Blog 14: Infectious Diseases.

I wish to block most of Monday from my mind, but part of the outfall of events from that day, is the evident need for cleaning products and a lockable medicine cabinet. These necessities become apparent as I further explore the environment which the children live in and the impact it has on their lives.

There is a washing machine and a hoover here, but the care workers are not allowed to use either due to the cost of electricity. So, you have three care workers trying to look after 26 children, provide 24-hour care for them, and do the cleaning, with only a bottle of pine gel. As you can imagine with a dozen of the children in wheelchairs there are some issues surrounding toileting and two of the children are incontinent.

If the ladies want to use cleaning gloves, they must provide their own. Since they are paid a pittance this is a big deal. There is no soap provided at the sinks for the children to wash their hands and toilet roll is rationed in little piles on their bed every day. Tuesday morning is spent in down town Maseru buying bleach, gloves, masks, toilet roll, soap and various cleaning agents. I know that this doesn’t solve the long-term problem and intend to ask the bookkeeper about extending the provision in the budget for cleaning products.

Once again, I am so grateful to the people who gave me donations in Wales and the means to provide these essential items. The search for a medicine cabinet proves fruitless and I make do with buying some lunch boxes for each child’s medicine and putting them in a cupboard I find in the office. I put this into a bedroom with one of the care mothers so she can supervise the children taking medicines.

The system up to now has been that the children being responsible for taking meds, or not as the case may be. Christine found one of the children had not been taking their HIV medicines (ARV's) for the last month. These should be taken every day to keep the immune system fit, or their viral loading becomes high and they are vulnerable to infections. I found one of the younger children with a bottle of epilepsy medicine in their pockets. Last year when I was here she was fitting a lot, this year the teachers say she is falling asleep all the time in class. Who knows what dosage she has been swigging from the bottle.

Other items on my shopping list are ten washing up bowls, ten large water containers with taps, and soap. The former items are for the pre-school teachers and the infectious diseases and hand washing course I am running this week. There is simply no point in running such a course without providing the means for hand washing, as most schools do not have sinks, running water, soap or flushing toilets.     

I also buy some board games for the children. Many of them have learning difficulties and are behind at school.  Evidently a special education teacher was visiting Saint Angela’s, but they have recently stopped coming because they are no longer being paid by the organisation that sent them. It is unclear whether the children gained anything from the experience anyway. Meanwhile, they are sitting in classes where the norm is chalk and talk and learning by wrote. This is  not ideal for them and simple games can provide them with some planning, numeracy skills and fun.

A further shopping expedition follows on Wednesday morning, as before they left, the big hearted Irish builders gave me an envelope stuffed full of thousands of Maluti to buy bedding for the children. The dormitories look more like a hospital wards, with their plain blue sheets stamped with Saint Angela. Thirty-two reversible toppers are finally bought after a long hot morning tracking down a bargain. The instant brightness they bring to the rooms made it worth the effort.    

We manage to get back just in time for me to set up for the pre-school teachers hand hygiene course, due to start at 2 pm. The teachers from six schools finally arrive at 3.30pm with big smiles. I adapted the course from a training pack designed by Marion Baker, who I met on the ILO programme last year. To make a visual impact I have brought some special glow gel and dust and UV torches to show how germs spread. I have already doctored the signing in sheet with dust and the results are rather good against the black skin, bringing lots of excited chatter when I shine the UV torch on participant’s hands.

The course finishes with the issue of bowls, water containers and soap so the teachers can set up a hand washing facility in their own schools and hopefully ensure that their pupils adopt hygienic practices. The items are received with much gratitude, but not as much as the Powys LHB certificates for attending the course (thanks Helen), which receive a chorus of Hallelujahs and a photo call.

On Thursday morning I am finally able to get some physiotherapy training done with Christine. She has proved naturally adept at assimilating these skills and spotting where the children need extra help. Her high heels continue to fascinate me, but she can whip a pair of flat shoes out of her bag instantly when a steadier base of support is required.

We whizz through the basics of movement, joints, stretches and use of equipment. I was hoping for a bit of a chill before the children come for physio, but just before 1pm the next-door pre-school teacher comes in and announces that the teachers who didn’t make yesterday’s course will be arriving at 2pm. Even given “Basoto time”, arriving 24 hours late for a course is pushing it.

Nonetheless, I go back to the guest house, pick up the stuff I need and am ready for them at 2pm. At 3 pm I am still waiting and the preschool teacher comes in again and announces the teachers are now not coming because they have gone to a funeral. Sometimes the way this country works is totally baffling.  

Christine and I quickly adapt to the situation and give the Saint Angela’s kids a hand washing course instead. I shake them all by the hand, having already loaded it with gel. They are all rather freaked when I shine the UV torch on them, thinking it shows actual germs. I don’t enlighten them, as the fear brings the instant effect of them all obsessively washing off the apparent bacteria the light reveals. Hopefully this lesson will remain with them in the future since they usually eat meals with their hands.        

At 4pm Veronica and Manyanye arrive and I leave Christine with the kids while I show my visitors around. It is nice to be able to share with them what a great facility the physio room is, how enthusiastic the kids are and the potential benefits that Saint Angela’s could offer children living with disability to realise their potential.        

This morning I write a job description for responsibilities of a physiotherapy assistant at Saint Angela’s and there is more staff training with Christine. The children finish school early on a Friday afternoon and they are then usually tasked with doing their weekly washing. They sit on the ground with a washing up bowl in front of them, trying to do their best with their deformed arms and hands. For the boys with brittle bones it is particularly painful to sit on their bottoms and the old fractures of the bones in their legs. Today Alex has been afforded the luxury of staying in his wheelchair and balancing his washing up bowl on top of another.

I spent the previous hour with him while he patiently built a small car with a small screwdriver and spanner. I remembered I had brought it with me after I noticing his fascination with tools, and thought he might enjoy doing it.  I'm not sure who got the most pleasure out of the task, him building it, or me watching him. Making him and the other children do their washing seems harsh, but I suppose the argument would be that it instils independence in them and they will need to be responsible for their own washing in the future.  I sigh and walk back down the muddy road towards the guest house. The lights dimming and there’s a storm coming.