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...
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