Kwaheri Kijabe

Today is our last day in Kijabe, Kenya. Three weeks have come and gone quickly and tomorrow a company called Safe Ride Safaris will pick us up for a four-day safari in Lake Nakura and the Masai Mara. People at Bethany Kids and the AIC hospitals have been thanking me for coming and introducing speech-language therapy here, but honestly I feel as though I have learned more from being here than anyone else. In the photos immediately above and below, mamas and their babies are returning home after successful cleft lip surgery. They will return next year, when the babies are bigger and stronger, to tackle the closure of their palates.

I have met some amazing people. Below is a photo of Mercy (chaplain at Bethany Kids) and Ann (new speech therapy assistant at Bethany Kids). Ann is also Mercy's daughter. We were treated to a delicious Kenyan meal at their home last night. Mercy has told me now that I have "given birth" to speech therapy here, I have to keep feeding it, it's "my baby". Mercy has this hypnotic way of speaking that I could listen to for hours - a very wise woman. I feel a big responsibility on my shoulders to ensure that this new position and speech therapy service really work out here. To all my SLP friends back home, I'm gonna need your help!!

Here is my class. . . (L-R) Elizabeth, Carol, Joyce, Michael and Ann. A mixture of OTs, PTs and other support staff. Peter and Stanley were missing this day (both PTs). We spent a total of about 20 hours together, with me doing powerpoint presentations and leading discussions on the topics of cleft palate speech therapy, cerebral palsy, hydrocephalus and spina bifida, Down syndrome and autism. I tried to hit on all the patient populations they work with here. We accomplished alot together, including translating handouts for parents on ways to stimulate speech-language development now that their child's cleft lip / palate has been repaired, as well as creating our own photo articulation test using all Kiswahili words!

Below is a photo of Ann, myself and a young lady named Francesca. Francesca is a child mentor at the hospital. She runs a playroom for the kids in addition to counseling the moms and providing support. She is truly a wonderful person who has had a very difficult life but has an unbelievable strength. I should really do a whole blog post on her life story. Just briefly, she was a patient at Bethany Kids as a young person (like many of the staff here actually) and lost her leg to spina bifida. Despite her own health issues, all the patients draw strength from her!

And here is Elvis! I know one is not supposed to have "favourites" but I can't help it. I really warmed to this little guy. He came from far away with his mom because, even though he had previously had his cleft palate repaired, he was having serious speech problems. In fact, when we assessed him, I realized I had never heard such a severe case of VPI in my career. That is, his soft palate (even though repaired) was just too short to do the job of closing off his nasal cavity from his oral cavity and his speech was excessively nasal. He had also developed all sorts of compensatory misarticulations such as trying to valve at the level of his glottis (vocal cords).

I have peered into the mouths of hundreds, if not thousands, of children in my job back home. It's part of doing a thorough speech assessment. But I have never seen such a deep pharynx - it was like looking into a cave. I asked the ENT surgeons if he could be considered a candidate for secondary surgery and they agreed. Elvis got a phayngeal flap and I was so happy for him. I also went in with Ann to watch the procedure - a great learning experience for both of us.

Here is Ann in her scrubes, getting ready to watch the surgery on Elvis.

A close-up of little Elvis. . . the surgery involves excising a piece of tissue from the posterior phayngeal wall and attaching it to the soft palate to bridge the gap. I went to see him several times after the surgery but could not get him to speak. I was anxious to hear if his hypernasality had been corrected or at least, decreased. However, Elvis was just too sore and groggy to speak and then was discharged two days later because the bed was needed. Hopefully, Ann will see him to follow-up at one of the mobile clinics the hospital organizes in his area.

Dr. Dan and Dr. Lousie (both from Canada) performing a cleft lip / palate repair. Dr. Dan has been here for years and Dr. Louise was doing a short-term mission.

Two of the most disturbing and challenging cases she had were two eight-year-old boys, both from Mogadishu who were caught in crossfire and received terrible gunshot traumas to the face. Dr. Louise performed major reconstructive surgery to their little faces but obviously they are severely disfigured for life.

Ann and I were asked to see them for speech afterwards. I cannot put their photos on this blog as it is very upsetting to see. One boy lost one eye, has no nose left, no upper lip, no maxilla and no alveolar ridge. Amazingly, his speech is understandable because his tongue was not damaged. He makes lip sounds such as. p, b,. and. m. by closing his bottom lip against where his upper lip would have been. He has, in the short time since injured, developed all kinds of ways to compensate for missing oral structures and when I watched him and his mother interacting, I could tell there are very few instances of communication breakdown between them.

