Jenna #3

So its Wednesday today and two more days at the clinic have flown by since I have written. I'm sitting here back at the guest house and its rather sweaty but what can you do. I have a little Haitian buddy who must be around 10 years old who has been hanging out with me in the afternoons while I have been working on the computer. Yesterday he did some coloring and today he is working on a puzzle. Kids here don't have electronic toys and they LOVE things like coloring books and puzzles.

Two great days at the clinic. Since my last post I decided that I should address the issue of evaluations and I was grateful to find out that Deliris had done a fair amount of training with the therapy aides on evaluation and that she had promised them an eval form but had never gotten around to it. Voila! A useful project. I spent yesterday afternoon discovering the joys of google translate and was able to put together an eval form in French which I took to the clinic today. My translator, Pierre Riche Junior volunteered to fix my French after I got the form typed. Apparently google translate is good but not perfect and I couldn't put in all the little accent marks that are necessary. So I emailed it to him and he looked at it for me.  It took a bit of doing as everything in Haiti does, the printer doesn't work with this computer, the wifi goes down just as you finish typing a section, but the stars were all aligned and I was able to get a printed copy to take with me today. There are two sets of aides, two work on Mondays and Wednesdays and the other two work on Tuesdays and Thursdays so it was a bit of a risk. I had discussed the eval form with the Tuesday/Thursday group but due to time constraints presented it today to the Monday/Wednesday group today. Thankfully they were pleased with it, engaged right away in helping Pierre make corrections and modifications as they way I expressed some things was not as clear in French. So giant victory and if I accomplished nothing else this week I would feel my trip was worthwhile

But it gets better! Little Islana, who is 2 years old, is the little girl who we brought the walker for. She had another appointment today and I got to work with her with the therapy aides. I have been careful to always say, "What can I do for YOU?' to try not to be an overbearing American and they said they would like some more treatment ideas using the equipment they have but are not sure how to incorporate. So knowing that standing was a goal for Islana I was able to use a little rolling walking toy with cars and shapes etc. on it to get her standing and interested in the toy. One small aspect of the treatment at the clinic is that it seems they are so focused on their NDT and other techniques that they sometimes treat the children like little adults, pretty much straight exercise. I wanted to model the value of play in engaging the child in activities meaningful to her. We started out playing with a little doll and car and asked her did she like the doll? She said no, the car! so we transitioned to the walking toy with the cars on the top and sure enough she did not want to sit down. Good girl!!We did a great treatment with her, using both hands together, reaching across her body, supporting herself on her hemiparetic arm, awesome.

After that Shantia had brought a game that she likes, a counting game which happened to have instructions with it in French. Some other children from the orphanage were supposed to come for therapy but they didn't come for one reason or another, so we taught the aides the game. A lot of laughs, hopefully building connections we can take with us. We have a couple of ideas for continuing support for the clinic once I leave, one is that we have a computer that we may be able to set up for Skype consults for questions about treatment, another is sending some reusable laminated sheets for them to use on more school based interventions.

I was happy to meet Agnes today, she is with the Hungarian team that funds the clinic. She gave me a lot of information about the FLAME program that the aides have been trained in, and was able to tell  me about other places they are using it including Albania. It has many advantages, it uses simple equipment that is inexpensive and can be built on site out of local materials, it is very organized and easy to teach to people who are not therapists, it can be used for a variety of disabilities, and it incorporates elements of physical, occupational and speech therapy so a lot of bang for the buck.. We exchanged information so we can be in touch and I can continue to learn about it for use in the future.

Over lunch I happened to be looking at my Disabled Village Children book about building wheelchairs and it came to me to have a conversation with Pierre about wheelchairs. I asked him had he ever seen a wheelchair on the street and he told me a story about a woman he knows, 33 years old, who needs to use a wheelchair. It is a big problem to get any kind of wheelchair here so if you can't walk you are pretty much limited to bed. Even if you do have a wheelchair to get around the house you can't really leave the house because the streets are so bumpy and filled with rubble and trash that you could never roll a wheelchair down the street. Most of the affordable (relatively) transportation here is on something called a tap-tap, which is like a modified pick up truck, open air in the back. Some have seats but many you just stand up in the back and hang on for dear life as the truck rumbles over the bumps. So it is impossible to get a disabled person on and off a tap-tap. That means even a trip to the doctor is out of the question. This friend of Pierre's doesn't really have any family so she can't even get out to get any groceries. No Meals on Wheels here. Its like every problem you think you could help with has 20 layers of complexity about it. Can't get a wheelchair anywhere except maybe a hospital. Can't afford to buy a wheelchair. Even if someone gives you one, can't use a wheelchair because you can't fix the street. Never mind does the wheelchair fit, do you have a pressure sore, on and on and on. These people fight for every day. The basics of water, food, and shelter are as much as some can manage and more than many can manage. Just keep remembering, help the one in front of you as best you can.

So it makes me think more about little Islana and how important it is that she learns to walk, and walk well. Otherwise she will be homebound as soon as she is too big for someone to carry her on the tap-tap to get to the therapy clinic. That's why a lot of children don't come to the clinic, no transportation. Then you think, well, we could get a van. A wheelchair van. Whoops, no wheelchairs. And the gas. and the van would definitely break down because every road is like mountain biking. Hmmm.

One more cool thing about today: a lady showed up at the door this morning carrying her baby. She said she wasn't there for therapy but instead she came to thank us. Apparently she works at the school and last year she came to one of the medical clinics. She was pregnant and her blood pressure was really high. The medical team gave her some medication immediately and sent her to the hospital. She came today to thank us for helping her and to show us her healthy baby.

Can't have a better day than that. I'll sign off on that note. Oh, except for a prayer.

Dear God, how can I possibly thank you for all the joy you brought me today. Thank you for the opportunity to serve you in this way. Thank you for providing for your children and help us to share what we have with all people. Help all people with disabilities throughout the world but especially those who live in places where there is no one to help them. Bless our loved ones at home for supporting us so we can be here. Thank you for all the wonderful Haitian people who have been so open and loving to us. You are our strength, You are our salvation (to quote a friend of mine). Amen.