“There is chaos. Kids are not coming to school"

The community had a very different atmosphere this week...schools are closed as one of the teachers unions, SADTU, have embarked upon a "chalk-down"...which has resulted in no lessons being taught in some schools across the country. When there is no school, the children don't have anywhere to go, so many of them spend their time playing on the side of the road, sliding down banks on cardboard boxes and following us to our prac venues.

Perfect day for sliding down the hill on cardboard boxes!

An online newspaper reports: "A Mariannhill primary school principal said his staff were “just sitting” in their classrooms. “There is chaos. Kids are not coming to school" (News24).

It really is sad, as there is talk that this may continue for at least 3 weeks, and may even become aggressive. What I was most concerned about was that the children were just wandering the streets without supervision. This area is known for drugs, crime and abuse, yet there is no-one checking up on the children! 

This little girl wanted to know why we were 'running away from her' while she followed us to our prac.

On a happier note, we walked past Mariannridge Cafe to say a quick hello to the ladies who sit and knit at the cafe each week. They knit teddy bears for children who have been abused, that are given out at R. K. Khan Hospital. This week the UKZN nursing students were busy setting up for their antenatal program by the cafe. Everyone was in such a good mood, and the ladies were so proud of their massive pile of knitted teddy's that were on display!

Setting up for the Antenatal Program

The pile of hand-knitted Teddy's that will be given out to abused children at R.K. Khan Hospital

 

I am learning more and more about what it means to be part of this community. I LOVE the interactions that I have with people while walking between prac venues, and seeing the difference that people are making in Mariannridge. It is extremely different to the community that I come from- I am used to living behind high walls, fences and security, and driving to the shops, where you may bump into someone you know...if something happens in my community, you hear about it in the newspaper or Facebook! In Mariannridge, there are no walls or fences surrounding the houses, you walk everywhere and meet people on the way who will update you on any news!

Candy Floss Pre-school was also chaotic this week, but I still loved it! We arrived during their break time...the children had so much energy and just loved the attention that they got from us. 

Tyre racing at Candy Floss!

When their break time ended, we began screening hearing, which is proving to be slightly difficult in the noisy environment. Hopefully next week we will be able to make arrangements with the teachers to move their class to the other side of the room so we can decrease the noise level. As expected, many of the children present with impacted wax...I am holding thumbs that their parents will take our referral letters and advice seriously! 

Candy Floss!

This week I would like to introduce my blog readers to the new venue for community based rehabilitation- Candy floss Preschool! If a name like that doesn't make you smile...well, then you must be diabetic ;-)

There are a few things that I observed during our first session that I found interesting. First, there are a LOT of children here! The building in the above picture is big hall/church where children have their school lessons during the week. There aren't any dividers to separate the hall into different classrooms and block out the noise- it literally is one big building with a few different classes happening at once! I get the feeling that there are actually too many children for the venue- from what I observed on Thursday, the classes rotate- one class will be playing outside while the other class eats at their desks.

A few other interesting observations:

• The children love to push old car tyres around the playground. They find it such fun! And if another child takes their tyre, it means war! I would love to see if the occupational therapy students can incorporate some of their aims into an activity that includes these tyres...Im sure the children would LOVE it!
• The teachers are really helpful! They have shown us all of the patience in the world when we have gone to them with questions or requests and are really pleasant to work with.
• These children might not have the most health-consciouse parents...the bins are filled with empty chip packets after lunchtime. Literally filled to overflowing- the children go through a lot of chips! This is slightly concerning, as these chips are not the most nutritious, and are packed with flavourants and preservatives...not the ideal food for 4 and 5 year olds to be eating, particularly while they are at school!
• There are both English and Zulu speaking children at the preschool. This means that we have to be prepared to do screening, language and auditory skills development in both languages...taking into consideration that we do not have an interpreter this term!
• It is LOUD! Outside, inside...there are happy energetic children everywhere, which is going to make it a bit difficult to conduct hearing screenings. But Im up for the challenge!

