May 30 Student reflection: Jenn

Putting today’s sights and experiences into words will be a challenge, but I am going to try my best. Our day started bright and early when we left at 7:00 (okay, maybe closer to 7:30) this morning to head to Livingstone, Zambia where one of the seven natural wonders of the world—Victoria Falls—is located. After piling our luggage onto the bus, we embarked on a seven-hour drive to our destination.

The drive was long but doable. We stopped at one of the few rest stops along the way where we paid 2 kwachas to use the restroom—I would say a rather fair price for clean bathrooms. After eating our packed lunches on the bus, I soon dozed to sleep before waking up by the hot sun coming in through the right windows. Everyone sitting on the right side seemed to move over as much as possible, although moving didn’t seem to help much. It was amazing to see all of the towns we passed through, and the homes along the road. I’m not sure if I will ever become used to driving on the left side of the road.

We arrived at Chanters Lodge in Livingstone a little before 3:00. We settled into our quaint living arrangements and were soon picked up by our Victoria Falls guide, Oliver. We all piled back into a bus and were shuttled to the falls. Baboons greeted us at the entrance to the park, roaming freely about, obviously used to the tourists. We got out of the bus and began our walk towards the top of the falls. The sight was extraordinary to say the least; I don’t think my pictures will even do it justice. We then began our walk along to the other side of the falls, where we would receive a cool and refreshing shower from the falls. To try to prevent from getting soaked, we pulled ponchos over our clothes and placed all of our electronics into Ziploc Baggies. The further we walked, the more mist we felt, until we were in what felt like a heavy rain shower. We crossed the walking bridge, which is situated upon rocks and offers a surreal view of the falls and their plummet to the bottom—hundreds of feet below us.

Falls!

Falls!

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OLYMPUS DIGITAL CAMERA

We made our way back along the trail and were all still very excited about the sight we just beheld. We made our way to the market where vendors were eager and a little pushy to have our business, and then were lead by Oliver to the driving bridge, which connects the Zambia side of the falls to the Zimbabwe side.

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OLYMPUS DIGITAL CAMERA

When we finally returned to the lodge for the evening, our dinner awaited us. I think we were all tired from the long drive and breathtaking sights. I would have to say Victoria Falls is by far the coolest and most serene place I have ever seen.

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May 31: SAFARI!!!!!

Pictures are worth a thousand words……

Impala - LOTS of them all over the park….

Impala – LOTS of them all over the park….

Nile crocodile….

Nile crocodile….

Hippo!

Hippo!

Cape buffalo

Cape buffalo

Boat cruise!

Boat cruise!

Kudu (antelope family)

Kudu (antelope family)

Male kudu with horns

Male kudu with horns

Warthogs!

Warthogs!

Elephant! We saw hundreds!!!

Elephant! We saw hundreds real close!!!

Giraffe - we saw at least 10!

Giraffe – we saw at least 10!

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Baby elephant!  We saw at least 5-10 babies!!

Baby elephant! We saw at least 5-10 babies!!

Giraffe peek-a-boo!! :)

Giraffe peek-a-boo!! 🙂

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We saw several herds of elephants!!!

We saw several herds of elephants!!!

Team in the safari jeep!

Team in the safari jeep!

And – see our Facebook page at https://www.facebook.com/PurdueUniversitySlhsStudyAbroad for some videos!!

Student reflection: Kate

BEIT CURE HOSPITAL
Today we had the privilege of visiting Beit Cure nonprofit hospital. After a tour of the beautiful facilities, we split into rotations to help in the kitchen, interact with patients in the children’s ward, and observe appointments in ENT, Audiology, and physiotherapy. I began my day observing ENT appointments which turned out to be an amazing experience.
Dr. Uta allowed me to take part in her exanimation of the ears and did a wonderful job explaining the differences of care in Zambia compared to America and Europe. I got to see examples of very interesting cases that included outer and middle ear problems. They were so interesting to me because these cases were more severe or advanced than any example I have seen at home. Many conditions they see that cause hearing loss are preventable and treatable; however, many people do not know what resources are available to them because healthcare treatment can be so limited, especially when they cannot afford to pay. So by the time the patient is seen by a doctor, the condition has grown to be much worse than when it would be identified and treated in a country where healthcare is more readily available.
Government funding and private donations allow Beit Cure to function and provide healthcare to those who cannot afford to pay; however, they also see private patients who can pay for treatment. This system starkly contrasts hospitals I have experience with at home in America. After observing Dr. Uta work with patients for an hour or so, I gained exposure to patients of a range of ages and economic status and the level of care did not change from one patient to the next. Dr. Uta explained how this system ensures that there is no preferential treatment toward those who can afford treatment over those who cannot pay anything toward treatment. I found this to be a great way to approach treatment, especially in a society where so many people who need treatment cannot afford to pay for it.
After observing ENT, I walked over to join Katelyn and spend time in the children’s ward until lunchtime. This building is full of children recovering from or preparing for treatment for various ailments including hydrocephalus, club foot, and spina-bifida. Some children were alone in their beds while others had their mothers, fathers, and/or siblings with them. However, every child welcomed our offer to play with them. I learned that no matter how uncomfortable or tired a child may seem, you can likely bring a smile to their face with some bubbles. After hours of blowing bubbles, bouncing balls, reading books, and laughing,

