"Mama you are so strong"

I sat in awe as I heard the horrific story of how the Mama in front of me came to lose her hearing. She fumbled beneath her scarf to point out the rugged scar on the side of her head where the bullet had entered, and bravely told me the story of how the gunman, her own husband, had pulled the trigger. First aimed at her, then at each of her children, and finally at himself.

"Mama you are so strong"

The physical scar is quite something, and I thought it a miracle that she is still alive, but what gripped my heart was the strength and determination that is getting her through each day. She beamed with thankfulness at each small action that was taken to help her- from removing impacted wax to rescheduling her different appointments for the same day to avoid multiple trips to the hospital. I'm thankful that I got to meet this lady. I'm thankful that audiology services are made accessible to her because of community services, and I'm thankful that I get to play a small role in giving back a part of what was taken from her on that day. The social situation that many of our patients find themselves in makes one consider what we actually have to complain about.

Community Service 2014

It has taken me quite some time to figure out my password and sit down to write about what Ive been doing for the last few months... 5 months, in fact! I don't know if time goes really fast for everyone in the working world, but I honestly find it hard to grasp that I am nearly halfway through my year of community service!

Over the last few months I sat through and (thankfully) passed my final year oral exams to finish off my Bachelor of Communication Pathology in Audiology. Such an incredible feeling of accomplishment after 4 years of studying! On the 1st of Jan I moved to the South Coast of KwaZulu Natal to begin my year of Community Service at a small but friendly District hospital.

If anyone is wondering why and what community service is, let me set the record straight: It is in no way related to the community service that is given as punishment for breaking the law, and no I have not been to jail! (People have asked...haha!). Community service is a year that most health professionals in South Africa are required to do after completing their degree. A lot of us are placed in rural areas and it becomes quite an adventure! The year is very community focused, which means that we are not limited to working in our hospital, but visit the smaller clinics in the surrounding communities as well as do home visits. We often have to leave our car and walk down hills and muddy terrain to get to our patients!

Amazing views on the road to Tonjeni clinic.

I work closely with an occupational therapist, physio therapist and speech language pathologist on our clinic and home visits, all of whom are also doing their year of comm serve and make the adventure that much more enjoyable! Our community visits are quite unpredictable, and we are learning to just take everything as it comes as we reach out to those in the community who need us.

Rehab team home visit out at our furthest community

Some days we see more cows than people.

Community service has been the most fantastic experience so far, and I am learning to be an audiologist in often less-than-ideal settings and situations. It sure forces me to think outside of the box and problem solve! I can't wait to see what adventures the rest of the year has in store... if I find some time in between hiking to waterfalls, swimming in bilharzia infested rivers and taking full advantage of living 600m from the beach, I may post updates more frequently ;)

Back at Mariannridge- with Spread the Loaf!

First week back at Mariannridge! It was great being back at the preschool and seeing all the kids smiling faces. We were greeted with a stampede of hugs on arrival, with shouts of “hello teacher!”

We were also so excited as we have new audio screener! And our other screener had been repaired, which meant that we could now bring 2 screeners into the community- we brought one to screen at the preschool, and the other to the clinic.

We had a few spare minutes while the teacher was finishing off the morning session in the small room that we usually use for screening, so we took a walk down to the café to see the ladies who run the soup kitchen. I have been helping one of my close friends (who is a student speech therapist currently doing her Community Based Rehab block) with an NGO that she has started called Spread the loaf. She raises money through donations and raffles, and we then buy a few hundred loaves of bread to hand out to people in communities that are in need.  This July, Rotary have helped us out with some sponsorship, which has enabled us target more communities. We decided that Mariannridge will be one of the communities that we distribute bread to this round, and the ladies who run the soup kitchen were delighted to hear the news! 

After discussing our plan for Spread the Loaf, we headed back to the preschool where we started screening the age 4-5 year olds with our NEW screener. This was the youngest group that we had been screening, and we found that with a few children we had to switch to play audiometry, which they then responded well to. As always, we had a bit of trouble with the background noise, but it is just one of the things we had to accommodate for. 

