Our Last Hurrah

1/14/15

Hi all! Annie and Sam back again, reporting on our last full day in Addis.

We started our day at the Joy Autism Center, part of the NIA foundation and the first school for children with autism in Ethiopia. The Joy Autism Center was founded 13 years ago by Zemi. Her wonderful son Jojo, whom we had the pleasure of meeting, is on the autism spectrum. In addition to teaching 80 children at their school, the Joy Autism Center also advocates for the rights of people with autism. When Zemi’s son got his diagnosis, she learned that it wasn’t a rare disorder, and wondered why she never saw other children with autism out in the community. She soon learned that many children with autism were being kept in their homes without access to education or socialization, and was inspired to create a place for them to learn. The stigmas associated with disability in the US are present here as well, and without a national special education program, children need advocates like Zemi.

The school was in a sunny and lovely building, with fully equipped classrooms and dedicated therapy rooms. We were given a full tour and walked through an average day. We were particularly struck by the integration of communication into all of the activities. In addition to regular class time, the children receive a variety of therapies. There are no designated speech therapists on staff, due to the shortage of formally trained SLPs in Ethiopia. However, each teacher is trained in all of the therapy programs developed by the school.

We were thrilled to be able to contribute something by training the staff on Stories for Effective Communication at the end of our visit. After our crash course, the teachers collectively crafted a sample Story for Effective Communication for one of their students. The teachers and staff expressed enthusiasm about incorporating this strategy into their classrooms.

We spent a lovely couple of hours picking up some last minute souvenirs around Addis on our way home from the school. Perhaps the highlight of the day was a few hours spent with the incredible Dr. Rick Hodes, who has been living in Ethiopia for the past 24 years saving countless lives. It is hard to express how inspiring it was for us to sit with this man (and a few of the children he is hosting at his home as they recover from spinal surgery) and to hear about his work. Please visit his website, and check out the documentaries (Making the Crooked Straight and Zemene, to name a couple of notable ones) floating around out there about his work!

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Couldn’t resist a group funny face photo! Featuring Dr. Hodes and a few of his hosted patients.

We know we speak for everyone when we say that this trip has been a transformative experience. It has been a privilege to meet and work with all of the wonderful people at the 4 sites we have visited. We have learned more than we can post on this blog, and fallen in love with Ethiopia along the way.

Thanks for following our journey, and see you back in NY!

Cleft Palate Training Day 5: Goodbye For Now

1/13/15 Gregorian —– 5/5/2007 Julian

With sadness and a lot of laughter, we wrapped up our cleft palate workshop at Yekatit 12 Hospital today! The morning started off in typical fashion, with a dynamic lecture by Dr. Crowley on detection and treatment of submucous cleft palates.  After that, it was time for the final exam, after which Grace, Noel (Soliana), Annie, and Rebecca went to observe cleft palate surgery #2. It was an amazing, surreal experience. Grace discovered she has a future as a surgeon, while Noel, Annie, and Rebecca realized that their stomachs were weaker than they’d expected.

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After lunch, we began an afternoon of bittersweet goodbyes. We saw our clients for the fifth and final time, and marveled over the gains so many had made since the first time we met (one little girl made everyone teary-eyed by saying her first “K” sound ever!). We also were able to use our newly-printed Amharic cleft palate articulation books, which parents happily took home to continue using with their children.

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After a whirlwind conclusion to the clinical part of our time together, everyone convened for the presentation of certificates stating they had completed a workshop on speech therapy for individuals with cleft palate. Mesay and Berhane (the heads of Yekatit’s speech therapy team) then presented us with beautiful scarfs for our wonderful supervisors, and a plaque printed with our group picture to take back to New York! We were all touched by their generosity, and the entire TC team is so very grateful that we were granted the opportunity to work with Mesay, Berhane, and the rest of our fabulous colleagues (and new friends) that we met during the training. We know we’ll meet again someday!