Kate in the ward

Kate in the ward

Katelyn in the ward

Katelyn in the ward

it was time to join the rest of the group for lunch.
Turkey, nshima, and cabbage lunch was served by the kitchen staff along with Katie and Gabby who had helped prepare today’s meal. After eating our delicious lunches in the sun, we headed toward the main building to give a presentation on speech and language development as it relates to hearing loss. This presentation was given to the audio techs training to work in audiology at Beit Cure. My group and I were delighted with how much the audio tech students appreciated our presentation. They had many questions and were able to understand how this new information will help them when working with children who have hearing loss. It felt amazing to have the knowledge base to answer their questions with confidence and I am proud to have been able to do my part in the presentation. Next week, we will get to visit Beit Cure two more times and I cannot wait to continue my rotations in Audiology, physiotherapy, as well as helping in the kitchen. It was a joy to meet the staff today and I look forward to learning even more from them next week!

The Mighty Victoria Falls!!!

After a 7-hour bus ride starting at 7:15am,with a stop at Tooters (the place with the pay-toilets that are “disco” style) we reached Livingstone at 2:15pm to the familiar smile of Mr. Chanter at Chanters Lodge.

Disco style bathroom in Monze

Disco style bathroom in Monze

Chanters Lodge

Chanters Lodge

Then it was off to see the falls! No words or pictures can describe the falls and even though it is my third time to see them they remain breathtaking every time!!

First view of the "smoke that thunders"

First view of the “smoke that thunders”

Close to the water….before the falls

Close to the water….before the falls

Boiler up in Livingstone!

Boiler up in Livingstone!

The Mighty Falls! Pictures don't do justice to the beauty of the falls!

The Mighty Falls! Pictures don’t do justice to the beauty of the falls!

The soaked team!

The soaked team!

Monkey excitement!

Monkey excitement!

We came upon a boilermaker on the bridge between Zambia and Zimbabwe!

We came upon a boilermaker on the bridge between Zambia and Zimbabwe!

Sunset at the Falls!

Sunset at the Falls!

A beautiful Zambian sunset!

A beautiful Zambian sunset!

A BIG thank you to our guide Oliver for our great Vic Falls tour today!

A BIG thank you to our guide Oliver for our great Vic Falls tour today!

A Day at Beit Cure Hospital

May 29 2015: being posted a day late:

Today was Jennifer’s birthday and everyone sang for her in the morning before we got on the bus :)!

Today was our first day at Beit Cure Hospital – our primary community partner, primarily because Alfred Mwamba is the audiologist there and that is the reason this program began. Unfortunately, he is out of town, but we arrived there at 8:00am as planned.

My friend Violet was not there at reception and instead we met Lucy and then went to the ENT/Audiology building where we met Kelvin. Dr. Uta, the ENT surgeon arrived shortly after and she herself gave us a tour! Felt like we were getting VIP treatment, when since this is my fourth time here, I feel more like family!

The tour included physiotherapy, the children’s ward, the private ward where paying patients stay as well as the small area where there is a workshop to make mobility aids for children. Dr. Uta almost skipped this, but I requested we go there because it is so amazing to see the work being done there and how scraps and paper are made into mobility aids for children with clubfoot, cerebral palsy etc.!

The team that makes mobility aids

The team that makes mobility aids

Talking about how they make mobility aids

Talking about how they make mobility aids

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After the tour the students went to their respective rotations and I stayed in Audiology with a couple of them. It was very interesting to speak to Gemma, the audiologist from the UK who has been volunteering here to help with the audiology training program. It was also great to meet the two students Yaka and Olipa and hear their stories. Both are nurses, but have taken an interest in adding audiology to their skill set. Yaka, missing her family in Gambia is here for the one-year program while Olipa is here from Ndola Hospital, also missing her grandchild! They seem to be doing the audiometric assessments pretty independently, and when we had a little quiet time, I explained a couple of audiograms that involved masking to Yaka and our students. Our students got to assist getting tympanograms on a couple of children, and it was eye-opening for them to see that most of the cases seen were all preventable conductive hearing losses that would have been treated easily in the US. Lauren and Connor who were in Audiology at the time used bubbles to distract a young child while getting tympanograms and it was delightful to see Olipa get so excited about that and how effective it was to get the child to co-operate! So, for the next child, Olipa got to help distract the child and enjoyed herself blowing bubbles 🙂 Other students were in physiotherapy, ENT and the ward.