Saturday came with much anticipation and an early start, as we had to collect and pack just under 1000 loaves of bread into the 2 Bakkies (Thats pick-up trucks, for any non-South Africans reading this ;) ). We made 3 stops in various communities, meeting with people of influence who would ensure that those who were most in need received bread. These stops included 1000 Hills Community Helpers, a pastor down in the valley, and someone who is involved in a orphan housing project in Ntshongweni.

This is only about half of the bread that we distributed! Team Speech-Audio!

Mariannridge was our last stop, were we met up with one of the ladies who runs the soup kitchen and is involved in the knitting project. She has such a heart for the community and was definitely the right person to connect with to hand out the bread, it seems that she knows everyone! Mariannridge have an online forum where they can express their concerns and community news, so between the forum and word of mouth, those in need were able to collect bread :)

Our final stop- Mariannridge!

I think that it is important for the community to see that even though we are students, we aren’t just in the community because we need to fulfill the requirements for our degree, but because we have a genuine care for helping people and improving the community. The reason I have gone into the field of audiology is because I love working with people and want to make a difference in people's lives- sometimes that difference can be made in ways that do not include an otoscope, audiometer or hearing aids but random acts of kindness that might meet someone's need at just the right time!

So this week was exciting and different for me in Mariannridge, both as a student audiologist and as someone who wants fully grasp the community aspect of our Community Based Rehabilitation clinic.

'Hunting down Hearing Loss'

Myself and my good friend and fellow student audiologist Lesley began this week's prac in Mariannridge with the aim of finding members of the community with hearing aids in order to start up a group aural rehabilitation- we aimed to 'hunt down hearing loss' in Mariannridge. We thought that the best place to start would be by asking the ladies down at the cafe. These ladies are very involved in various projects in the area, such as the Thursday soup kitchen and the teddy-bear knitting project for children who are victims of rape. They were able to give us the names of 4 different people of various ages who use hearing aids or have hearing loss. It was interesting to note how differently thing work in small communities- everyone knows everyone! It was great being able to chat to these ladies and find out more about what the do in the community. They were pleased to hear about this blog and gladly posed for a photo for it :)

Two of the amazing ladies who work into the Mariannridge community

Before leaving, 2 community members who were at the cafe had concerns about their hearing and wanted to talk to us about it. As we only had our otoscopes on us, we did otoscopic evaluation and then offered advice on which public hospital to go to for a hearing evaluation. This was slightly challenging as one of the community members could only communicate in Zulu, and my Zulu speaking is not yet at a level of having full-on conversations! Thankfully the ladies who run the soup kitchen were willing to help translate for us :)

After obtaining the names of people in the community, we headed over to Mariannridge Primary School to find out if the office staff know of any children who potentially have hearing loss or use hearing aids. The staff were very helpful and suggested that we print out some forms that the individual teachers can fill in to give us accurate information.

Mariannridge Primary School

On our way back up to the clinic, we were greeted by some children aged (I'm guessing) 2-4yrs, who excitedly ran across the road to give us hugs! While I love all the hugs we got, I was slightly concerned about them not being supervised...and running across the road without looking! Thankfully the roads aren't busy in the community, but it just takes 1 car...Anyway, Lesley and I spent some time tying their shoelaces and having 4-year-old conversations with them, and attempted to teach them how to cross the road safely. They seemed to understand, said 'good-bye'...and ran straight across the road without looking again!

Once we had reconnected with the rest of our group, we decided that it would be of greater benefit if some of us went down and did some language stimulation and auditory skills development with the children playing on the road. Plus, at least we could watch over them for an hour or so and prevent them from running across the road! By the time we got back, he children had run off on another adventure, so we headed back to the cafe/library area to look for other children who were not at school or creche. Before too long we had 5 young children join us, so we took them into the library and learned shapes, colours and animals, using a book and an iPad. The librarian was so welcoming and has asked us if we will run a story book session in the library with one of the creches in the area some time. This is a great opportunity for the speech therapy students to join us for a team approach :)

I really enjoyed this week, interacting with various people in the community. I am starting to see the benefit of building a relationship with people in the community, even though we do not work directly with them for assessment or intervention it is so helpful knowing people who are aware of how things run in the area and know everyone else in the community. It is also so encouraging to see how people, such as the ladies who run the soup kitchen and knitting project, care about the community and are making a difference in people's lives!

