Thumbs up!!

Today was my first full day of swallowing/feeding therapy. It was quite an experience! Caroline is so great and I feel like we are already learning so much. When we first got to Haven 1, Caroline introduced us to the babies that have feeding issues and gave us a brief history of each baby.



Me, Dennis, and Sidney. . . .2 members of our feeding group :)

Bennet ready for therapy in all his gear to keep him from scratching himself.

Many things such as a baby's fine motor skills, gross motor skills, language and of course feeding skills are assessed to qualify them for our swallowing/feeding therapy group. Of course not all the babies at the Havens have feeding difficulties so we try to target the ones who need it the most. Gross motor skills are tasks such as sitting on their own unassisted, pulling themselves up during "tummy time", and working on head support and stability. We also play attention to their fine motor skills such as if they can reach for objects, fisting (which shows if they are tense or relaxed), tracking (holding your finger up and seeing if they follow), if they bring objects to their mouth or not, etc. We then assess their language. We want to know if they are cooing, smiling, laughing, babbling, have eye contact or not, turn to sounds, respond to their name, etc. All of these things play a big role in how a baby is feeding. The feeding issues we have seen in some of the babies also qualify them for our group including: anterior liquid loss (milk coming out of the front of their mouths), weak- to no suck, shallow breathing, weak non-nutritive suck (i will explain later on), overactive gag, spitting up, tongue protrusion, aspiration and abnormal oral facial structures.

After learning about each babies histories, Caroline also went over what a typical therapy session will include and how to perform each task. (The order of the tasks depends on the baby and his or her needs) but usually the first thing we do when we get into therapy is change them and get them clean and happy. (This is a big deal and can really play a big role in a baby's feeding) Next, we have "tummy time" where we are trying to get the babies to pull their heads up and get their muscles working and stronger.
Tummy time with Miller and Lushomo! They did an AWESOME job! So proud!

Sometimes tummy time is really difficult for these little guys! :( but we try to encourage them and not give in to their sad little cries as much as possible. We want them to get better!

We then perform Beckman exercises, which are oral motor exercises that are used to stimulate the baby's muscles used for feeding. This was really new to me. She instructed us on how to massage their upper and lower lips, outer cheeks, and inner cheeks in a soothing pattern to stimulate their muscles. We also use a “z vibe”, which uses vibrations to stimulate their muscles as well. For some babies, it relaxes their muscles causing them to gain more control of their tongue for feeding. Some of the babies absolutely LOVE this, and some think it is the devil. I had the pleasure of working with Teagan this morning and she has a love hate relationship with the z vibe. She is okay with holding it on her own and putting it in her mouth when SHE wants it there, but if I tried to put it anywhere near her she cried and threw a fit! Towards the end of the session she got more used to it though. YAY.

angry Teagan

happy Teagan. haha :)

We also give the babies pacifiers to work on their non nutritive sucking. Non nutritive sucking is different in the fact that they are not actually feeding so this type of sucking is generally faster and has shorter pauses than normal nutritive sucking. Non nutritive sucking is really important because it can increase their oxygen levels in the blood, decrease heart rate, and increase weight gain. Which is a big deal! So we make sure to incorporate this into our sessions as well.
After all this is completed we sing to them, show encouragement, give them their bottles and document their progress and look for more things to work on…and if we notice any particular problems while feeding during the session. It is only day one of my week of feeding therapy and I can already see what a difference these exercises and the z vibe can make. Caroline said some SLPs don’t believe this type of therapy approach works, but I have seen it work already with the two babies I worked with today. After doing this on Sidney, (a child with TB and that is also HIV exposed) her tongue was way more relaxed and she was able to drink more controlled with less anterior liquid loss. I am so excited to be able to help these little guys!

After a busy morning at Havens 1 and 3, we headed to lunch. I wasn’t feeling too good by this time and was having some stomach trouble. (slightly caused by being spit up on so much…but I’m getting more used to it) After lunch, Kaylee, Rachel and I walked back to the house together. When we got there Rachel went to unlock the door. After a long struggle Kaylee took a try at it, and then I followed..... NO LUCK! The lock was broken and we were locked out of the house! AHHH. After everyone else got there we each took a turn trying to wiggle the key into the door….. Still no luck. Catherine’s “bobby pin idea” was a FAIL as well. Haha. We ended up going to get Ian to climb through the bars of the window (since he is the smallest of course)…. SUCCESS! After about 30 minutes of struggle, we were finally inside, this time through the back door! WHEWWW. What a “situation!” haha. Props to Ian for being able to fit through this tiny spot!