In the ward

In the ward

After the last patient Olipa made tea for all of us and we chatted for a bit before we went to lunch. Gabby and Katie were in the kitchen and served the lunch.

Serving lunch!

Serving lunch!

In the lunch line

In the lunch line

Lunch!

Lunch!

Kitchen staff Kelvin, Mbita, Elijah and Jimmy!

Kitchen staff Kelvin, Mbita, Elijah and Jimmy!

After lunch we set up for the training presentation on the topic of typical language development, how it is affected by hearing loss, and strategies for parents and caregivers. The attendees were Yaka and Olipa as well as the other three students (Patson and Precious who of course I know from previous visits) and also another student from Cameroon. The training appeared to be a success as they made good comments at the end and we hope that it will be useful for them.

Attendees at the training presentation

Attendees at the training presentation

Right at the end of the training Chisomo came and we ended up chatting for a while and she decided to go to dinner with us.

Anyway, William was stuck in traffic and came almost 1 hour late! The students were standing together and singing / playing some games. We ended up not going to Sugarbush, but rather to a Thai restaurant and had our first dinner all together, including Chisomo. It was nice and there was some good conversation at the table. Jennifer had her birthday celebrated with ice cream with a sparkler on top of it which the wait staff brought out singing :).

The students reflected on the day with these thoughts:

  • Beit Cure did not look or feel like a typical hospital – the ward had bright walls instead of sterile white and the playground had special swings for the children with disabilities
  • The kitchen staff impressed everyone, especially the fact that everyone at the hospital from the patients to the staff and top administrators are served from the same pot
  • They talked about cultural differences observed in the doctor-patient interaction, where the ENT nurse Charity appeared to be “scolding” a patient’s mother as she advised her to advocate for her
  • Also, that the health care professionals do not introduce themselves to the patients
  • They discussed the cases of ear disease they observed and how these were preventable
  • They discussed how they take their education for granted while people like Yaka were so eager to learn because it is not as accessible to her
  • They enjoyed the presentation and it was humbling to have the audience members so interested and thankful to us

And the top comment of the day:

  • One student commented that people think we are going to Zambia to change things, but today the realization dawned that “doing this is changing me” and it was a profound realization

And another reflection from Katelyn

Today the team had a great day at PCOE (Pediatric Center of Excellence) and two separate Special Hope Network compounds. To begin we took a tour of PCOE, which is part of the pediatric department of the University Teaching Hospital. PCOE initially specialized in HIV/AIDS, then furthered their services to accommodate the needs of the children they see. Next our team split into two groups and tackled two separate compounds with Special Hope Network employees to screen the hearing of over 50 children. Overall, every team member gained a lot of knowledge regarding HIV/AIDS, the healthcare system in Zambia, and hearing screenings.

As PCOE has developed, they conduct a variety of consultations; such as OT, physio, child neurology, child early intervention groups, child early learning groups, speech therapy, HIV evals for mothers and infants, counseling for sexual abuse, and pharmaceuticals. After our tour to see each programs’ room we listened to a presentation regarding HIV/AIDS, the neurological effects of HIV, and the developmental intervention clinic (DIC). Lastly, we created schedule cards and narrative stories for the speech therapy sessions, early intervention groups, and early learning groups.

During the presentation, my eyes were opened to the many aspects HIV plays in a child’s life. First, Alice, the Director of the DIC shared some statistics about Zambia. We learned that of the 14 million people in Zambia, 50% are under the age of 15 and 17% are under 5. As I looked around at my classmates, I could see wide eyes and mouths opened. This number surprised me, and made me reflect on my cultural awareness as in America our elderly population is growing. In 2013, the Zambian government drafted an early child development policy, which is very exciting to hear as early intervention is key for child development. Lastly, another interesting aspect of the presentation included the steps taken at the developmental intervention clinic of the PCOE. The process includes referrals (self or hospital), intake, neurological assessment, therapy assessment, intervention, and outreach. This process is incredibly thorough.