Here is one of my favourite signs so far. It says "Only God Knows Butchery". Kind of gives new meaning to the term "mystery meat". . .

Ann and I, along with David the adminstrator of Bethany Kids Africa, did a day-long trip to. Joytown Primary School for Children with Physical Disabilities. in Thika, Kenya. I later wrote a short proposal for funds for a speech therapist. Most of the kids have severely disordered speech, secondary to cerebral plasy. It was a hard day for me, because there is just so much need there it almost overwhelmed me. But the fact that such a school exists, with staff dedicated to working with these kids, is encouraging.

Below is a photo of Frances, a little guy with hydrocephalus and spina bifida and a great sense of humour.

Hereis another little boy who could really use a picture communication book. He is nonverbal because of cerebral palsy.

Some of the kindergarten students. . . they later sang to me without any prompting. Of course I was delighted!

Driving back from Thika, beautiful tea farms everywhere. All Kenyans love their chai time, but it's their coffee that I love the most.

Baboons are a regular sighting on the front lawn of where we're staying. The babies hitch a ride on their mamas' backs.

Ted took a great shot of Mt. Longonot at evening from the front veranda of our place here.

Jackson and his adorable friend, Terryanne. Somehow they managed to communicate and play together and have lots of fun, despite the language barrier. I have never seen Terryanne without a huge smile on her face.

Many mornings, while I was at the hospital, Ted took the boys to the library at Rift Valley Academy (boarding school here) to do their work in a conducive environment. It's a huge campus with every amenity. I imagine some people choose to be missionaries here just to get their kids in such a great school.

Just one of the gyms at Rift Valley Academy. There are gyms, soccer fields, racquetball courts, tennis courts, basketball courts, a pottery studio, music roms, art studios, two libraries, a chapel, a huge cafeteria, the list goes on. . .

So tomorrow we head out on safari! On Mt. Longonot, we saw two cape buffaloes come stampeding the hill. On the way back from visiting Longiro, we saw zebras. And on the way back from Thika, we saw an elephant. So I kind of feel like I'm on safari already but looking forward to more animal sightings. Kwa heri for now!

More Photos of Longiro

We had a great visit with Longiro and learned so much more about him and his life. For example, he loves soccer (they call it football here) and his favourite team is Manchester United. His favourite subject in school is math and he thinks he would like to become a teacher when he grows up. He lives with his grandmother in a mud hut and his bed has no mattress - they use a cowhide attached to a frame instead. Mostly, it was wonderful to see how happy and outgoing he is and how well he is growing and developing. We are allowed to continue sponsoring him until he turns age 22. If he continues to do well in school, spomsorship money should enable him to go beyond high school and get a higher education (college or university).

We were disappointed that we could not drive all the way to Malaral, where he lives with his grandmother. It would have been wonderful to see his village and meet his extended family. But we were thankful that the visit was not cancelled altogether due to the "insecurity" (as they term it) in the area. We found out later that the Compassion staff came very close to cancelling the visit because of violence in the region, which would have been a huge disappointment.

The drive to meet him was long and uncomfortable, but that goes without saying in Kenya (or probably all of Africa for that matter). The roads are terrible, the vehicles barely roadworthy (we almost lost a wheel at one point - had to pull over on a busy highway to tighten the lug nuts!) One thing that helps to pass the time is to read all the strange and humorous signs along the roadway. Here are a couple of my favourites: "Mama Chika's Meat Centre and Hotel Lodging" - and then in fancy cursive script underneath - "also diesel and petrol". Kind of a one-stop shop, I guess. Another said "Cool Bar and Butchery". In fact, just about every butchery I've seen is a butchery plus something else, maybe hotel, maybe gas station, maybe photocopy place . . . strange.

We also crossed the equator and stopped for the photo op. Of course, someone was waiting there to relieve us of a few Kenyan shillings for the honour of crossing the equator. A man demonstrated how the water spins clockwise down a drain north of the equator and then counter-clockwise just south of the equator. So that was our science lesson for the day!

Some other funny things we saw on the way . . . little boys wearing Obama toques (he certainly seems to be revered here, not surprising) and we saw one little guy wearing a Toronto Maple Leafs sweater. I commented that it was nice he was a fan but he should realize they will likely never win another Stanley Cup. Of course, he looked at me blankly. These clothes probably came all the way from Value Village - we see them for sale at very affordable prices for the local families at the markets.

