This group of students is SUPER punctual and today was no different despite the early morning start of 7:45am!
Today we were at PCOE all day and we demonstrated a great deal of flexibility as the schedule changed as we went along!
Christi was the busiest person all day as she was in consultation with specific cases that had been selected to come in to see her. In the morning students had rotations with Christi, making additional low-tech AAC materials for the center and rotating through the three pediatricians’ consultation with the HIV positive children that they were seeing. However we got called on to test about 5 children’s hearing and were able to do so.
- B: who has had ear pain in her LE for 6 months and finally got checked – she may have a fungal infection. She said she wants to go to America when she is 17! I told her to study well and maybe she can! If only these smart children had the same opportunities as we do – what a difference it would make in their lives…..
- N – who has a profound hearing loss after a fall and seizures in 2011 but is verbal and per Mom third in her class at school! I asked them to come to Beit Cure next Thursday when we are there– I really hope they do!!!!
- E: who we could not test – did he not get the task or is he Deaf? We conditioned him with a big plastic tub as a drum and he seemed to get the task, but we could get no responses. How does one find a space in a school for the Deaf for him??
The morning session went on until almost 1:00pm and a couple of students also got to observe physiotherapy sessions.
We had a quick lunch in the courtyard and then were back for the afternoon session, which included rotations with Christi, Sr. Ornella the pediatric neurologist, and hearing screenings. So – Christi was busy seeing cases and providing support all day!
Once again we went straight to dinner and this time we all had dinner together (all but two of the students) at the Mint Café at Arcades mall – an old haunt where Jenn and I went several times. Christi and I also had to do some grocery shopping – water, PB, jelly and chips for our daily packed lunches.
Things discussed at tonight’s pow-wow included a lot about the kids at PCOE and about HIIV:
Students commented that although they know that HIV is common in Africa, seeing a child dealing with it is sad. It is not a number anymore, but a face. “They have to be on meds for life and it’s not even their fault…..”
They talked a lot about the pediatricians they got to observe who were following up with children who were HIV+:
- The pediatrician asked the parents if the child was taking their medication and some parents did not seem to know….
- We discussed factors for this: cost, education, etc.
- There were children in charge of taking their own meds and who had been taking the wrong pills
- The physician asked children how they were doing in school in addition to talking about their health and meds
- There were a lot of things the physician wanted but could not do because it was too expensive, or not available etc.
- They asked patients to bring their meds, quizzed them on when they took them etc. If they did not bring them said they have to bring them next time
- The doctor had a LOT of patients, one was walking in before the previous one was out
- Their policy is to schedule the child with a different doctor each time so they don’t see the same one each time – opposite of the US
- Patients were carrying their own charts and there was no one guiding them as to where to go
- They were surprised at how many patients were unaware of their test results or could not remember child’s last test
- Doctor asked parents too if they were taking their meds and asked a mother to get tested because her husband is HIV+ (even though they were a pediatrician)
- Sad moments when the physician asked the caregiver “are you the mom” – “no”, “where is the mom” – “dead”, “what about the dad” – “dead”. Another patient missed appointment because her son died last week. It was really emotional…
- Surprised that many of the kids came alone to their appointments…
- Discussed reasons such as lost wages, cost etc.
- We usually ask how the child is doing in school; here they ask “are you in school”?
- They talked about the adolescent mentor program where they met 3 kids over 18 years who were there to be friends to the younger kids who were HIV+. They were like mentors and counselors – taught the younger kids why the meds were important, and provided a support group. Parents usually don’t tell the child they are HIV+ and the child has no idea why they are taking the meds
- They talked about the SLP cases:
- A lot of the SLP cases had asphyxia – different from the US where this would not happen. Here they have no place to go for medical help at childbirth especially in rural areas
- They talked about how some of the kids would be thriving with more resources
- There was a range of children from the child who had no social interaction – and was not in school because it is too far to walk, so she sits in the field all day while mother works to the child who was wowed by the iPad app that can help hims communicate!
- They also talked about cultural differences:
- Noticed difference in parenting style between here and the US: parents seemed to be more forceful or strict as they told kids to “sit down” or do whatever they were being told to do.
- And about gender roles: where asking if a husband is at home with the baby while the wife works would be ridiculous and Zambians may be offended with that question….