Some of my goals at Candy Floss creche for Term 2:

• To learn all of the teachers names and greet them before I begin the session. This might seem like something small and insignificant, but recently I am becoming so aware of how other professionals perceive us as audiology/speech therapy/ OT students and professionals. I never want to be that professional who pitches up to a venue and does my own thing without even greeting those in charge. I would rather spend an extra 2 minutes building rapport with the other professionals, be it a preschool teacher, nurse or admin staff, than having that extra time for my session. At the end of the day, we need to have a good relationship and mutual respect for each other and the different professionals, and I feel that this 'small' step will show endless benefit.
• To have a mini-awareness session with the children about ear care, in particular about not putting anything in their ears! This is well needed as we have already identified a child with tissue stuffed into his ear in the first week.
• To become more proficient in instructing in Zulu. Its just one of those things that I have to continually work on to give the children and all of my patients the best service that I can. There really is no way around it as an audiologist in South Africa- and Im ok with that!

Candy floss ir right across the road from the clinic, where I will be based every second week. We spent some time there this week, doing otoscopic examinations, speech and language screening with the speech therapy students and giving advice to parents on ear care.

From my experience there this week, I think that our focus may be on creating awareness about hearing and counseling parents on how to stimulate language development. We are planning on making some posters and pamphlets on ear care and language development to leave in the clinic and stick up on the walls- the patients generally have a 4 hour wait before they are seen, so we may as well give them something to read during their wait :)

Its been a good start to the second term, we have so many things to get started on!

Term 2!

Its been one of those weeks when I have worked with a lot of children! In fact, I didn't see any adult patients at all! Working with children is messy! This week resulted in my Saturday being spent disinfecting all of the toys I use for assessment and therapy...everything-from blindfolds for games at the creche to blocks to teddy bears-has either been drooled on, put in a kids mouth or used as a tissue...But every time I am able to complete a hearing screening or assessment, or achieve my aims in a therapy session, I am reminded that it is WORTH it!

A new group of speech therapy and occupational therapy students have joined us, as the last group has moved on to a new prac. While I am starting to feel quite settled in to the creche and community, it is a whole new experience for the speechies and OT's who have just started. This week we spend a lot of time explaining and discussing what we have found to work in therapy in the creche, including taking note of the children who need a bit of extra attention during activities. I am learning how to share information that we have discovered over the past 6 weeks, while still leaving room for creativity, new ideas and different perspectives from the new students. I would hate to get stuck into the rut of doing the same games and activities every single week, instead of having our creativity challenged to make our 3 hours at the creche the best 3 hours of those children's week!

This week was significant because OT and Speech and Language assessments have been completed in Rainbow creche! Individual therapy programs are starting to unfold for those who show significant delay- as opposed to group therapy where we target very general aims. Group therapy still goes on for the rest of the Grade R's (5 year olds), where we have been focusing on development of auditory skills, fine and gross motor skills and language development. I still have to learn a lot about the cultures and socio-economic backgrounds of these children in order to ensure that the instructions and stimuli used in our activities are relevant. I feel as if we were not really on top of our game this week with some of the stimuli, and this showed as the children lost focus easily.

We should be completing the hearing screening at the creche in the next session. So far we have identified many children with impacted cerumen, and have nearly finished developing an information letter to be sent home to the parents...the reality is that the parents wont be able to take their children to the hospital for cerumen management, so we are trying to suggest alternatives, such as using olive oil or cerumen softening drops. To be honest, I don't even know how many of the parents will spend money on olive oil or softening drops... so if anyone reading this blog has any other suggestions for cerumen management in this community, share the ideas! I get frustrated that so many children in communities in South Africa don't get the help and intervention that they need!

It seems as though this prac might be changed up a bit, as new locations within the community are added...I am excited to get involved in other parts of the Mariannridge community!