A beautiful day with blue skies – more typical for Lusaka winter weather than yesterday and what a busy and long day we had today! We left the lodge at 8:00 am to reach Munali Secondary School by 8:30. The plan was to do hearing tests on the children at the unit for Deaf kids in the school.
It is a lovely school with nice grounds that were well maintained. One of our students had an interesting comment as waited to start: the grass was being watered at the school, and she remembered how at Beit Cure Hospital yesterday they had the water shut off and could not even do laundry! Such is the disparity and as Lars said yesterday: “TIA – this is Africa”!
We spent some time setting up in a classroom and even this was a good experience as we had to adapt and be really flexible:
- We had one audiometer with a bad power cord and so had to do some trouble shooting and eventually decide not to use it
- We did not have forms at the start and adapted and made hand written forms that we could use
All good experiences for the student clinicians to learn about flexibility and teamwork!
The Beit Cure ENT truck also came and was parked around the corner from us. So, we were in one classroom with 3 audiometers doing the hearing tests and the truck was outside with students looking in ears and Patson the Audiology technician and Evelyn the ENT nurse checking ears, removing wax, etc.
The classroom was interesting because there were microphones attached to all the tables in the room – which looked like antiquated wired FM system microphones – obviously not functional, and somewhat incongruous in the room….?
It was a very efficient morning as we tested 105 children between about 9:30 – 12:45! Most used sign language and our 4 students who knew some sign really enjoyed being able to use their skills and interact with the kids. And even the students who did not know any sign were very good at figuring out ways of communicating with the kids. It was an excellent example of great teamwork between the 12 students who rotated stations when asked to do so and enjoyed every experience and opportunity! And we had an interesting Deaf individual Emmanuel who works at the school and came in every so often into the testing room and kept re-instructing the kids on the hearing testing 🙂
After the busy mornings work, for the first time our bus and driver Emmie were late. So we sat and ate our lunch on the grass, and Emmie showed up about 30 minutes late with apologies – he was getting the bus cleaned!
Our next stop was the Pediatric Center of Excellence – a unit funded by the US Centers for Disease Control and part of the University Teaching Hospital campus. The PCOE specifically serves children who are HIV positive or at risk for HIV and/or have at least one parent who is HIV positive. We reached there at 2:00pm and after some time to set up and quickly orient the students we were ready to go again! This population of kids was very different from the morning: these were primarily young children between 2 – 8 (except for a couple of older ones) and almost all were cognitively impaired. So, they were screened using an objective test where they did not need to respond (DPOAE). We had 2 rooms with 6 students each. Once again – what a way we made it work to have 6 students screen one child! One did the paperwork, one did the history and looked into the ears and put the tip in the child’s ears, one ran the equipment, two entertained the child and one oversaw the whole thing! It was great to watch the team and how they all helped each other and rotated stations so they all got turns to do each station, even the younger undergraduate students!
We were late leaving the PCOE because we were called to the ICU to screen a child. Jenn, Kate and Jill went to see the child while we waited for them chatting with Mr. Mwamba. Another interesting experience for the students!
We reached the lodge at 5:40 and had a 20-minute break before we had to leave again for the Manda Hill mall to meet the University of Zambia (UNZA) students. S0 – a little background information – our students group and the UNZA student group who are all undergraduate students in Special Education have been having e-mail exchanges over the past 2 months or so and this was to be our first meeting. Unfortunately, we were at the mall and did not find them. I really felt terrible, as the primary organizer of this program, but the students were so understanding, and I really appreciated that. Hopefully, we will still have a chance to meet them since we have more than another week to go…
So we had dinner at the mall – a few had pizza, a few others had Indian food. Jenn and I had errands to run. We bought lots of large water bottles again and also some small notebooks for the students to write thank you notes to our community partners. Got home and had our de-briefing of the day again in the “presidential suite” (our room)!. This is a great thing to do and I feel that I learn more about the students each day as we talk about the day’s activities and their thoughts. Today’s student comments:
- The undergraduate students really appreciated the fact that they got to participate in testing and did not just observe
- They really appreciated seeing ears that were not “normal”: they saw fungus, eardrum perforations, a cockroach in the ear, etc. and really appreciated Patson showing them interesting ears so they had a chance to see them
- They enjoyed using their sign language skills, and really liked the interactions they were able to have with the Deaf kids at the school who were so happy to see us
- They appreciated the teamwork also!
- One student commented that she feels we have been here longer than we have – can’t believe we have actually only done 2 days of actual program work! She said “each activity we have done so far alone has been enough to make this trip worthwhile”. Those words meant a LOT to me as I have spent countless hours over the past 18 months or so working on organizing all these activities and I don’t have words to describe how I feel to see them being successful and appreciated by the students
Finally we packed our lunches for tomorrow, which is going to be a little more relaxed……but more about that tomorrow! 🙂
Here’s the student reflection for today:
This is only our second day here but the variety of experiences we’ve had so far has been amazing. This morning we traveled to the Munali Secondary School, a secondary schools for boys, girls, and deaf/hard of hearing individuals. Our goal was to test the hearing of the deaf/hard of hearing students.
We had 3 audiometers performing hearing tests in a classroom, a station for otoscopy, and the Beit Cure Hospital mobile ENT unit onsite, which was performing earwax removal and dealing with other medical conditions (perforations, fungus in the ear canal, foreign objects (someone had a cockroach), etc). We were able to provide hearing tests for 105 students and have 23 more that will need to be tested at a later date. One of the best parts of the day was communicating with the students. I only know a little bit of sign language and was very thankful for the 4 students along on the trip who knew different levels of sign language. It was inspiring to see how the children were just as motivated to communicate with us as we were to communicate with them. We learned about their schooling, hobbies, compared American and Zambian sign language signs, etc.. They were interested in knowing if there were deaf people in America—were there deaf men? deaf women? They were so intrigued to know that they weren’t the only ones—that there was a whole nation full of deaf people in America as well. It was unanimous when we all boarded the bus that we did not want to leave and wanted to come back as soon as we could.
Patson is my role model – he is Mr. Mwamba’s right-hand man (audiology assistant) and is the ultimate jack-of-all-audiology-trades. Superstar. He can do hearing tests, make earmolds, repair hearing aids & equipment (or anything technology related for that matter), perform cerumen removal, sign (some),etc…and to top it all off has a very kind personality.
After eating lunch we headed to the Pediatric Centre for Excellence to screen children’s hearing (ages ranged from 2-15). This center is designed for children who are at risk or are suffering from HIV/AIDS and provide assessment and intervention for developmental delays in areas such as physical therapy, occupational therapy, and speech therapy. The majority of the children we saw had speech and/or cognitive delays. We did otoscopy and DPOAE screenings on all the children and Kate and I got to run across the road to the University Teaching Hospital to screen a girl who was in the ICU. These have been truly amazing audiology experiences for us!
I’ve been so busy talking shop that I’ve left out talking about how awesome our group is! Today required so much teamwork and I left today so impressed with our undergraduate students and their abilities at clinical tasks that we learn in our first year of graduate school. – Jill