The past few days I have been busy trying to finish up all my evaluations for both the Miriam Home and For Jonathans Sake, finish wheelchair modification/evaluations, developing AFO schedule, developing a way to thicken liquids with cornstarch for the children who have aspiration problems, come up with special education curriculum, love on my kids.
The evaluations have 2 parts to them. The original evaluation portion that I type into the computer and then add on goals and a treatment plan and then a separate 2 page document that will have the kids name, pictures of the most appropriate toys, list of toys on 1 side and on the other side the treatment plan, goals, and pictures of positioning for each child. I was able to completely finish 28 For Jonathan Sake Evaluations and the picture portion for the parents. I finished 24 part 1 of Miriam Home Evaluations and developed a system that I can finish the picture parts from home with Courtney’s help .
I have 9 children who have been having problems with aspiration and 1 little girl Rachel who has been aspirating really bad. The pediatric physical therapist and me sat down and were videotaping how to position Rachel for feeding. We quickly realized that it did not matter how we positioned her that she as going to aspirate and that we needed to come up with a plan. Ideally Rachel needs a G-tube but in Haiti this is not sanitary or possible. Another option would be a trach but also not possibility in Haiti due to sanitation. The only idea we had was to thicken all liquids and all food continue to be pureed. The PT had heard of using cornstarch which we actually have in Haiti. So the last few days I have been playing with and developing a recipe for how to mix it up so we can teach one of the workers to do it everyday for all the kids that have aspiration problems. I am still trying to get my workers to understand that it is water (there liquids) not food and to not give them water.
We have a special education teacher coming in for a month or so to work with the children. I set up a schedule of what children I wanted her to spend 1 on 1 time with everyday and what ones I wanted her to spend time with 1-2x a week.
I also developed a daily stretching program so that all my kids would get stretched everyday. It will take 4 hours for all my kids that would benefit from stretching to get stretched for 10 minutes a day. I developed a video that goes threw a basic stretching regime that is in English and creole. So that Americans can stretch them or a Hatian can be taught to. We are still working on who will do this and exactly how it will look.
The last few weeks the language barrier has been rather difficult. It is very hard when you need your workers to understand something related to the kids health and not be able to communicate it then and there because you don’t have a translator. Also when your workers are trying to ask you a question and you don’t understand. I really need to learn Creole. I also need to keep working on my sign-language. I have not finished my sign-language, English, creole, picture DVDs yet but plan to in the next month or so as I study for the my boards.
I had a meeting with my workers on Friday to debrief them on what I have been doing the last 6 weeks in Haiti. It ended up being a 2 hour meeting but went amazingly well. They took everything really well even though I totally overwhelmed them with tons of information and changes BUT Courtney reminded them that everything we were doing was to make the children’s life better and that we would make it as simple and easy as possible for them. I talked about the children’s new AFO’s and how excited I was for the children and the potential they bring. I said when I come back I believe that Ju-Ju and Steven will be walking. I talked about how there will be a schedule of when they are to wear them and I would be sitting down and educating on how to put them on. I talked about the importance of feeding the children in an upright position & the reason why I am so strict about it. I introduced the new thickened liquids for 9 children to try to prevent aspiration pneumonia. I also wanted to encourage them and tell them how great of a job they do. Because of Courtney and my workers I have so much more peace coming home because I know my kids will be taken care of when I am not there.