Prevention is better than cure

This week my group was at Candy Floss preschool. We were greeted with literally 40 hugs each on arrival!

Not having a separate classroom to take the class to, and wanting to keep the class away from the room where hearing screening was taking place, we decided to stay outside and sit the children in the shade of the tree. They didn't want to sit on the dirty floor, so we made a plan and collected the tyres that were lying around and used those as seats. It worked well!

One of our main aims was to run a mini 'workshop' on ear care with our grade R's (5 year olds). Our aim was to teach them about not putting things (including ear bud's/ Q-tips) into their ears, not listen to very loud music and to care for their ears. Prevention of hearing loss is better than cure! We created a big poster with them, which was then put up in the hall to remind the children of what they learned that day.

Having fun making a poster on ear care!

The children seemed to enjoy it, particularly the localization activity that we added in at the end! The children took turns being blindfolded and had to find the clinician (or 'teacher' as they call us!) who was using the shaker (a tin filled with a few popcorn kernels!). We were working outside so we had plenty of space to work with. Once each child located the clinician, they were given a picture of an ear to stick onto our poster. The children were very proud of their poster :)

At one point, we asked the children who they should tell if their ears are paining. I expected them to all say their mom or their dad- but as they began to answer I remembered that many of the children in this are have a different family structure that the one that I was raised in. The answers that came out included "aunt, big sister, cousin, granny, grandpa". There are many reasons why these children may not have given "mom" or "dad" as their first answer. As I had experienced at the clinic a few weeks before, an aunt had taken her nephew to get his medication- his mother was probably working, so the aunt then took the responsibility of bringing him to the clinic.

Some of the children might not actually live with their parents. According to Statistics South Africa, in 2011 there were 2.01 million orphans because of HIV/AIDS. Other times, parents have to go work far away, so children are left to live with a family member. Whatever the reason (and I'm sure there are many different reasons in that class) it was a gentle reminder of how different life may be for the children in this area.

We ended our session with some activities targeting rhythm and rhyme, identification of syllable patterns (through clapping along to each syllable of the rhyme) and a game of "I spy" to focus on developing skills in alliteration.

Despite it being a large class, I was surprised at how well they listened and participated. I think it helped that the activities required the children to be quite active and did not go on for too long. Before leaving, we gave some bookmarks on ear care to the teachers and principal - I hope that they will be used both for their own benefit and for the benefit of the children, since they see the children every day and we are only there for a few hours once a week! One of the teachers expressed that she has a concern that one of the younger children in the preschool might have a hearing loss. I am glad that they are willing to work together with us in identifying those that may be at risk- we aren't able to screen the whole preschool because of time constraints, but if we use a team approach and communicate with the teachers I'm sure that our screening program will be more effective in identifying those who need attention!

On a side note, an observation that is made every year (and recorded in the yearly handover file) is that there is a lot of litter in the area! The occupational therapy students have done a great job so far in organising more bins, however I think creating a cleaner community is going to take a lot more effort and education that we realise! The litter was something that I particularly noticed this week...

Litter lying around the bins...

The litter after snack time at the preschool

I am looking forward to something different next week- a home visit to a stroke patient in the community!

“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!

Week 4: Listening Program

Week 4 at Rainbow Creche! This week it was only the student Occupational therapists and Audiologists at the creche, as the Speech therapists were conducting assessment at another venue.

We have been looking at doing listening activities with the children in the creche to develop various auditory skills. Up until this point, the only clinical therapy I have done as a student audiologist has been speech therapy, language therapy and currently, aural rehabilitation. So again, I felt challenged and slightly out of my comfort zone, not knowing where to begin. Thankfully, I have found a program for preschool children that is soley focused on developing auditory skills.

The program can be downloaded for free off the UK's Department for Education here. The activities are quite lovely! Many of the activities are active, which is great for us as we can add in some goals for OT and Speech therapy. Reading through some of the activities, I am learning to think more creatively about activities and developing listening skills.

We started this week off by making bunny ears with the children, which were used to make the children aware of their ears and listening during later activities. The children were required to colour in a template- which incorporated fine motor skills, while we whispered instructions to them. Whispering requires the children to actively listen and pay attention to what is being said (This worked out well for us as we had to keep the noise levels down for hearing screening that was being conducted next door).