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The group then headed back to Yod Abyssinia for a traditional Ethiopian meal. We had been there once before and decided it was our favorite restaurant in Addis, but this visit was even better because it was full of lively people, and there were amazing traditional Ethiopian music and dancing to watch while we ate!

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2 more days to go until we head back to the US (while some of us will be traveling to some other places). Can’t believe we have come this far!

Rebecca & Grace 🙂

Cleft Palate Training Day 4: Operation!

Another day at Yekatit 12 for cleft palate training.  We had another wonderful class/lecture in the morning featuring interactive role-playing between TC students and the rest of the class.  The TC students role-played as patients while the other students acted as clinicians.  Each “patient” was assigned specific cleft palate speech characteristics, and was instructed how to respond to treatment.  This exercise proved extremely helpful, and we all felt more confident and competent when working with our patients later that afternoon.

After lunch, a few of us were lucky enough to observe a cleft palate repair on a 19-year-old patient with a “syndromic cleft palate,” as described by the surgeon.  It was fascinating to see a repair up close, as well as the musculature that we’ve learned about but not physically seen.  The patient we observed was quite unique, as the patient’s small oral cavity caused the levator veli palatini muscle to insert into the nasal septum.  Throughout the surgery, the surgeon explained the steps he was taking in the repair, directing our awareness to the presentation of the patient (oral care, jaw shape, etc.)

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Prepped for surgery

When we got back to the hotel, we met (along with cake and cookies) to watch the movie “Making the Crooked Straight,” a documentary that follows Dr. Rick Hodes, a man who provides medical care all over Ethiopia.  He provides free medication and raises surgery funds for patients with tuberculosis of the spine and other illnesses (or arranges for them to have surgeries in other countries).  Dr. Hodes and his work is truly inspiring, and if all goes as planned, we may be meeting him for dinner on Wednesday!

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Documentary screening party!

Finally, we ended the evening with a birthday celebration for our fantastic filmmaker/photographer Josh Hayes (happy birthday, Josh!).  It was a nice way to close a full day of training, clinical work, and cultural enrichment.

-Michael and Georgia

Parents and Palates: Nehemiah and Cleft Palate Training Day 3

1/11/15 Gregorian —– 5/3/2007 Julian

Back to the wonderful Nehemiah Autism Center! This morning we held a parent training. To our delight, twenty parents and family members attended.  We incorporated a visual schedule as we did for the teacher training day to show what we worked on. And as we did that day, as each activity was completed, as a group we, in unison, exclaimed, “alekah.” For introductions, the parents shared something they loved about their child (i.e., “My child is as handsome as me,” “My child is affectionate and loving”) which made a deep impact on our day at Nehemiah. Social stories, which we (credit to Dr. Edmondes) had renamed Stories for Effective Communication (SEC) and communication passports were introduced. The parents were eager to create the SECs and communication passports for their children. They expressed their appreciation and how their child would benefit from these. GO TEAM TC!

One unforgettable moment was when we entered one of the classrooms and saw the calendars, name tags, and visual schedules we introduced at the teacher training. Teddy described that they had started using them in the classrooms right after they returned from Christmas break! SUCCESS!

Calendars, Nametags, and Visual Schedules!

After the training we were off t0 Yekatit 12 Hospital for our third day (half day to be exact) of Cleft Palate Training. We made it just in time for the therapy sessions. We split up into groups of 3-4 therapists-in-training. We saw roughly 15 patients. Different therapy techniques that were learned in class were applied. Each group created goals and homework for each client that would be seen the next day. It was a very productive and educational experience!

Back at the hotel, with no break, we had a mini lecture to make up for the first half of the Cleft Palate Training day we missed. Dr. Crowley made sure all the TC students take the quiz that was missed due to attending the parent training at Nehemiah Autism Center. LEVATOR VELI PALATIIIINI~~~ aka the muscle we will never ever forget.

Stay tuned for the remaining days we have left here in Ethiopia!

