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!

RidgeCity Week 1

We have finally started our Community Based Rehabilitation (CBR) practical sessions in the community! My community is Mariannridge (AKA RidgeCity), located just outside Pinetown.

It wasn't the smoothest start, as we (Student audiologists) weren't able to access the hearing screening equipment before leaving. But none the less, we were able to get involved in the local clinic and preschool. Armed with our otoscopes, gloves and alcohol swabs, we worked together with the student speech therapists who were conducting speech and language screening on all of the Grade R's (+-5 year olds) at the Preschool. We were able to do otoscopic examinations and oral peripheral examinations on all of the grade R's in the first half of the morning.

We identified a few children with impacted wax, and many more whose teeth were decaying. Oral hygiene may be an area that we need to create some awareness in, particularly from the speech therapists point of view!

I really enjoy working with preschool children, they come up with the funniest things, and otoscopic evaluations and OPE's can always be turned into a game. And if all else fails, the reward of a sticker is a sure way to gain compliance!

Some of the children do not speak english. Whilst there were Zulu-speaking students around who could have been used as translators, or taken over the examinations all together, I decided to take on the challenge and have fun putting my limited Zulu vocabulary to use. It didn't go so badly, I was able to get my instructions across and complete the examinations.
I really do enjoy trying to speak Zulu with both children and adults: some of the reactions are priceless! I also find that it is a great ice-breaker!

The second half of the morning was spent in the local clinic, observing the facilities and how the clinic runs. One of the things that stuck out to me was a sign in the waiting room that read: "Waiting time is 3-4 hours". It really does become a whole-day experience, it can't be fun waiting that long! Particularly when you have small children with you!

All in all it was an interesting day, and I look forward to returning next week!

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!