Saturday Post -- 16/03/13

Amanda and Shona

This week, we not only moved into our new home but received a much-anticipated visit from Amanda's old university roommate, Shona Blatch, a speech-language pathologist. Shona was working with Amanda's fellow audiology worker Odalys Arce (who has some speech therapy training) as part of a week-long drive to give guidance to speech therapy clients and to give Odalys the tools to continue therapy. 

Shona with Odalys, outside FT's headquarters.

Around 20 patients had been identified by Amanda and Odalys for treatment in the previous weeks and Shona was able to see most of those patients in her short time here.

Why did you come to Bolivia?

Amanda invited me. I've always wanted to use speech therapy in a Third World context, in another country. So when the opportunity came, I jumped on it. 

This week's pictures were all taken by Shona, including this typical Benian
lunch (rice with dried beef and egg).

What were the circumstances that led you to decide to come here?

The day before Amanda invited me I'd asked somebody to pray for an opportunity for me to serve and the very next day, I got Amanda's email! And then everything just fell together. It was in January, so fairly short notice, but I already had my vaccinations from previous visits to Africa and Asia, which helped a lot. 

Amanda with Arturo and Poppy. Our pristine-white
exterior walls are already a distant memory with
those two around.

What have your impressions been of Trinidad?

I've only been here a week so still don't really feel I've had time to process it all! I felt like it was a cross between Asia and Africa. It's a busy place and yet everybody seems so relaxed. Even though I had very little Spanish, everyone made an effort to communicate, which I thought was great.

The view from Shona's bedroom window.

And the Foundation?

I had looked up the website beforehand so it was exactly as I'd expected it to be. I thought it was pretty neat to learn about how they can't do things the same way as back home because of the weather and humidity -- for example, with the hearing aid molds, they use an acrylic resin instead of the usual material. I found it difficult having limited supplies and no formal assessment materials, so basically everything we did was from scratch. Also, therapy really depends on follow-through at home, so I can see the long-term difficulties Odalys will have with clients if they don't show up to appointments regularly or practice at home. Speech therapy is not a quick fix! 

Shona making noises, with patient. She specifically requested that we not
post the image with her tongue sticking out the side of her mouth.

So, what did an average speech therapy session look like?

An average appointment would take an hour. The patient would come in, we would chat a little bit about what concerns the parents have, with the child to see what they sounded like and how intelligible they were. We had a range of patients, for example, a three-year-old who hadn't started talking, as well as older children with speech delays. 

We would then carry out a structural assessment to see if everything looked normal in their mouth. And then I would have them do little tasks to see if their articulators (tongue, lips, etc.) functioned properly. It was at this point that I realised just how poor the dental care is here, and not helped at all by all the pop they'd been drinking [Trinidad has its very own Coca-Cola factory]. One night, for example, I saw an eight-year-old kid wandering about the street in his pyjamas with a bottle of Coke!

This patient, with Downs Syndrome, was
a bit of a player.

I would then carry out a speech test, by presenting a list of words representative of the various sounds in Spanish. The patients had to say each of the words back to me. We would see which sounds they'd say correctly/incorrectly. Then, we would see if we could teach them to say the sounds correctly and then finally, we'd choose our goals for therapy. And to finish, we'd have a question-and-answer session with the parents.

Amanda and Odalys.

Were all your patients children?

No, we had some adults. For example, we had a teacher with voice issues. We explained to her how to use her voice properly and look after it, i.e., drinking lots of water and avoiding coffee and Coke, and taking voice rests. We did some voice exercises, stretching her vocal cords, showing her how to produce voice gently rather than using it harshly. 

We also had a stuttering client who was an adult. With child patients, we taught the parents how to model slower speech and praise the child's fluent speech. But with the older client, I taught him some more direct therapy methods. I was a little shocked that the methods taught down here to address stuttering are methods that have been discontinued in Canada.

To bring the curtain down on a top week's work, we all went out for steak
last night with Odalys and her daughter, Karol, left (a recent addition
to the English classes, too).

Any funny stories? 

One day we were working with a little girl to expand her vocabulary. I pointed to her head and she replied, "lice"!

Finally, and at the extreme risk of sycophancy, did you have a good time with us?

It was great to be able to catch up with Amanda and it was great that, although I didn't always know what was being said in conversations with her friends and colleagues, I could catch a word or two and work it out from context, so I didn't feel entirely alienated from conversations. And Amanda did a fantastic job translating. 

I appreciate Craig and Amanda's hospitality. The visit was a great opportunity to experience what their day-to-day life is like so I can go home and have a better understanding of it. 

Amanda with ventriloquist's dummy.

Prayer

• For safety, energy and patience for Shona as she embarks on an epic journey home. She has a short flight to Santa Cruz at 7.15pm this evening, where she has to wait till 2am (!) to board a flight to Panamá, where she will spend pretty much all day tomorrow before flying to Toronto at 5.30pm. Yikes!
• For our kitchen, i.e., that it would finally arrive this week from Santa Cruz (there have been blockades on the road to Santa Cruz all week).
• For the speech therapy patients with whom Shona met this week, that they would be diligent in acting on the expert advice received this week.

Praise

• For an immensely fruitful week with Shona, both professionally and personally. We give thanks for her friendship and for giving up a week's holiday to provide such invaluable support to the Foundation.
• For a pretty smooth transition to the new house this week. No major problems to report.

¡Que Dios les bendiga!

Craig & Amanda