month because that's when we'll be able to do a ton of training of teachers and hospital staff.. Plus, people are aware we exist now. We even had a direct SLT referral the other day from a health centre!! breakthrough....

"choo"

Finally. An integrated school, that actually (almost) does what it says on the tin!!! Visited Matagaro Primary school this week, which is a primary school that has a special educational needs (SEN) unit attached to it. Not only is it on the school’s site, but some of the children have actually been integrated into the mainstream school and all of the children have break at the same time. Admittedly, this is to much disgust from some of the parents of the ‘normal’ children, because they believe that their children will ‘catch’ whatever difficulties the children with special needs have. They think that if their child interacts with, or even walks on the same ground that a child with epilepsy/learning disabilities/cerebral palsy etc. etc. has walked on, then they will be infected!
I’d love to be able to change the attitudes of these parents, but I know that it won’t happen in the time I am here. I just have to be grateful that the head teacher and the staff at Matagaro believe in giving all children, whatever their need, as equal an opportunity as possible.

Having the head teacher on side is definitely a novelty! The head teacher at Matagaro has a background in teaching children with SEN, it was so refreshing to observe him interact with the children in the unit as he would with any other child.
The other novelty factor of this unit was that every child was introduced to me by their name, not their disability, they were all engaged in a craft activity and the little girl with severe CP was in an adapted chair to support her physical needs, whilst taking part in an activity…
When we discussed the training and support we’d like to offer, the head teacher and class teacher couldn’t have been any more enthusiastic. And not because they thought they would be getting paid to attend our training… I can’t wait for September to come when I can properly get involved with this school and I know that I will be fortunate in working with receptive staff and the loveliest of children.

I visited the Kisumu EARC this week to support them in their assessment day. They’ve not had any SLT input for a long time, so it was felt that before their long term volunteer, Jonathan, arrives it would be beneficial for me to attend on a couple of occasions so that people start to become aware of SLT and what we can offer.
I realise how blessed Vihiga EARC is after spending the day in Kisumu. Vihiga has a recently renovated conference centre in which there’s plenty of space to hold conferences and training days, run our CP clinic, assess children and store all our resources. We’re also looking into soundproofing a room (with egg boxes!) in order to be able to offer proper hearing tests. Kisumu EARC is on the site of Joylands Special School, it has an office, a store room and a small room in which assessments are carried out. There are limited toys, and often not all of them are offered to the children that visit because they are likely to be stolen. However, the staff team are wonderful! Again, they couldn’t be any more welcoming to me, as were the parents of the children I assessed.

What frustrates me the most here (and there are a lot of things that annoy me…) is that because this is an underdeveloped country and so many of the children I see and assess are from unbelievably poor backgrounds, there is no opportunity for them to receive support like the children I have worked with back in England have. For example, in Vihiga I assessed the most beautiful 6 year old girl called Latifa She has cerebral palsy, her birth mother has abandoned her, so her step mother is her primary caregiver. Her comprehension is age appropriate, poor gross motor skills and has to be carried everywhere (it’s too expensive to buy wheelchairs here..) and very limited speech. However, because she was born in the slum, there is no way her family will ever be able to access any kind of vaguely high tech communication aids. Even low tech, especially if they involve a printer…  At home, there would be options for a little girl like Latifa. She did however, suck through a straw for the first time during our session and attempted to say Rachael - I let her off with just calling me “choo“!!! 

Tomorrow (Friday 15th July) we have an event at the EARC. Safaricom (the main telephone/internet provider out here) and the Red Cross have teamed together to provide school uniforms for hundreds of children across the district! I can’t wait to see their faces as they receive uniforms that fit and haven’t got half of them missing..

".....and this one's Autistic...."

As if I'm nearing the end of my third week in Vihiga already. In some respects I'm glad, because it has been a boring week doing more sorting of the grant. And no, our report and all the receipts and photographs haven't been collected, so we're a week over the deadline which means there's pretty much no chance Yellow House will receive the same grant next year for Vihiga. SO frustrating!! One things a definate though, I will never change my job to be an accountant after all the money handling and receipt counting I've done this week! I think I'll stick with Speech Therapy..!!

Wellington took us to a Special Educational Needs (SEN) unit he was really proud of this morning. The main reason he's so happy with it is because it's attached to a mainstream school which obviously therefore means it's an inclusive school. This is a novelty here and very forward thinking. However, just because it looks good on paper, doesn't mean it's working.
The school itself has 550 pupils, of those 550, 17 attend the SEN unit. The unit has no pictures, is dark, has four wooden desks which all the children squeeze on to, apart from the little girl who always sits under the desk. She's 5 and has spent the whole of her 5 years up until recently tied to a tree.
There's another girl that often sits at the front in the middle of the floor, she's an exception to the class because she was ''allowed'' to attend the school even though she hasn't achieved the milestone of self toiletting. As I was going round to all the children in the class, I was being introduced to them by their name, they all welcomed me with big wide eyes, clearly thinking - 'who is this mzungu (white person) in my classroom??' I got to the girl that's on the floor, I don't know her name, she was introduced to me as "and this one's autistic"... For a child with Autism she had excellent eye-contact, constantly sought my attention and wanted to engage with me....
It's so difficult not to judge the teachers and whoever has made the diagnosis that a child has Autism. I know a lot of their thinking is as a result of a complete lack of awareness and education in the area of special needs, however it's hard not to get angry with them for labelling a child in a way that is going to be detrimental to their upbringing.
I got asked for money today. I knew it would happen, but I didn't expect it to be from a headteacher. I am gradually learning how to respond to the weird and wonderful things people say to me in the street, however to be sat in a headteacher's office and for her to just come out with 'well you're a mzungu, you must have some money I can have for this school'.... I found myself speechless.
Wellington keeps reminding me that the colour of my skin immediately makes people here associate me with wealth.

On the back of the school visit today, David, Wellington and I all sat and started generating realistic ideas of how we can run training sessions in schools. We want to do it in a way which means it isn't the Ugandan or the mzungu giving people information and them taking nothing on board, apart from the annoyance that we haven't paid for them to attend the training - oh yes, that's how it works here, if you want people to turn up to training you have to pay them... Not something I'll be reinforcing.... So instead Wellington and the other staff at the EARC are going to run the training and we're going to attend as a team. This will hopefully be a more sustainable way of keeping SLT awareness going after we have left..