Today was our last day at Beit Cure Hospital, our original community partner and the reason the SLHS in Zambia program could be developed. Although I remained in Audiology all morning, students had the opportunity to once again rotate through Audiology, ENT, physiotherapy, the children’s ward, and the kitchen. Sadly the laundry rotation was not an option because the machine was not working!
Audiology was fairly busy this morning and I worked mostly with one of the audio tech students Yaka who is from Gambia. We saw several adult patients and then were hugely pleased to see Ian the Physiotherapist from Cheshire Homes where we had been last week arrive with about 6-7 children we had seen there who did not pass their screening!!! Cheshire had bussed them to the hospital, and there they were scooting about, or in a wheelchair, or carried in by Ian. It was great to see how quickly they had provided follow-up for the children who needed it!!!! Some highs and lows about this though: one child came in with the referral form and I saw that we had screened him in 2013 and 2014, and again this year; and he had not passed all three times. However, we were unable to test him and he did not receive any help. Two other children had mild hearing losses: the good news is that their ears were checked and they were clear (no ear disease); however, because the hearing loss is mild it was recommended that they be monitored. In the USA these children would be fit with hearing aids or other amplification at least in school to ensure academic success and it was particularly painful to me because I have been involved in a project on how even mild hearing loss can have significant negative impact on speech and language development as well as academic success. But it is also important to see that the conditions here are different and the strategies used here vary. The last of the kids I saw was little 7-year-old Frank (name changed for privacy). He was verbal, easily did the task and we confirmed the hearing loss that we had identified at Cheshire Homes. It was great that Patson the audio tech was able to take ear impressions and Frank will return next Friday June 12th to receive hearing aids. We hope that he will be successful in using them and continue to make progress in school and in his communication. Although we were only able to help one of the several children who came from Cheshire, we hope that it will be worth it for Frank!
Also exciting was that Yaka was able to observe how we condition a child to be tested using a play task and actually was the one who tested Frank in the end – so she got to practice what she observed!
After lunch at the hospital kitchen we had a final wrap-up with Alfred and his team including Patson and Precious who work here as audio techs and are completing the training program, Yaka, Olipa and Evelyn who are in the audio tech training program, and Gemma an audiologist from the UK who is here helping train the students. All the audio tech students thanked us and were so grateful but we feel we learned so much more from all our experiences than they did during our time here. Alfred also talked about how this experience will help our students have a better global perspective of how resources are different in different parts of the world, and yet how we can creatively use the resources available to continue to serve patients to the best of our abilities.
Because we had an early finish time, we decided to drive out of Lusaka to Sugarbush Farm – a rustic café in a beautiful garden with a store called Jackal and Hide (leather, fabrics, and other all authentic items made entirely from materials in Zambia using environmentally friendly materials and methods). Our plan was to shop and then eat an early dinner there. So we browsed and bought a few gifts, but then found out that the café is not open for dinner. However we met the manager and decided to have coffee and brownies there and return to Lusaka for dinner. We had a great “show and tell” with everyone sharing what they had purchased (no pics because many of them were gifts that they want to be surprises!), followed by coffee and brownies (which turned out to be GIANT sized) and then had our pow-wow right there in the open instead of in my room at Zebra Guest House – it was a nice change!
Pow-wow discussion today:
- Students shared interesting things they had observed or learned about in clinic today such as
- Wax in the ear that was so old and hard it looked like a stone
- Endoscopy performed by Dr. Uta to look in a patient’s throat
- In-office placement of tubes in a patient’s ears
- Eardrum laceration from using Q-tips
- Procedure for stapedectomy (surgery used to remove the stapes bone in the ear and replace it with a prosthesis)
- Description of tumor in the ear
- Patients who are HIV positive tend to have more bouts of ear infections
Other thoughts from today’s rotations:
- The children here are really tough – because they tend to be stoic and not cry much even when they have procedures that are painful
- The children in the ward loved the attention and even the parents enjoyed it
- Some people don’t know their date of birth and tend to just use January 1st as their date
- Physiotherapy education is a three- year program (compared to 8 years for the AuD) but the therapist appeared to have a lot of medical knowledge
And then there were several really good observations relating to the wrap-up meeting we had:
- “It’s really cool to see the ripple-effect”: Alfred graduated from Purdue, he came back to practice in Zambia, now he is training audio techs who will return to Gambia, Cameroon and northern Zambia and the knowledge is spreading
- “I liked what Alfred said about thinking globally”: it is a different perspective, thinking differently and thinking outside the box
- “I am so happy to have been exposed to this program. Now I see this as more helpful to me. They [Zambians] are going to thrive even without us”
- “I got a bigger perspective: I can go beyond thinking of working in just a hospital or school”
And finally, there was a discussion of AuD students coming to Zambia to do clinical externships!!
Definitely some very thoughtful observations today!
Today was also the day we had asked William to join us for dinner and when we asked him where he wanted to go he selected pizza at Debonair’s – so off we went. It was great to have him with us for dinner and I chatted with him some more and learned more about his family. William was so appreciative of the dinner and said that his two little girls would enjoy the pizza that he was taking home for them!
Unfortunately the internet stick is having fits tonight so I am unable to upload the picture with William 🙂
Back to the lodge and we made our final packed lunches and dispersed quickly! Can’t believe that tomorrow will be our last working day in Zambia this year!!!