The weather was still kind of blah today. It rained a good bit yesterday so everything was still a little wet and the sun didn’t show it’s face hardly, thus taking it longer for our laundry to dry! (still havent gotten that back...Ha) It was around 65 degrees with a breeze, but not chilly enough for a jacket. It is so crazy to see the natives around here. Since this is their “winter”, they think it is “SOOO COLD”. When we got to Haven 1 this morning we all laughed to see how some of the children were dressed. You would have thought it was below freezing outside in their “Eskimo gear”.

Little Lisa the Eskimo

Tomorrow we will continue our feeding/swallowing sessions at Havens 1 and 3. Please continue to pray for all the babies!

P.S. Matt says "THUMBS UP FOR FEEDING/SWALLOWING THERAPY!!" haha :)
Nighty Night!
Lacey

What an Experience!

I have now had the opportunity to meet the boy that I will be working with at the orphanage. His name is Gwembee and he is 22 years of age and has been diagnosed with MR. My CAPSTONE project was originally going to be on Augmentative Alternative Communication for non-verbal children. However, since Gwembee is higher functioning than we originally thought I am now going to be doing a case study on children in Africa who are primarily non-verbal. I am learning a lot from Gwembee. The first time I worked with him I did a lot of getting him to imitate actions, then had Gwembee do some oral motor movements. Now Gwembee is to the point where he is able to identify objects when given a field of three objects. He is also able to imitate words and sometimes says them spontaneously. I think for this first week I will be working with Gwembee on vocabulary. I am honored to have the privilege to work with Gwembee. He has taught me a lot about children with special needs in Africa. I am sure there will be much more to learn.

Child's First Language

You know we always learn about making sure that the children or people we work with have a test administered in their first language and we are getting first hand experience on what a difference it really does make. As y’all probably know they speak chtongan to one another, but also know English (with a different accent). The Aunties at the Haven speak in Tonga and we knew this would be an obstacle in our therapy before we arrived. However, with the help of the Aunties we have managed to gain control of our groups and they are becoming very receptive to our American accents and we are beginning to elicit expressive responses from many of the children. A couple of us are trying to learn therapy specific commands that might help with behavior and transitioning from activity to activity. I have been able to receive basic chtongan lessons from our night watchman, Webster. He has taught me to say “thank you, drink, sit down, come, come here, stand up, no.” Their language is difficult for me to hear correctly, because they are not very loud and they say it so fast. Of course it’s funny because they think us Southerners talk TOO fast…ha, good thing we don’t have any people from the North with us that would be like Michael Johnson fast! We have 4 different language times during the day. The first is at Haven 2 with the toddlers and this is mostly like TLC, then we go to Haven 1 with the babies and 1-year-olds for a language introduction class, the 3rd type is individual time where we chose babies at Haven 1 who just need extra attention, human touch/voice, language enrichment, we also help them with physical milestones like sitting up, crawling, or walking (this is PT, but we go ahead and include it with our language), the 4th session is at Haven 3 with the at risk babies and toddlers and we basically do the same thing with them and they have been the most receptive and expressive group for us. They are so sweet and they are always smiling and welcoming to what we have to teach, I will try to video it so everyone can see! I think we will really be able to build on what the group did last year and what we have already accomplished. We are excited to see how they perform by the end of our trip! ~~~Catherine~~~