Before beginning the session, we met and discussed how we can correct the children if they are colouring incorrectly, and how to encourage better listening and concentration. I feel that this was highly beneficial as the OT's and audio's each learned something from the other profession, that enabled us to actively participate during each activity. I learned about identifying if a child is using the incorrect grip when holding a pencil, encouraging the children to rest their hand on their page and move their wrist while colouring, and that children should be using longer crayons and pencils, as opposed to small stubbs, as this will help to develop the right grip. The OT's also explained how different hand strengthening exercises can be done using playdough that will aid in the development of fine motor skills.

As student audiologists, we were able to share with the OT's about getting a child's attention before explaining an activity, encouraging them to sit still and not talk while listening, and gently holding a child's hands while talking to them if they are finding difficulty in sitting still and paying attention.

I feel that this time of sharing before beginning activities should be done each week, so that we are able to learn valuable skills from each other that we can apply both to CBR and other clinics.

This week we were able to begin hearing screenings on the children. We decided to start with the children who are most at risk for having a hearing loss (eg. child with cleft palate, delayed fine/gross motor skills, and those who battle to follow instructions). This required us to consult the OT's, as they have spent more time with the children than us. Our aim is to screen all of the children, but since we are only there once a week, it may take a while to accomplish this. One of the children that the OT's suggested that we screen first did not pass the hearing screening and is being referred for a full diagnostic assessment. I now realise how beneficial a team approach can be for identifying those at risk.

We wont be at the creche this coming week, as it is human rights day! I look forward to being back the following week, with our full team :)

Week 2: Thinking outside the box

It is hard to believe that a whole week has passed since my last community based rehabilitation prac in Mariannridge! Today was our second week working into the community. While we are still trying to find our feet and figure out what our role is in the community, it is getting a lot easier and more enjoyable- particularly as we are learning to ask questions instead of just assuming things! Feedback and input from our supervisors is really useful and we are constantly being challenged to think outside the box.

The box being our screening audiometer.

Over the last 3 years of our training, we have learned to rely on our expensive audiological equipment. However, living in a 3rd world country, the reality is that one day we may be placed in a hospital or assessment centre that doesn't have this equipment, or we may have to wait months for our audiometer to get fixed, with no back-up machine. It is also likely that we may need to work out in a community that does not have electricity. The thought of not having a screening audiometer is quite intimidating!

So we are currently in the process of discovering our role in community based rehabilitation without an audiometer... we realise that this requires us to research activities that can be used to improve on the children's auditory memory, discrimination skills and the like, as part of early intervention for those who are at risk for delayed development, learning problems, hearing loss and auditory processing disorders.

We were able to incorporate some of our aims into the games that the occupational therapists and speech therapists were already wanting to play in the creche. A game of "Simon Says", with multiple-part commands was played. The children had to remember what all 3 instructions were before following through with the actions. We were also able to have 'Story Time', where we asked the children details about what we had just read. This was to target their auditory memory.

Once our time was up at the creche, we headed back up to the Cafe/community centre where I finally decided to introduce myself to the knitting ladies. I feel that we are sometimes so focused on getting to our location, setting up and accomplishing our aims, that we miss out on things along the way- such as a simple greeting and introduction. It only took 1 minute of my time, and before I was finished explaining what we were doing in Mariannridge I had been ushered towards another lady to discuss the concerns that she has with her son's hearing, and a few minutes later another lady approached us about motor and speech concerns that she had with her son.

I left those conversations feeling more connected, welcomed and understood by the community as a student audiologist, even though I had only spoken with a group of +-10 ladies. I definitely need to remember to go into the community each week with a humble attitude, remembering that I am there to serve them, and that a smile and "how are you" can go a long way!

International Ear Care Day: 03/03

The 3rd of March is International Ear Care Day! It seems like not many people have heard about it, or really know what to do about it (I only heard about it on Friday), so maybe we can share some ideas on how we can each play our part! 