While observing the early learning group, the OT fused OT activities and speech/language activities. The group included the child, their caregiver, and two therapists. During the session each child had the chance to select a song to sing together, rolled play-doh like they would for nshima, and colored a picture. Each song had hand motions to enhance gross and fine motor skills. Also, during each activity such as rolling the play-doh and coloring the picture there would be a song. The OT said there was a song for each activity to allow maximal auditory input in hopes the child would develop words or speech sounds. The therapists at PCOE are clearly making an impact on these children’s lives. Throughout the session, I observed an extraordinary amount of patience, wisdom, and care. These images will forever be in my memory to reflect upon.

Our next adventure lead us to a Special Hope Network compound where we conducted hearing screenings for over 50 children and a few adults. Most of the children had an intellectual or physical disability and a heart made of pure gold. The amount of patience the caretaker and children had while waiting to get a hearing screening spoke to my heart. Many of the caretakers did not even realize the details of the screening, and were quick to leave after one test. The little things in life like waiting in line for 15-30 minutes at a fast food restaurant, doctor’s office, or bathroom irritate me, but seeing these individuals waiting without grumbling makes me reflect on my actions. As the week progresses, I see more and more situations I am learning from and taking away valuable lessons.

Reflecting upon today as well as the previous days, I joyfully pronounce how close our team has become. I could not imagine experiencing SLHS in Zambia with any other group of people. With great guidance, we have experienced and learned many things as well as helped organizations or spent quality time with children who will always have a piece of my heart, even if I do not know their name.

Thursday May 28: Student reflection from Jennifer

Today, we went to PCOE, Pediatric Center Of Excellence – which was a center initially focused on HIV and AIDS but expanded its services once they realized the need for other services.  We were fortunate enough to receive a tour of the place. I was quite impressed by the amount of things that were done there. Ranging from neurology, male circumcisions, speech, physio, and occupational therapy, to pharmacies, consultations, and sexual abuse check ups and consultations as well as early intervention group therapies for children with autism, and many more! The parents of children with HIV had to come in for a consultation to make sure that they were giving their children the correct medication. During the consultation, they had to bring in the medicine so they could check how many pills were taken and left since they were distributed. Then, they were asked to explain how frequently they were giving the medication along with the correct dosage.. Since the center wants to reduce the amount of HIV/AIDs in Zambia, I was impressed how they went the extra mile to ensure quality for the children and families. For example, when an individual is referred to another facility or department they call the family to make sure that they have reached the next destination to get the correct treatment they needed.

We were then presented a HIV/AIDs presentation by Alice and Sister Ornella and learned that all their services are free of charge to their patients. The facility sees about 1,200 patients a month, which means they see more than 14,000 patients a year – which is awesome because so many individuals utilize this facility! We were split up into rotations, and on my first rotation I worked on creating and laminating cards for communication boards and narratives stories for children at PCOE.

Making AAC materials at PCOE

Making AAC materials at PCOE

On my second rotation, I got to see a neurology consultation. The neurologist saw a child who had cerebral palsy and epilepsy. They talked about which types of medication to take and make sure they go through the process and meet with the pharmacist. She also was able to talk about the Complete Blood Count (CBC) Test results along with the Electroencephalogram (EEG) results. It was a great experience to see the differences between the PCOE at University Teaching Hospital in Zambia and compare it to the hospitals back in the U.S. I definitely learned a lot at PCOE about their facility, HIV/AIDs awareness and their services that they provide to the community of Lusaka, Zambia.

Later in the day after lunch, we went to Special Hope Network. When we arrived at our assigned compounds, there were families waiting outside the facility to get screened. They were waiting patiently and when we arrived, they didn’t rush or get angry with us when we were setting up our equipment or had technical difficulties with our OAE machines. They were very polite and understanding  – it was very admirable, especially since sometimes we couldn’t perform a hearing screening because the child was crying or moving a lot.

The parents didn’t ask many questions but they were very understanding even though we had to refer some families to Beit Cure after waiting in long lines to get tested. I was very impressed by the cultural courtesies of Zambians. Comparing it to the U.S, I feel that people here in Zambia are very patient, polite and take things slowly (except for driving, of course). I definitely enjoyed the environment that we were placed in at The Special Hope Network, as there were lots of patients to see but none of the patients were impatient or tried to rush us after waiting so long. With the help of the graduate students, Katie and Gabby, at our compound –  I feel that I am learning how to perform otoscopy and test/use the OAE machines better each day that we perform hearing screenings. I am definitely excited that I am getting more experience using the equipment and being exposed to the clinical settings of audiology. I am very excited for our day tomorrow at Beit Cure and for the rest of the experiences we will have during our stay here in Zambia!

Team at SHN N'Gombe Compound

Team at SHN N’Gombe Compound

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