Back in Boston

I safely returned on Sunday after leaving Zanzibar 30 hours earlier! Thanks again to all of you who have followed along and commented! It was so nice to know that so many of you were interested in what I was doing in Kenya.

The Sun!

The sun has come out in Zanzibar! Its a beautiful place! I have now been to all the oceans in the world, and swam in all the swimmable ones!

Masai Mara

My trip to the Masai Mara did not go exactly as anticipated, there were a few bumps along the road, both literally and figuratively. But what would a trip to Africa be without a few unplanned adventures?!

The drive to the Mara took about 4 hours from Kijabe, about half the time is on “paved” roads and the other half is on dirt roads. The second half of the drive was very cool in that there were lots of Masai villages and camps along the sides of the road. They are very beautiful as you drive by, you see the bright colours of the Masai clothing along the sides of the roads. The homes tended to be very primitive, most were mud huts, some had tin roofs held down with stones, but many were made of mud as well. In the center of each group of houses was a fenced in circle for their animals.

Arriving at our lodge in the Mara was quite a change from life in Kijabe, we were greeted with warm cloths to wash our faces, fresh mango juice and of course tonnes of food on the buffet! I unfortunately got sick the night we arrived so I didn’t get a chance to enjoy much of the food. It also meant I missed two of the four games drives, which was really disappointing. I was thankful that I had gone to Lake Nakuru the weekend before as we had been able to see so many different animals there. The Mara is also such a big game park, so the safari experience was very different from Nakuru, in that we would drive for long periods of time without seeing any animals.

What I did experience in the Mara on one of the game drives I was able to go on, I will likely never forget. It was the first elephant we had seen, he was a large male, all alone eating grass. We were able to get quite close to him and were taking pictures and watching him, when all of sudden he became very agitated and upset. His ears came out and he turned and began to charge our van. To make matters worse, the van would not start as we had been having problems with the battery all day. We all really thought we were going to be trampled to death by an elephant that day. Fortunately he stopped about 6 feet from the van, watched us for a while longer while we cowered on the floor of the van, and then slowly began to walk away. It was probably one of the scariest moments of my life. And has changed my perspective on elephants entirely. The next day when I was sick, the girls did see more elephants in a heard and had a much more positive experience, I’m sorry I missed that. I was feeling better the last morning, and was able to go on our last game drive. We saw lots of giraffes that morning as the sun rose, it was very beautiful.

the elephant right before he started after us

I’m now in the not so sunny Zanzibar, with fingers crossed that the weather will improve. It can’t rain for 3 days straight, right?

Last Day in Kijabe!

Its hard to believe today was my last day at CURE. Before I arrived, two weeks seemed like a relatively good length of time to visit. But these two weeks have flown by! I have learned a lot about Kenyan culture, disability and disability services as well as being again reminded how fortunate I am to live and work in North America. I also have a great list compiled of what to bring the next time I come! =)

This is the rehab team, Elvis the OT on the left and David the rehab assistant on the right.

I am now on a week of "vacation", three days in the Masai Mara and then five days in Zanzibar! I can't wait!

Disability Services in Kenya

Yesterday I had the opportunity to travel to Nairobi with a team from the hospital to see what other hospitals are offering with respect to rehab and what equipment they have. CURE has been invited to put together a proposal for a therapeutic play room and so we went to do some research.

We were gone for over 12 hours, so it was a very long day. But I really enjoyed it and learned a lot! I love learning about disability services, and it was great to see what Kenya is doing. We visited three different facilities, as well as a bunch of shops to pick up hospital supplies and to price items for our proposal.

First stop was the Association for Physically Disabled in Kenya. They had a very modern rehab department that looked very similar to anything you might find in North America, if not nicer. The funnest part for me was their wheelchair workshop. They manufacture all of the custom wheelchairs for Kenya. For all you wheelchair people out there, check out the front castors on this chair! They know how to make chairs for rough terrain!

We also visited Gertrude's Children's Hospital, very nice also with a great rehab department and very friendly staff. I was very popular yesterday with all the Kenyan OTs we met! I love meeting other OTs, no matter where I am in the world!

Our third stop was a private hospital that looked like a 5 star resort from the outside. It had marble floors, balconies. Very chi chi! However, besides their hydrotherapy pool, they don't really have any OT services. Overall, a GREAT day!

