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At the Japanese garden
In the midst of the flowers Written from the plane, sent from Istanbul Airport- awesome free wireless internet! They do it right!
I’m writing this update from a plane- I’m flying Uzbekistan airways from Tashkent to Istanbul, and from there I’ll fly to Antalya. I’ll post this blog next time I have internet. The last 3 days of our stay in Uzbekistan went by quickly. Monday and Tuesdsay we went to the neuro hospital for children. I’ll write about that in a minute. Tuesday night I got some sort of sickness and had all the symptoms of flu- I won’t go into details. But Yulduz is convinced it was the marinated Korean salads we ate- I ate most of. I don’t even want to think about salad for a long time, or carrots. I cringe even thinking about salad right now. Yuck. Can anyone reading this believe THAT? Wednesday I woke up feeling horrible and decided not to go to the CP hospital for the last day. It was a good choice to stay home, because I kept feeling sick the whole day and basically laid down almost the entire time. I did attend a meeting with the MTI staff in the afternoon, which was really
good to be at because we gave them a bunch of our suggestions for the specialists that are needed on future teams, and our input about what supplies and method of trainings would be most beneficial for the orphanage. They are doing a new project as well which will train parents to take care of children with disabilities so parents don’t give their kids up to the orphanage, but instead have the tools they need to care for their children. MTI is doing so much great work here in Uzb, I really respect their efforts and I’m quite impressed. It felt good to be able to give our input, to make the trip for future teams more worthwhile, to suggest greatly needed supplies for the orphanage, which MTI can provide, and to suggest the types of specialists that are most needed: we recommended behavioral specialists, psychologists, physical therapists, prosthetics and orthotics specialists, special education teachers, more occupational therapists, and an orthopedics doctor. Sharon doesn’t feel that more massage therapists are needed, as what they are currently doing is pretty good.
So, Wednesday night (last night) I finally started to feel a little better. We slept for about 3 hours
or so then woke up early to go to the airport. I felt better this morning, although my stomach isn’t totally back to normal. It was quite a fiasco at the airport, and I had several epiphanies about the way the world works. I won’t go into detail about that, but I also realized that I have too much luggage (too much STUFF), that I don’t understand the way things work in other countries- things are accepted here that would never be tolerated in the US, and vice versa. That we were all 3 grateful to be so well taken care of by MTI (maybe a little overprotected sometimes), but they certainly made sure things worked out for us, that official looking people with stern glances and uniforms aren’t so scary like they used to seem. We’re all just people, trying to make it in this world.
The CP hospital/Neurological hospital for children: This is a place where kids with neurological disorders come to stay for 3 months at a time to get intensive therapy, then return home for 3 months, then come back again. It is government funded, and much better off than the orphanage. Although many of
their practices are different from the US, they are doing a lot of things “right” according to our standpoint. It was a little frustrating coming in with them expecting us to teach them, when we had limited knowledge of what they wanted to learn and what they already know. Monday Sharon taught massage, and afterward Ella and I asked the group of therapists and caregivers questions, trying to get an idea of what they wanted trainings in. We realized that there was some misunderstanding about who would be attending our lectures, because “massage therapists in Uzbekistan have a different scope of practice than massage therapists in the US. Massage therapists do more than just massage- they are like OT, PT and massage combined- they do all the hands on therapy. The caregivers do basic activities of daily living with the children. We realized that instead of only the caregivers coming to our OT lecture Tuesday, we would want both massage therapists and caregivers for the whole 2 hours because we thought it would be relavent for both groups.
Ella had already prepared a basic outline of NDT/Bobath theory which they had told us beforehand they wanted training in. I
reviewed this theory and we spent Monday night practicing on each other and planning how we were going to teach it. We were both a little nervous because we hadn’t used the NDT techniques on kids with CP before, and we were supposed to teach it to them! Tuesday’s demonstration and lecture went alright, although the caregivers and therapists didn’t want to practice the techniques we were demonstrating. These are hard techniques to learn unless you practice hands on with real people, and can’t easily be learned just by watching. They were surprised at how much TIME it takes and began asking us questions about how much time we spend with patients in the US, etc. Here are some realizations and things I learned over Monday and Tuesday
Handwriting: All kids are taught to write with their right hand, but this poses a problem for kids with CP because they often have more function in their left hand. The instructors aren’t trained to teach left handed writing and have a VERY difficult time dealing with this when teaching children. There is a problem with kids writing backward and mirror image because their left hand isn’t their dominant hand although
it has more function, writing with incorrect hand posture, smearing their ink, etc, and the staff were quite bothered by this.
Babies are tied up when they are born until they are a few months old, because this is the traditional way things were done before soviet times and since after soviet times people have gone back to traditional ways, thinking this is best. So the babies are wrapped with their hands down by their sides for several months. The caregivers were asking us if we thought this was good or bad for the children. We told them that from our western standpoint it’s not good because babies need to move and use their arms and hands and learn to play so they can develop normally. We told them that perhaps this delays babies development. However we had to be careful about what we said because we didn’t want to offend their culture.
When the kids are given therapy, beyond activities of daily living like learning to dress themselves and eat, etc, it often looks like this. 5 kids in a room, strapped into a standing frame, with nothing to do. They are just strapped in there. However,
we didn’t get to see all of the therapy that is done, so I’m sure they do more than that. Ella and Sharon observed an outpatient treatment of a small child, which was apparently unbelievable. The therapist had been doing this for 25 years, a strong believer in this therapy: Basically Ella said it consisted of quickly moving all the child’s limbs quickly (like, very fast) through all range of motion in all joints as the child screamed and wailed. What kind of therapy is that? I’d like to read up on it and find out WHY they think this is good for children. Well, I’ve written a lot, so I’d better save you all and stop writing now. I’m going to write less often in Turkey.
I’m still missing Alaska and Seattle and all of you friends in both places! Feel free to leave a comment on the blog or send me an email with updates on your lives!
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