Here are some more photos of our trip to see Longiro:

More Kenya happenings from Mitchell

Longiro, the boy we have been sponsoring through Compassion Canada:

Longiro (age 9) wearing his new Canada ballcap:

From Mitchell's Journal:

Kijabe, KENYA (Mt. Longonot Climb, visit with Longiro, and surgical observation)

On November 11, we climbed up Mt. Longonot (actually a volcano) with Ann (the lady Mom is training), Daniel (a friend), and the person who drove us there. It was a tough climb, especially for Mom and Jackson. We fell a couple times but we managed to make it to the rim of the crater. Once we got to the rim, we stopped and ate lunch. After that, me, Dad, Ann, Daniel and the driver decided to climb to the highest point of the crater, but mom and Jackson were too tired, so they stayed behind. Climbing to the summit was even tougher, but once we made it, we stopped and took some pictures and went back down. Even though it was hard, I had a lot of fun.

Animal crossing on the way to Mt. Longonot:

Heading out, Mt. Longonot in background:

Ann and Mom:

The summit in the distance:

Looking down into the crater from the top of Mt. Longonot:

Ann had no trouble except for slippy shoes:

Dad and me at the summit (I was the first one to reach the top):

Passing people coming up as we go back down:

A couple days later, we were going to drive to Maralal to visit our Compassion child Longiro. But because we would have to go through a dangerous route (Isiolo, where an attack had just occurred and 11 people were killed) , the Compassion staff who came with us had us stay at a hotel in a different town instead (Nanyuki). The drive was long, but it was even longer for Longiro. Once we arrived we waited a couple hours for Longiro so we were worried for him. Once Longiro arrived he came to our room and we talked with him and his social worker and then ate dinner in the restaurant. We also gave him a soccer ball, a Canada shirt and cap, some school supplies, and two mini sticks. It was late, so we all went to bed. The next morning, we played soccer for an hour, ate breakfast and then we drove Longiro home. It was sad saying goodbye, but we had a good time.

On Wednesday, we got to go to work and chapel with the E.N.T team. First, we went to chapel for half an hour. Afterwards, Jackson went home and Dad and I went to go watch surgery. First, we saw Dr. David and Dr. Kevin cut and dissect two cleft lips, and then we switched rooms to watch a cleft palate being repaired by Dr. John. We went back to the other room to watch the two cleft lips being stitched together. In the end, the little boy was healed and I thought it was very interesting and fun to watch. Here are some photos from the operating room:

Enter Dr. Mitch:

Me and Dad in scrubs:

Impano (Mom worked a bit with him) and his Dad - they came all the way from Samburu:

Impano, age 14, and this is his first surgery for cleft lip:

Impano and his Dad getting ready to go back home:

Dr. John, ENT from South Carolina:

Dr. John and team:

Dr David and Dr. Kevin (Dr. Kevin said he played alot of video games when he was my age and he thinks it may have improved his dexterity):

I really liked watching surgery:

Happy Birthday Jackson!

Walking in Kijabe . . .

Little girl standing in the "commercial district" of Kijabe . . .

The "Super-Duka" (grocery store) in Kijabe . . .

AIC (African Inland Church) Hospital Sign . . .

The Smile Train ENT Team . . .

Today is Jackson's 8th birthday and he's celebrating it here in Kijabe, Kenya. I'm pretty sure he's wishing he could be back in Ottawa, though, celebrating at a party with all of his friends. For his next birthday in 2010, he wants to do either a bowling party, Midway, or Ray's Reptiles. He's already planning it. We had a cake for Jackson and the whole ENT team was here to sing to him and share in a bit of a celebration. They have gone back to the States now while our family has one more week here.

Below is Jackson's favourite photo of himself taken on this trip, so he wanted us to post it today. This was taken in Alzonne, France at our friend Gerard's vineyard. A hunter named Rolland let Jackson hold his gun while he was out hunting for wild boar!

We had what I feel was the defining highlight of our trip just recently. We made a two-day excursion to the Kenyan village of Nanyuki to visit with Longiro, our Compassion child. We have been sponsoring Longiro for about three years, writing letters back and forth, telling him about our lives in Canada and learning about his life in Kenya. Mitchell wrote about this visit, as well as climbing My. Longonot and watching some cleft lip/palate surgery, so I will post that next.