I'm not usually a flower picture taker, but this is a real life poinsettia tree! They grow everywhere around here and apparently are always flowering, not like us at Christmas!

Lake Nakuru National Park!

On Saturday I traveled to Lake Nakuru National Park with some friends who are working at Kijabe Hospital. It is about a 2 hour drive from Kijabe and is a small game park, home to both black and white rhinos as well as flamingos. Here are a few pictures of some of the many animals that we saw! We had a fantastic day and we fortunate to see so much more than just that, even our driver agreed we had a very lucky day!

a rare black rhino, it crossed the road right infront of us!

a pride of female lions

a family of white rhinos

hyenas

cape buffalo and antelope

the lake of flamingos (the picture doesn't do it justice, it was so beautiful!)

Clubfoot Clinic

Today was my first clubfoot clinic! We literally saw about 25 kids in a few hours. Most of their current caseload have finished with the casting portion and are now on the maintenance part in which they wear special shoes to maintain the correct foot position. At first its all the time, then its only at night as to not limit motor development. I also was able to watch a few tendon release procedures which was hard because the babies were screaming and in some cases the parents were crying too.

One of the coolest parts of today was that we had a few babies come in who are at part of the Masai tribe. It was like I had stepped into National Geographic. I wish I could take pictures, but we are not allowed and it would be quite unprofessional. It took everything I had not to stare the whole time! Its amazing what they can make their ears do. I really didn't know it was possible.

Tomorrow I am headed to Lake Nakuru National Park in hopes of spotting some rhinos! (and other animals of course)!

Thumb spica anyone?

Today my splinting skills (or lack thereof) were put to the test. Fortunately there were no clients involved. Elvis and I honestly spent a good 3-4 hours today working on making templates for a thumb spica hand splint for a kid we have coming in on Monday! It was terrible considering we both were trained on how to do this. I also realized how reliant I am on the internet, because as home I would have just googled it, not spent 30 minutes trying to draw one only to finally realize when I did get online that I had the shape entirely wrong. We did eventually get it and made a really nice template for future reference!

I had a few more babies today with motor delays. I've learned that toys for children and especially babies are very uncommon here in Kenya. No rattles to teach hand grasp, etc. So when trying to give parents strategies on how to get their baby to turn its head to the other side, or position their thumb correctly, is a challenge. I thought getting parents to do "tummy time" at home was hard! Here, I think the babies are carried for the first year of their life at least. Its no wonder their motor milestones are delayed. I did have one really cute little guy who was talking up a storm and he isn't walking independently yet. Its fairly common here to put children (no matter what age) into the parallel bars to promote walking. I was in charge of this kid and I was staying far away from the parallel bars, but that was all he was interested in. He was going back and forth in them like no bodies business! He wouldn't walk anywhere else but in there! It was kind of funny.

We have some nursing students this week and they have been spending the afternoons with us because they run out of patients to see. They have been great to have around because their english is very good and they have been teaching me many things about Kenya and Kenyan culture. One of them took me up to the market this afternoon after work to get some tea and some fruit. I'm so excited to eat fresh passion fruit again!

Below are a few pictures of the Rift Valley because its just so beautiful! I went on a walk yesterday and was able to get a few more pictures from a few different angles. Enjoy!

We've had some beautiful rainbows the past few days, the picture doesn't do it justice.

The blue roof is Kijabe Hospital.

My digs!

So I've decided not to move up the hill to stay with my friend Leah who is also working here because I have really nice digs! I went up to visit after work today just to make sure. While it would nice to have the company, I don't think you can beat my porch view!

Covered porch, so I can sit in the rain (I've made it home every day just in time) and watch the lightning over the Rift Valley.

My own bathroom, with hot water!

And my room.

Work was challenging and thought provoking again today. I felt today like my time in Iqaluit has helped to prepare me for the some of the challenges here. Today was a clinic day, which means people were here from all over the country to follow-up. Some of these people won't be back for a very long time so we had to do something for them today and we had to do it quick.

One of the hardest things I saw today were two boys, each about 10 years old and each had broken their elbows. When they were casted, their arms were positioned very poorly and as a result, the are unable to bend or extend their arm fully. When asked to do this, they were in incredible amounts of pain. This however, only seemed to matter to me. Their parents and Elvis reefed on their arms so badly and so often, I almost had to leave the room. These kids were screaming out in pain. It was horrible to watch. I don't usually make kids cry in my day to day job and I certainly have never caused pain like that! I wasn't even sure where to begin with them because in North America, I'm sure we would approach this quite differently.

