Today was the first day of clinic, what an exciting day! For me personally, it was the first time I ever got to see a real life patient that was actually concerned about hearing loss. It was an early but exciting morning for all of us. I woke up at 6:45 am and enjoyed two pieces of one jam and one honey toast. Everyone was really excited to wear their maxi skirts!
We got going and there was a ton of traffic, so we got to PCOE sort of behind, but hey, that is the Zambian way! We first went to PCOE, the Pediatric Center of Excellence, which is a center sponsored by the CDC and is dedicated to helping children with and at risk for HIV and AIDS. However, they offer therapy sessions to any child. We went to present our Augmentative and Alternative Communication devices (AAC) to members of their staff, which ranged from an undergraduate student to neurological doctors to special education teachers. Ms. Masters introduced and explained some AAC devices, and then all of the students presented what they had been working on last week. Julia and I presented our Market Cards, which are just basic note cards with different food items you can find in the market such as fruits and vegetables. The cards included different prices for nonverbal children to use to interact with vendors and get exactly what they want from the market. They can utilize these cards in multiple ways by creating verb cards such as “want”, and build sentences using these. They can also use them along with a communication passport to explain why exactly they are using these cards to communicate, so they do not get so much hassle from any confused vendor who has never interacted with a child who is nonverbal. The audience members had a lot of questions about how to adapt them to their specific needs, such as working with change and different values of Kwacha, which I appreciated since the session was all about what they needed in their community.
Our presentations went splendidly! I remembered to slow down my talking which is always good, but my hands were shaking I was so nervous! After our presentations, we worked with the audience members in a make and take session so they could create their own AAC devices. It was wonderful to see how much they appreciated simply being able to take home communication strips some other students, Breanne and Kelly, made from a plastic folder and Velcro. It just shows their desire to help their students or patients as much as they could. I was chatting with a Special Education teacher during the session and learned that she constantly has new students coming and old students no longer coming to class; I simply couldn’t imagine adjusting a teaching program that rapidly, or even feeling as though you are making a real difference in a child’s skills since attendance is so low.
We then went into the stuttering techniques lecture and Ms. Masters again did a great job of introducing a topic many of the audience members had never learned about before. You could tell from the questions asked that they were surprised there was no real cure for stuttering, and that therapy focused on reacting and anticipating stuttering and the emotional aspects. Once they got a chance to hear some examples multiple times they were able to learn quickly, which I quite admired. Julia and I then presented on the techniques of cancellation and pullout, both are used as a way for a child to react to stuttering and continue producing the word they intended to produce. Then I was much more comfortable speaking to the great audience.
After our presentations, we took a few group photos and hopped on the bus and ate our lunches as we traveled through the heavy traffic to the Special Hope Network’s main building. Special Hope Network is an organization started by the Nelsons, who were inspired by their adopted children, twins Molly and Maggie and their son Sam, who all have Down Syndrome. Their organization focuses on assisting children with intellectual disabilities in anyway that they can, such as individualized education, physical therapy, and of course making their therapy time as fun as possible. We got a quick tour of the very nice facility and got to meet some of the children in the program, who were all sweet and friendly. Sam, the Nelson’s son, was very outgoing and the “head of marketing” of the organization.
We then broke up into two groups to visit the facilities in the compounds to do some hearing screenings. I went with the group to the Garden center and had an experience that was better and much different than I imagined. We set up a great system in two different rooms with Dr. Krishnan in one room with two undergraduates, and Andrea, the third year Audiologist graduate student with two undergraduates in the other room, and an undergraduate interacting with everyone in the waiting room, with the undergraduates rotating every eighth child. We used DPOAEs to screen these children, a screening that does not require a response from the child and is simply pass or refer. I was performing the DPOAE screenings right away, and I was feeling quite nervous about hurting a squirming child. I had always practiced on well behaved college students and even then I was nervous about hurting them. But with Andrea’s support I was able to build my confidence. I was surprised at how much trial and error was utilized in these screenings when choosing the size of the tips for the DPOAE’s. There was one particular child that I tried at least five different sized tips on, but never managed to find a good seal. I learned that it is okay if everything does not work out perfectly, a lesson I am still learning.
By the time I had my turn with paper work and rotating to Dr. Krishnan’s room, I was feeling much more confident. I was actually quite surprised at how many children were well behaved and unafraid. So many were so happy and smiling we had to get the child to stop giggling in order to continue rather than make them stop crying. A child that stuck out to me was one who was carried in by a family member, and that I thought was maybe 13 years old. When she was sat down and we began to ask case history questions, she was able to answer for herself that she was 17 years old. I was astounded at how old she was, and how much damage her cerebral palsy had done on her body, and how much stress that must put on her family. Yet, she was so friendly and kind, and so was her caretaker. That is a wonderful attitude I have found that many Zambians have. Even though life has its difficulties, they embrace it with happiness and friendliness. Most people think of Africa as a giant mush of unhappy people below the poverty line but that is anything but true. Just because they live below the poverty line does not mean they cannot embrace life and the blessings that they do have.
Side note: Dr. Krishnan called Kelly a gangster after arriving to breakfast with a big black hoodie over her head. And dogs bark and cats constantly fight in our back yard.
I noticed that people give me special treatment or interest in me if I shared the same first name with them.