Quarantine

This morning we were able to sleep in a little later than usual at our extremely nice hotel, the Protea. We ate an incredible breakfast there and then had about 15 minutes before we were supposed to leave. Catherine and I wanted to find phone cards so we headed over to the little shopping center next door. We saw Dr. Tullos over there with Khaki Jackie and decided to catch a ride back to the hotel. When we walked up to him, we found Ian huddled over a trash can. Poor thing! He was really sick. After a few minutes of getting him feeling better, the four of us got in Khaki Jackie. Dr. Tullos said he still needed to go find some eggs for Leonard and Catherine and I could go with him if we wanted. Catherine mentioned a jewelry store she saw on the way in and Dr. Tullos offered to drop us off so we could check it out and then he’d pick us up in about 15 minutes. So he did. The store, Zambezi Jewels, had a few cool crafts and some really pretty jewelry. So pretty, that we decided it was too expensive for us! Since we had some time left, we decided to go next door to another craft store. The shop owner, a white man from South Africa, asked us where we were from. When we said Arkansas, he said, “Well you must be Republicans!” We laughed and he asked us a million questions. He was quite the character! He showed us every single thing in his store, including some baboons made of seashells who were named after him (Mike), the other boy working (Nawa), and the old man sitting on the porch who had apparently just been released from jail the day before (Pops). Dr. Tullos finally picked us up and on our way back to the hotel, Dr. Weaver called. We were 15 minutes late! On the way to Livingstone yesterday we had all of our bags inside with us and it was so cramped. We had decided to buy a tarp and some bungee cords from Spar, a grocery store, and strap our bags to the top of Khaki Jackie. This task was not as easy as it may sound and we ended up sitting in the parking lot for 20 minutes or so trying to get it all figured out. Meanwhile, Ian still felt sick, and Sarah, Jaime, Meghann, and Marja were also looking a little green. We were finally on the road and not as squished as the way there. We were supposed to be back at 1 for Leonard’s lunch but we were already off to a late start. It seemed to take twice as long getting back, especially since everyone was feeling so queasy. We had to make a pit stop on the side of the road for a bathroom break about halfway home. That was an experience for sure! Right, Lace? We finally made it back to Namwianga around 2 (an hour late for lunch) and half of the group went straight to bed. Lacey, Kaylee, Catherine, Caroline, Dr. Weaver, Dr. Tullos, and I were the only ones to go to lunch. Leonard had cooked the traditional Zambian meal of sheema (a corn meal that is kind of like grits that you pour a chicken broth over) along with rice, cole slaw, and rolls. It was interesting. After lunch, we decided to all go to the Haven and just do the feeding group since Marja was sickly. It ended up going pretty well. It was nice having a few extra hands. Caroline had me explain a few things to them about using the z-vibe and some of the Beckman exercises. I feel like I’ve learned so much from her and it’s only been a week! We did have a little run in with some new folks, but we won't say much about that, ahem, B Weave! Since it was only B Weave, Caroline, Lacey, Kaylee, Catherine, and I in Khaki Jackie, we decided to see how fast we could go over the speed "humps". Every time we came to one, another car would be heading towards us so we'd have to slow down. Finally, at the very last one which happens to be the biggest and right next to the soccer field (where a game was going on and tons of people were watching) we were able to pick up some speed. B Weave FLEW across is and the four of us in the back were airborne for like 4 or 5 seconds! We all screamed and everyone looked at us. We laughed hysterically the rest of the way home. We had sloppy joes for dinner and then did some Zumba and abs. Now our water isn't working and we're all sweaty. Uh oh. Hopefully it will be on for showers in the morning! And hopefully everyone who is sick will be feeling better tomorrow! (written by Rach)

Moonbow

So today we started our morning off at the Haven again with more of the same. Feeding and Language groups. It is always a good feeling when you drive up and kids coming running out, arms open, smiling faces to you. Oh, it is amazing. You can tell the kiddos are warming up to us more and more everyday and we are falling into their routines. We know when to feed, change, sleep, and change again. I really think we are helping the Aunties here. They have seemed to enjoy our presence and are beginning to like us. Slowly but surely, we are winning them over with our southern charm.

After lunch we packed our overnight bags and loaded up in the “Khaki Jackie” and headed to Livingston. 10 girls and 2 boys do not pack light, so the 2 hour (very bumpy, with less than desirable roads) drives was a wee bit cramped. We arrived and checked into the hotel for the night.

Everyone decided it was time for dinner so the quest for food was on. Some ate pizza, others had hamburgers, all were delicious. After dinner, everyone headed back to the hotel for some rest before heading out to the falls.