I also had the chance to try and teach some developmental stuff as kids were being sent up to us to "learn to walk" when they can't even sit independently.

I think my favourite part of the day was taking the kid I talked about yesterday who is visually impaired, outside. He doesn't go out very often according to mom, and we went out into the sun and I had him feeling flowers, rocks and sticks. It was fun! He was much happier than yesterday which was nice to see too!

No time for chai breaks today! Hopefully tomorrow!

First full day of rehab

This entry my be fairly OT based, so I apologize in advance to any of you who aren't OTs. Today was my first full day at the hospital and some things were very similar to my job in Boston and others were very different. We saw a lot more kids today and outside of our two "chai tea" breaks (yay!) we were pretty busy. So much so that I even saw a few kids on my own. That was a challenge since most people do not speak english that well, or they don't understand my english!

One of the main differences is the attitude towards rehab. We were dragging young, sleeping kids out of bed, less than 24 hours post-op, to start walking. There is no coddling, some of these kids were clearly in a lot of pain, but no one gave them a break or told them to take a rest. They are super cute though, I just want to hug all of them!

I observed/participated in my first clubfoot casting today. From what I understand, this is only performed by specially trained pediatric orthopedic surgeons in North America. Here, there is no precision or measurement to it. We casted a two month old baby, by turning the foot as far as it would go. He will stay in the cast for a week and then come back and we will do it again. Once the foot is as close to midline as possible, then we will start to put it into dorsi flexion. Again, just by holding it as far as it will go and casting it. I think the part I found the most amazing was that the parents totally accepted it. I've seen parents crying about things at home that seem so menial compared to this.

I think the toughest kid we had today is a boy about 6-8 years old. He is blind, but is at the hospital for surgery to his leg. He does not ambulate, his mom carries him everywhere as he also does not have a wheelchair. I think he should also have a diagnosis of developmental delay or autism, as he is non-verbal and is totally dependent for all of his self-care. He lives with his mom as his dad left them once he was born and it was clear there was something wrong with him. Since he is only at the hospital for surgery, the plan is to discharge him in a few days. From an OT perspective, he would really benefit from some intensive therapy to try and increase his independence a little bit and get him mobilizing or at least in a wheelchair. The challenge is they live 7 hours away, so we have three days to try and make some significant changes in his life! This one was hard for me as it really demonstrates the difference between services in Kenya and those in North America.

This is the CURE hospital, the rehab room is the windows on the front, left side.

On a more positive note, just after I arrived home from work today there was a sun shower and a beautiful rainbow! I enjoyed sitting under my sheltered porch watching the rain fall over the valley.

Arrived in Kijabe!

After a long couple of days of travel I have finally arrived at my home for the next two weeks, Kijabe, Kenya! There seems to be a lot of confusion surrounding the fact that I am not a doctor (most of their visiting guests are) so I was even greeted at the airport with this sign...

The CURE hospital (where I am at) is very small compared to the "large" general hospital next door. We only have 30 beds, Monday's are a quiet day for rehab, we saw 3 kiddos today. On Wednesday and Friday they run clinics which seem like it will be much steadier. The rehab department consists of Elvis, a Kenyan trained OT. It was interesting to talk with him a bit today about what OT means in Kenya and why he choose this profession, etc. I think my splinting skills are really going to improve over the next two weeks. There is also a brace making workshop where I am looking forward to spending some time.

My accommodations are great, but I am planning to move tomorrow so I can stay with my friend Leah who is also working here. But my current place sits on the very edge of the Rift Valley which is beautiful! I may have to come down here to hang out just for the views.

More to come! I hope all of you are well!

Kubeba Paw Blog

Welcome back! The bear paw blog is temporarily being renamed to the Kubeba paw blog (that's swahili for bear paw).

For those that didn't know, I'm headed to Kenya for three weeks on Saturday! I'm going to be at the AIC CURE International Children's hospital in Kijabe, Kenya for two weeks, teaching and learning from the rehab staff there. And then my friend Leah and I are going to be vacationing for a week, our plan is to safari in the Masai Mara and beach it up in Zanzibar!

I'm hoping to post regular updates on my time at Kijabe here (fingers crossed the dial-up internet will be cooperative!) And I would of course love to hear from all of you while I am away.