The theme for 2013 is "Healthy Hearing, Happy Life - Hearing Health Care for Ageing People"

The 3rd of March has been selected because the two "3's" represent ears. Unfortunately this year the 3/03 falls on a Sunday...But I'm sure if you want to "shift" it by a couple of days it's no big deal :) And for those working in schools, Im sure you don't have to stick to the theme 100% ;)

If you would like to read up on what WHO says about it, click here. 

My audiology class had a massive brain storming session yesterday to see what we could come up with, and eventually decided that we would divide our class between two old age homes in the area, where we will perform hearing screenings, give a brief talk on ear and hearing care, hand out some pamphlets, bookmarks and other free stuff and leave time for Q&A's. We are still working on bringing a 'fun' element into it...so if anyone has awesome ideas, send them this direction!

It is a really great opportunity to reach out to the community and raise awareness, and there are so many ways to get involved!

Have you participated in International Ear Care Day before? 
What ideas do you have to share with Students, Audiologists or Teachers who want to participate and help raise awareness this year?

Setting the scene: The 1st world-3rd world country

I am only one, but still I am one. I cannot do everything, but still I can do something; and because I cannot do everything, I will not refuse to do something that I can do. - Helen Keller

I love South Africa. The amazing beaches, friendly people and warm weather. I get to suntan by my pool even in winter, or study in my hammock outside. The latest Fro-yo franchise has opened 10 minutes away! There are so many cultures that add to the flavor of beautiful South Africa! The South Africa that I live in is a first world country, and very comfortable.

10 minutes down the road, things are quite different. Its a 3rd world country, uncomfortable to see, let alone to live in. POVERTY. I begin to dislike South Africa, or rather, the situation that the majority of the beautiful South African people live in. HURT. Literally every person you meet has been affected by HIV/AIDS in some way. Grandmothers or older siblings look after young children, as their parents have passed away. Children may walk kilometers to get to school, in broken school shoes, carrying nothing but a pencil and dirty work book in their school bags. BROKENNESS. Statistics (Rape Survivor Journey) tell us that in South Africa there is more of a chance that a woman will be raped than learn how to read! Sub-standard living conditions, lack of public healthcare facilities, alcoholism, gang violence, FEAR.

As a student audiologist I realise that if I am going to meet people where they are, I have to have some understanding of the situations that they come from. No matter how much I have learned about the hearing and vestibular system, auditory pathologies, electrophysiological tests, hearing aids, aural rehabilitation, Deaf culture or the like in my 3 years of studying, there is still so much value in understanding the community and issues that surround their everyday life. If someone is late for an appointment, it may be because they had to leave home at 4am, walk 10km and catch a taxi. If they seem unresponsive in therapy it may be because there was no food at home and it's impossible to concentrate!

3 and a half years ago while on a mission trip in a small village in Mozambique, I was in a situation when I learned this lesson. I came across a mother, her toddler and baby, sleeping on a mat in the sun outside their mud house. I went over to offer a friendly greeting, only to notice that the toddler had a severely infected eye. The child was crying, her eye was oozing, with flies sitting on and around it. It was a heartbreaking sight. Once I got hold of our translator I was able to establish that the toddler had not yet been brought to the clinic! I was angry and couldn't understand how the mother could leave her child's eye like that! I was also angry that the mother was not making any attempt to wipe her child's oozing eye and keep the flies away! It was only later that I discovered that the mother was also sick, and that's why she was unable to calm her crying child. It is likely that she no longer had the energy to keep wiping her child's eye and shoo the flies away. I asked why she hadn't brought the little girl to the clinic yet- she simple had no money for a taxi or the doctor! Thankfully we were able to return early the next day and drive the family to the clinic 20 minutes away. We were able to pay the consultation fee for them- about 6 Meticais each (+- 3 Rand/ 20 US cents), including medication, and buy them some food to help them regain their strength.

If only I had known the extent of the situation before feeling angry and judging the mother! But nonetheless, it was an experience that I was able to learn from. I hope that I am able to give my patients and members of the community enough of my time to fully understand their situation, to show empathy and respond in kindness instead of judgement. There are so many factors that contribute towards the brokenness and poverty of individuals in South Africa. Each story is different, each life is precious and the future of each person can be brighter than it may look right now! Hope can be brought to every situation!