Victoria Falls was indescribable. Millions of gallons of water rushing with enough force to knock over tree and spray mist hundreds of feet in the air, AMAZING. The best part was on this rare occasion, we were able to see the “moonbow”. This occurs only when there is a full moon and the skies are clear. The light from the full moon cast a rainbow over the falls. It was breath taking. After capturing pictures of the bow, the group trekked around the falls to several other locations where the mist sprayed us like rain. A few brave souls (Rachel, Ian, Meghann, Jaime, Marga, Caroline, and Catherine) followed our dear guide across the bridge and were SOAKED when we returned.

I recommend everyone hopping a plane and coming to see this for yourselves, you will NOT be sorry.

Jaime

Day 2 at the Haven

Today at the Haven we continued to establish rapport with the children and the aunties. We heard a lot more talking from the children today and we are beginning to learn the routines of each Haven. I must say, the aunties do an amazing job taking care of the babies and I don’t know how they have the energy every day. For us, we are already exhausted by lunch time! However, tomorrow we are getting a little break because after lunch we are going to Livingstone to see the Moon bow. You can only see this phenomenon in a few places in the world and we just happen to be 2 hours from one of these places! Come Thursday, though, we will be back to work at the Haven in hopes of improving the infants and toddlers language, as well as, improving any swallowing or feeding difficulties in certain infants. Overall, we are really enjoying our time at the Haven and learning to adjust to the way of life here in Zambia.

Kaylee

Day 1 at the Haven

Today was our first official day of work at the Haven. We were split into three groups to work on swallowing, language, and tutoring. We are so blessed to have two extra supervisors, Marja and Caroline. They are AWESOME and so helpful! Some girls collected data on the at risk medically fragile babies that might have further feeding issues. The others looked at the developmental levels of the babies and assisted in tutoring school aged children. Tonight we had a "welcoming party" hosted by Mr. Perry and the Namwianga Mission. It was a very moving experience and Mr. Perry expressed his sincere gratitude for our work at the Namwianga Mission as well as taking time out of our lives to come to Zambia. They prepared a FEAST of their traditional meal (chicken, rice, and red sauce. . . and of course cake) and the boys choir sang a couple of songs for us and then asked us to sing one as well. They were all so welcoming and glad to have us! Tomorrow we will continue our work at the Haven by continuing to establish rapport with the children and collecting more data.
P.S. we got showers today!! YAYYY! :)
Lacey

HI! Well today started with breakfast on our own here at the B&E house. Our cook, Leonard, has Sundays off so it was up to us to rustle up cereal, fruit, toast or whatever else we could find. Worship service here on the mission started at 9 am Zambian time...So that means it started when the majority of people got there and others continued to trail in for another 30 to 45 minutes. The service was mostly conducted in English with a few Tonga songs thrown in for good measure. They sing many songs that most of grew up singing in the church so we are able to sing along even without song books to such tunes as Joy to the World and What a friend we have in Jesus. Although the melodies of some are slightly altered from our versions we have really enjoyed learning them the Zambian way. Some of the kiddos from The Haven got to come to church so most of us had a baby in our lap for the entire 2 and a half hour service. Those kiddos can eat more goldfish and cheerios than any other toddlers I've ever seen. Most of them were very well behaved and entertained themselves well with the hair bands on our wrists and our bibles. Dr.Weaver had the most energetic little guy but she handled him like a champ. After service we headed back to the Hamby house to heat up leftovers for lunch, we're all so thankful for Leonard's wonderful cooking. After lunch we all decided a short rest was in order. We worshiped here on the mission again tonight at 7 and then the service was followed by some special singing by the students here at the mission. All of the songs were in Tonga but we enjoyed listening to their beautiful harmonies. For the last hour or so we've been getting prepared for our busy week that starts tomorrow with language classes for the Haven kids, of course we did all of this by candle light because the electricity around here is just not reliable. It's truly an adventure living here in Zambia and the day of worshipping with the Zambians was definitely a blessing to us all.

