Not a rant in sight..... almost

Crikey, realised I’ve not written one of these for ages... 

Wow, what a busy, productive, fun and encouraging (as well as the usual frustrating) few weeks I’ve had.

I’m now officially an SLT training queen. Our goal for September and October was to train at least 2 teachers from every public primary school in the Vihiga District on the very basics of SLT. As I mentioned in my last post, it was a VERY basic training seminar, just 2 hours where David and I talked about speech and language, the development of communication and the different client groups we work with. The main goal was to find out from the teachers themselves what they wanted further training in, and we did this by asking them to fill in evaluation forms at the end of the sessions.

I met with the Area Education officer (AEO) today to discuss the results from the evaluation forms and to plan future training. It’s awesome how positive and keen he is, makes the whole process a lot easier. We have planned one full days training in November for half of the 60 teachers we’ve trained, and then the other one will take place in January. Annoyingly everything starts shutting down now due to end of year exams and the month off for Christmas, hence why we are splitting it in two. I feel it’s important to run at least one full days training before Christmas because I don’t want the momentum to stop. I keep meeting teachers who I have trained and they are so excited about further training, and are keen for us to come to their schools to support them further.

Not only are we training teachers in the Vihiga District, we have also run the 2 hour workshop in Emuhya, a neighbouring district for 34 teachers, and a full day workshop (with certificates provided!!) for 37 teachers in the Kakamega district. I was told by one lovely teacher that I was ‘empowering them’... bit deep, but I’ll take it!!

David and I have been discussing our role, and more and more it’s clear that not an epic amount of clinical work will be done by us in the time we’re here. However, I am happy with that. We’re not here forever, and who knows when the next SLTs will be in Vihiga, so I’d rather train teachers in strategies to support their learners with communication difficulties, to increase awareness that these children should not be punished for being ‘ignorant, dumb or thick’ and so that when/if the next volunteer comes the district is ready for them...

Talking of training, also now likely to be lecturing (pah!!) for two universities in Kenya: Mt Kenya and Bondo University Collage, who both run teacher training degrees in special educational needs... Very excited about this – fingers crossed it will happen...

Updates –

Tony: I wrote about this special little boy in August who has been abandoned and neglected by all who should be responsible for him. Unfortunately he never came back to the EARC which kept playing on my mind... There’s a student social worker, Francis, on placement at the EARC for 3 months and I set him the challenge of finding Tony. I could give him a name, his father’s name and his village. From that Francis could find out the village chief’s name and once he found him, could find out where Tony lived... Wish it was that easy... The Grandmother who came with Tony no longer cared for him. Not long after he came to clinic she ‘dumped’ him at his paternal grandparents. It’s so difficult not to judge this woman, because I saw for myself that she has very little money to support herself, let alone a child with stigma attached to him. However, he’s just that, a child. Anyway, thankfully Francis found the paternal grandparents and Tony (exactly the same as before, although no shoes in sight so grandma more than likely sold them!!) and requested them to come to the EARC the following week for assistance. Of course, I shouldn’t have been surprised, it was a no show!! Francis rang the grandfather and he said the maternal grandmother had returned for him and had taken him back. No idea why. So now, we’re back on the hunt for Tony again. It’s such a wild goose chase it’s unreal. However, we’ll find him and he’s going to be supported to attend a boarding school for children who are deaf and I have every faith that he will grow and develop so much more...

Tabitha – she’s the 14year old girl who has hearing loss, most likely as a result of malaria/the medication used to treat it. So, David and I ran a one hour seminar for all her teachers (27 turned up!!) to explain her hearing loss, what it means for her and to give really simple strategies on how to support her in the classroom. Wow, what an awesome training session. They were all so responsive, asked a million and one questions, laughed at my jokes (probably out of politeness, but still) and were just so keen to learn more about Tabitha and SLT. Following up after exams in November to check they have put the strategies into place and to catch up with Tabitha. I received a really nice text from the deputy head (oh, that was the other thing, both the headteacher and deputy head attended the seminar – unheard of!!) saying thank you for the training and that she really enjoyed my presentation style and it was a shame I wasn’t a teacher... Before telling me that a (and I quote) “naughty colleague of hers, liked everything about me...!!!” I’m now racking my brains to find out who this dashing young teacher could be!!! J