Love,

Özge (Ozzie) and Amika

TICCA & GGEAM ❤

Cleft Palate Training Day 2: Getting To Know You

1/10/15 Gregorian – – – – 5/2/2007 Julian

Greetings! Early this morning we met with our Ethiopian, Kenyan, Nigerian, and Ghanaian colleagues to initiate day 2 of cleft palate training and clinic. Josh, Lisa, and Jayne began by creating video tutorials with two of Ethiopia’s finest SLPs. These SLPs discussed how a variety of speech sounds are impacted by cleft palate, in simple, easy to understand language. Once complete, the videos will be added to those already on the leaders project website (leadersproject.org), so that SLPs with limited training in cleft palate and parents/guardians of children with no access to SLPs, can access the information and initiate a successful treatment program.

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Meanwhile in the classroom….

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Cate led an extremely interactive lecture on anatomy, during which students morphed into oral and pharyngeal musculature to pantomime movements of the vocal tract. An informative lecture for all!

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Lunch was again delicious, catered by the hospital. The time was spent getting to know our non-TC colleagues, sharing diverse cultural norms including cuisine, style, and of course speech and language concepts.

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We cleaned up lunch and prepped the treatment rooms for therapy. Two therapy sessions were conducted within each room! As such, preparation was strategic. As the patients arrived treatment groups rapidly assembled and treatment began! Students immediately implemented techniques learned earlier in the day; sometimes finding difficulty generalizing from the classroom to the treatment setting, however ultimately finding success and gaining confidence!

During stimulability testing, the students all reveled in watching patient’s faces light up in pride and amazement, as they listened to themselves produce certain sounds for the first time. Truly heartwarming and fulfilling, one reason we do what we do!

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Cleft Palate Training Day 1

1/9/2015 – or 5/1/2007 according to the Ethiopian Calendar

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“The big fly” in action

Josh Hays, our videographer (aka “the fly on the wall with a big camera”), finally arrived in Addis and joined the crew this morning. As soon as Josh loaded the van with his camera and equipment, we drove to Yekatit Hospital for the first day of cleft palate training.

When we got to the hospital, we were greeted by various professionals (SLPs, nurses, dental nurse, social worker, OT) gathered in the meeting room. Many of them were from around Ethiopia and other African countries such as Kenya, Nigeria, and Ghana. Our original plan was to have our lecture in the morning and meet the patients after lunch. However, we quickly realized that many patients were already at the hospital early in the morning waiting to receive Speech-Language treatment. So we (the TC students) and the rest of the professionals divided into groups to meet the patients after a short introduction.

Cate and Michael, the perfect incisive foramen duo
Cate and Michael, the perfect incisive foramen duo

We put on the white rubbery gloves and had our first encounters with the cleft palate patients. Patients’ basic info (name, age, etc.), case history (developmental, medical, surgical, etc.), cleft lip and palate profile, and detailed oral peripheral examination were then recorded on their individual assessment forms. When we came together to share the observed conditions of our patients, we realized how many of these post-surgical patients would need Speech-Language treatment services. Our first day of cleft training ended with a lecture on the anatomy and classifications of cleft lip and palate.

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Two more big events to note!

ONE, due to a list of unsatisfactory conditions, we decided to move to a different hotel. Thanks to Cate and Noel (Soliana)’s hotel hunting, we moved to Harmony Hotel. To share one thing – it was a first “real shower” I (Grace) took in Ethiopia and I wanted to live in that shower forever. It was quite an eventful move – more will be told over coffee and tea.

TWO, connections made!

Jayne here! Exciting collaborations happening in Ethiopia. We have met with a variety of U.S. and Ethiopian officials including education, political, and funding personnel. We discussed new ideas for general and inclusive education programs, grant writing, disability issues in Ethiopia, and how a group of 11 current and future SLPs might contribute to already impressive agendas. All parties were extremely open to collaboration. Stay tuned for progressive details!

Grace & Jayne