October 9, 2014

Hello all again,

Bill has been telling you I’d write and so here we go…

The first patient I became involved with was a new mom of twins who had a stroke sometime during or after their birth. When Woody and I first visited her, she was nonverbal, had no use of her right side, had a feeding tube and was very lethargic and disoriented. She was about a week or so post delivery at that point. We brought her twins to her to hold which we felt was important. The first time I helped her hold one baby, she seemed more interested in my arm than the baby. The babies were in the Neonatal Intensive Care Unit (Tenwek’s NICU) being fed through feeding tubes until about a week ago.

Here, when they are taken off the feeding tube, they are fed with small cups due to the expense of small bottles here and it appears to work amazingly well. This is the first time I’ve seen a NICU on the mission field so it has been interesting. (Last week there was even a tiny 28 wk preemie in there.)

Sorry for digressing…

Before she was discharged early this week, it was so encouraging to see her more alert, trying to talk and being somewhat successful, and become engaged in the exercises I gave her so she could do some range of motion exercises by using her less affected arm and hand to guide her affected hand/arm. She did them amazingly well. She seems to have a good support system as she heads back home and hopefully, as she is back in her normal surroundings, and with time, she will continue to make gains. Apparently, she is set up to receive home health type rehab services.

I’ve also gotten involved with some children with autism who Woody has been seeing. We’re working with the parents and school to give suggestions for activities, strategies and modifications and also trying to help them understand some of the behavior they’re seeing. We were so pleased to see the way the school is supporting one child we are seeing- alternating seat work with movement opportunities, although he often wanted to be by himself, his peers were involved in his day. The contrast between how he acted at the outpatient clinic and at school was startling and clearly demonstrated they were doing much right. The teacher was to be congratulated for her success in teaching him and the 39ish other students in the class.

Yesterday was a real high as I accompanied Woody and Solomon, the Kenyan PT, to deliver customized wheelchairs to 2 children. One child is at a school nearby that has a class for students with physical challenges. When I first saw her I was appalled to see her feet dragging on the ground as she propelled herself in the (standard large) wheelchair she sat in. What a difference it was to see her sit up taller with her feet supported on footrests. Then, we went to the home of an 8-year-old with spina bifida and hydrocephalus. It was an arduous trip on bumpy roads and as Solomon drove I sensed there was a discussion and some question in the front seat about exactly where this boy and his family live. We finally found a child who guided us. There were probably 20 people gathered at their typical mud shamba to see what would take place (it was quite a community event).

Eight year old Aaron was sitting on the floor very bent forward at his hips and head very bent back. I tried to imagine how the wheelchair could correct such poor positioning. Once he was placed in the wheelchair with built up foot plates so his feet could have some support, and a wheelchair tray in place which now helped his trunk stay more or less perpendicular to his thighs and his forearms on the tray gave additional support to his trunk, he looked like a different child. His perspective of the world is now changed from looking up from the floor to a more level gaze at his environment, and since his neck no longer needs to be so hyperextended to see the world, it is hoped that the head will adapt to a more upright position. Now he can go to the nearby school which was part of the urgency in getting him a wheelchair.

Aaron was happy, his parents were so thankful and we were thrilled for the difference having an appropriate wheelchair can potentially make in Aaron’s life. The 2 children and Solomon had traveled to Nairobi to a place that fits and then fabricates wheelchairs about 2 weeks ago. The funding for the wheelchairs is coming from the new foundation Solomon, Woody and Woody’s pediatrician-wife, Amy, are forming in conjunction with the Kenyan ministry of health and other agencies here. Yesterday’s experience was such a vivid picture of the need for and practical effects of this foundation in its infancy. We praised God for His provision, His working and His grace as we prayed with the crowd before leaving Aaron’s family’s home.

Thank you, Thank you, Lord!

These experiences are intermingled with the mundane activities of doing laundry (no dryers of course), buying fruit and vegetables at booths (dukas) not far from here, cooking and cleaning and even getting a shoe repaired (mud was coming in through a gap between the sole and the shoe-yuk!) I’ve enjoyed trying to communicate in some way with the vendors and I’ve found you can find an amazing variety of items right here around the hospital.

Mrs Kilowatt, OTR/L