CP Clinic – THE MUMS ARE FEEDING THEIR CHILDREN APPROPRIATELY!!!! I could have gone round and kissed them all I was so happy!! And, what’s more. It looked so natural, so I think they’re actually doing it all the time rather than just for show for the white lady in town!! We had been providing tea and chapatti to everyone attending, but that was going against everything I had been harping on about to the mums. So we stopped. Instead we’re making and providing uji (weird porridge type thing) that is made to the ideal, safe consistency and we have demonstrated how to feed the child with this. And it’s working!! Hurrah for ‘tough love’...

Normally I have a little rant on here, but this time, apart from the ‘usual’ issues of late seeking of intervention: a 16 year old lad came yesterday who was ‘fine’ until he was 3 years old when he started having seizures that would last for 2-3 days, and these went on for over a year. Afterwards he lost all speech and is massively delayed. Without the joy of technology it’s pretty clear from his presentation that significant brain damage occurred during that period. Yet it’s taken his mother 13years to seek any help!!! Grrrrrrrrr.

The lack of resources in schools and everywhere, distance to all the rural villages which makes some children’s attendance ridiculously poor and stigma, it’s been a really positive few weeks. So, no ranting... Let’s hope it continues.

Bit of a mixed bag..

I’m just back from a few days in Kampala, Uganda. It was the second meeting for setting up the Association of Speech and Language Therapists in East Africa (ASaLTEA) and it went really well. Jon and Stella came too, and I think they quickly picked up that the group of SLT’s in Kampala are a passionate lot that will talk and talk and talk around the one topic for ages without making a decision. However, decisions were made, and on reflection I think a lot of the faffing is due to them being worried that this association’s main aim is to ensure all the governments in East Africa recognise SLT as a profession, so there’s tons of pressure on them to get it right. The voting began to nominate the temporary exec committee who will be in charge of developing the constitution. Hopefully results will be in by the end of next week and the long process can begin.

We also went for a few days because it was my birthday on Tuesday and there was no way I was going to spend it sitting on a bus for 7-8hours! So, I embraced the western-ness of Kampala and really enjoyed proper mint choc chip ice-cream, coffees, cinema and a deeelish Chinese dinner!! Was a really nice way to spend my birthday, and again. Good to get away for a few days as the last couple of weeks have been really busy...

First of all – feedback regarding Marion, the young girl I wrote about in my last blog. Because the cleft lip/palate repair surgery only happens 3-4 times a year it gets booked up fast. Marion has been scheduled in for her cleft palate repair in April next year. I’m going to work alongside her before and after the surgery in order to support her speech development.

It’s been a funny ol’ couple of weeks at work. Our training sessions are going from strength to strength (not to blow my own trumpet!!), but for 2 reasons... David and I have run the same workshop 4x now, so it’s meant we’ve been able to adapt our training methods in order to improve the sessions. We’ve found that the teachers we are training aren’t the most forth-coming with questions/comments: at times it’s definitely been like getting blood from a stone! So we’ve now made it even more interactive and in our last training at Mukuli School we definitely noticed a big difference in the teachers’ attitudes and approaches. The other thing that has changed is that we contact the Area Education Officer (AEO) for him to co-ordinate the teachers. Since doing this, the attendance has doubled. We had 11 at one session, got the AEO involved at that went up to 27!! Plus, the AEO’s have both attended the training themselves which is definitely a novelty...

What’s coming out of the training is that teachers want to have further training, and when we explain that there’s no funding and that all that will be provided is lunch and soda, rather than travel costs, a lot STILL want training!! Downside is, the majority want further training in stammering/dysfluency: an area I have never, ever worked with... best get reading then!!

People are also continuing to be more aware that David and I are here, we’ve had 4 children coming from referrals from local health centres and community hospitals. 4 may not seem many. But to us, it’s HUGE!! The awareness is increasing and the parents are taking on board what we are saying... Lets hope this continues.

Unfortunately not all has been positive this week. Last week was really difficult for me, I am really struggling to keep my ‘professional’ cool in situations when I know I really have to...