Sarah Hendrix

Helping Hands

Hello. My name is Meghann Delaplaine. I just wanted to share about my week in Zambia and what it has been like working with the children at the Haven. The very first time I set foot inside the orphanage it was like a door to a whole new world had just opened itself to me. The children at the orphanage welcomed me with big smiles and hearts. Many of the children were left abandoned by their parent’s, some had serious medical ailments such as AID’s, Syphilis, and FAS while others were just developmentally behind due to unknown causes. Either way I felt like I was at this place and time for a reason. That reason is to help and provide support to the children at the orphanage. I was able to assist these children by helping feed them during meal time, rock the babies to sleep, and play with the kids using a lot of parallel and self talk. I was also able to get some of the kids to request during meal time by saying “more,” “no more,” and “yes please.” A lot of the kids were very talkative while others were just warming up to me. For the most part the majority of kids were a little standoffish, but quickly warmed up to me after the second day of being there. I am to the point where I am starting to remember a lot of their names. They are just so sweet and full of life! I hope to continue to help enrich their lives by providing opportunities for them to lead successful lives by helping them communicate to the best of their abilities. I cannot think of a more rewarding field than Speech-Language Pathology! It is truly a blessing to be here working with a bunch of great people and children.

Haven Initiation

Hi Friends this is Catherine! Today we were initiated into the Haven (orphanage for babies and toddlers) with wet diapers, play time, bathing, and the feeding of sheema. It was amazing to see how that many children could be cared for my the "mothers" of the house. There were 7 of us there with one or two babies, and sometimes 3 babies at a time with 10 more waiting to get attention. They were so well behaved though and just went with the flow of everything going on. We didn't hear any of them cry until they were hungry and I might or might not have fed my baby really hot sheema (unknowingly of course). I felt so bad, but that did not stop her from eating her full bowl. Starting on Monday we will begin language classes at the Haven, tutor some of the school kids, work on swallowing with the smaller babies, and go to the schools for hearing screenings. We have appreciated the last few days of becoming accustomed to our surroundings, but I think now we are all ready to go to work! And work we will :) over and out....Catherine

We are outta here....

Today is the day we say goodbye to Searcy. We bid a fond fairwell to McDonalds, Diet Coke, Chilis, and Wal-Mart for the next 6 weeks. Keep us in your prayers.

Here is our flight itinerary, just in case:

flight numbers are
May 16
Memphis to Atlanta Delta 0668
Atlanta to Dulles Delta 1752
May 17
Dulles to Addis Ababa Ethiopian Airlines ET 0503
May 18
Addis Ababa to Lusaka Ethiopian Airlines ET 0873


June 24
Lusaka to Addis Ababa ET 0873
Addis Ababa to Dulles ET 0500
June 25
Dulles to Atlanta 1961
Atlanta to Memphis 1265

These are just the flight numbers, you will have to go online to get all the info.

Jaime

6 Days....

So, six days from now six other girls and I will be boarding a plane and heading to Zambia for part of out summer vacation. This little blog right here will chronicle our daily triumphs and struggles as were learn what it means to be a speech-language pathologist in Africa.

We will be living at the Namwianga Mission in Zambia. While we are there, we will be providing hearing screenings, and speech and language services for school aged kiddos, and doing some language enriching activities at The Haven, an orphanage for birth to 2 years.

This is an exciting adventure for all of us and we CAN NOT wait until the 16th. So get here soon. Follow us, pray for us, keep us in your thoughts. We will take all we can get.

Here is our tentative schedule (Taken from laceynunnally.blogspot.com):

May 16 Depart from Searcy, Arrive in DC at 9:52 to collect luggage and go to hotel

May 17 Depart DC 9:30 am

May 18 Arrive Addis Ababa 8:30 am, Depart Addis Ababa 9:30 am, Arrive Lusaka 2:35 pm

May 19 Travel to Kolomo

May 26 Drive to Livingstone for full moon, spend night at Protea Hotel

May 27 Return to Namwianga by noon

June 19 Drive to Livingstone, High Tea at Royal Livingstone Hotel

June 20 Safari in Chobe National Park, Botswana. Evening worship at Protea Hotel

June 21 Victoria Fall and shopping, Sunset Cruise

June 23 Return to Namwianga

June 23 Drive to Lusaka, Check into Protea Hotel

June 24 Depart Lusaka 3:25 pm, Arrive Addia Ababa 8:25 pm

June 25 Arrive DC 7:35 am, Depart DC 2:30 pm, Arrive Atlanta 4:25 pm, Depart Atlanta 5:05

pm, Arrive Memphis 5:30 pm

Jaime