1)    The cerebral palsy (CP) clinic is continuing to grow, and parents are now bringing their children to see the speechies, not just the OT. However, some have been coming for the whole 3+ months I have been there and every week I watch the mothers feed their young child with severe physical disabilities chai and chapatti. And, every week I watch some of these children aspirate. Every week I discuss with the mothers the importance of posture, slow feeding and consistency of the foods/drinks in order to try and reduce their child’s aspiration. I am not qualified back in the UK to give this advice. Here, I have to. There’s no one else.

Last week at the clinic the chai and chapatti came round, all the mothers who I have given the above advice to were feeding their child chai from a cup, whilst the child was lying horizontally in their arms... All I could hear in that room (even above the children crying whilst receiving OT) was the sound of children choking and struggling to breath. I literally snapped. Grabbed Wellington and asked him to translate. Went to Mum number 1, her child is called Rebecca who has the most beautiful smile in the world. Every week I have demonstrated safer feeding techniques to Rebecca’s Mum. Obviously it’s not gone in. I told Wellington to ask Mum 1 if she remembered all that we’d spoken about and why. She said she did, whilst moving Rebecca into the ideal feeding position that I’d shown her many times. So I asked Wellington to ask her why she was killing her daughter. I told her that every mouthful was suffocating Rebecca. It may seem harsh, but I’d rather ask that question and insult the mother, than watch Rebecca die.

I then did the same with 2 more mothers. I’m holding a feeding workshop with a couple of mum’s tomorrow, (I started to write this on Thursday evening, it’s now Saturday and of course, the mothers didn’t turn up for the workshop!! SO frustrating!!!) to show them how to thicken fluids with cornflour (thanks Heather for that suggestion) and the safe consistency the uji (porridge) needs to be. Hopefully this works, because it has literally become unbearable every Tuesday to see these children so obviously aspirating...

2)    Hearing a child crying “hapana” (no) between every lashing of the cane. By a teacher. Caning is illegal here. Yet the more I am going into schools, the more I am hearing of it happening, or actually hearing it happen. The irony was, me, Wellington and David were sitting with the headmistress of Muluki School in her office  chatting about how successful the training had been, whilst eating cakes provided by the school. Halfway through eating the cakes I heard sounds I’d never heard before, and hope to God I never hear again: the sound of a child being repeatedly caned and crying “hapana” between each one. I could not believe it. I felt physically sick. I didn’t know what to do. Part of me wanted to run into the room and grab the cane from the ‘teacher’, but I knew that would only cause problems for everyone later on. I outwardly flinched with every strike, I couldn’t not, and a teacher that was with us went through and told the teacher to stop.

I went to visit a referral from Jon called Tabatha at her school. Tabatha lost some of her hearing 4 years ago when she had malaria. It’s not known if the hearing loss is due to the malaria itself or a type of medication used out here called quinine which is believed to have side effects of hearing loss. Tabatha is 14 and is so bright. She attends a private mainstream girl’s school, however her grades are slipping. She feels it’s because her hearing loss has become worse over the last couple of years, however due to the type of loss that she has, it’s more likely that she’s more aware of the hearing loss than she was at 10years as more demands are being placed on her in school. Tabatha told David and I that she isn’t sure if any of her teachers are aware of her hearing loss, or that if they are, it isn’t making any difference to how she’s being taught. Tabatha became really emotional during our chat, and after a while it became clear that there is one particular teacher that is repeatedly ‘punishing’ her for getting answers wrong in class, or when she asks for help. I asked her what she meant by ‘punishing’ and she said he teased her in front of other children and caned her most days... These are meant to be teachers that are doing all this ‘punishing!!’ I can’t describe the frustration and anger that builds in me when I hear all of this...

Anyway, we spoke to the deputy head and her class teacher about her hearing loss and gave them some basic strategies to support her learning. We are arranging to go back into the school in the next 2 weeks to talk to all of the teachers that teach Tabatha about her hearing loss and provide them with quick and easy ways to support her. I was really impressed with the deputy head – she has asked for further training for her staff about SLT, so David and I will be developing a new training programme specifically for secondary education.

Talking of training – I’m going to be lecturing for Mount Kenya University on their degree in Special Needs Education!! Meeting with the co-ordinator of the course to discuss when, but it’s very exciting! Things are happening...