Blog 18: It's all about the micro

So, Keneoue has bounced back with the help of Amoxicillin. The diarrhoea and sickness has stopped, and she’s even been quite feisty in her demands for food. Encouraged, I decided it was time for her to have a proper square meal and Sylvia blended her some rice, fish and vegetable soup. It’s amazing that with all the hazards Keneoue has faced she’s made it this far on milk and porridge. She’s a tough one for sure and seemed to enjoy having something a bit more substantial for lunch, if a little surprised by it.

She still fighting some flu, virus thing, which is going around, and many of us have fallen victim to. I have been trying to encourage the children to cough in their hands, or their elbow, but since many of them can’t control their hands, arms or heads, this is a major task for them to achieve. Lesojane has had a terrible cough and been off school all week, and is unable to bring his arm to his mouth, however much he tries. He has still been keen to come to physiotherapy, and tries so hard to accomplish the small tasks he is given, that I have brought to physiotherapy to him and had a few sessions in house 5. I realise how much it means to him when I come to the house and find him trying to use a washing up bowl, which has been left on the floor with clothes in it, as a therapy ball. Laying across it with his limbs waggling about in the air, doing some sort of swimming strokes.

His reach and grasp control has improved a little, but it’s going to be a long road if he ever is to control a spoon and feed himself. Masela can now do that with the aid of a special spoon with a large handle and an anti-slip mat (thanks Helen for another daring raid on the ward). Unfortunately, this morning I discovered that Masela can’t use a pen. Inspired by the spoon idea I thicken a pen by wrapping string around it, but it doesn’t work too well. I find that she is unable to identify the letters of the alphabet, or which ones make up her name. Such are the hazards of overcrowded classrooms.

I task Sylvia with trying to teach Masela some basic letters. Sylvia is the young albino lady who is helping me as a physio assistant. She is smart and speaks good English, but like myself, is not blessed with patience. We are both improving in this area with the fortitude needed to work with some of these children and constant repetition of tasks. It’s a working progress.

There are a number of albino staff and children at the orphanage and their skin colour can make a tough life even harder. Stigmatised in Lesotho, and in many parts of Africa, albinos suffer abuse, attacks, and are even murdered. If that wasn’t enough to endure, they are vulnerable to skin cancer, many can’t afford to buy protective cream and they usually have poor eyesight. Mamello has helped to set up Albino link as a support system and a community that provides employment and schooling for them at Phelisanong.

Anyway, Sylvia has done such a good job helping to feed Keneoue, I’m sure she can cope with the alphabet and Masela. Both she and Malineo probably didn’t realise how all-encompassing being a physiotherapy assistant would be, from being a teacher, building furniture, feeding children with swallowing difficulties, being a care giver and all round entertainer, besides all the usual stretches, strengthening exercises and use of mobility aids. With few resources, it’s all about multi-tasking and using your ingenuity. Having two willing assistants has made such a difference in the number of children we have been able to help and hopefully will sustain things after I have left.

Regarding the more traditional physiotherapy elements, the kids are going great guns. Kolosoa and Tokiso’s first hesitant steps on the posterior walkers I brought out with me, have now evolved into all out wacky races down the path. Both boys determine to overtake the other, shouting and laughing as they engage in Ben Hur type tactics, trying to win. Thanks again to those who gave donations towards the frames and helped in adapting the wheels.

Tokiso has also achieved his dream of walking to school after only two weeks of training. It does take quite a few rests and the assistance of one to guide his frame over the rough stones and down the hazardous slope between the school blocks, but he gets better every time he does it. I think the only way he could manage it independently, would be on crutches. There is an older boy here who is diplegic and uses this method, so I am encouraging Tokiso to strengthen his upper body, and improve his balance, so that one day he might be able to do the same.

Other children have also joined the walking brigade, up and down the path between their house and the physio room and across to the school, holding the assistant’s hands or using the small children’s Zimmer frames sent down from Saint Angela’s last year. They are all making progress in their own way and it’s amazing what they’ve achieved in such a short time.

I wish I could say the same for the health of the country, but there has been a serious setback in the vaccination program over the last couple of weeks. When I was at Saint Angela’s I was impressed one day when all the young children, with their mothers, queued for hours to get their measles vaccination, as they did all over the country. However, it turns out this vaccination had not been tested and has resulted in serious side effects. The hospitals have been over flowing with extremely ill children from this life-threatening event. It has been a tragedy for the children and families effected and caused a huge political storm. After this who would trust their child to be vaccinated again, or put their faith in the ministry for Health.

Sometimes when you are faced by such mal practice, and laid low by a virus yourself, it’s hard to hold onto the conviction that your efforts are worthwhile, or will help change things. The government here has been a disaster since the last coup and caused many aid organisations to withdraw from the country. However, as my Canadian friends tell me, there are good things happening, and Phelisanong is one of these, building a community with a skill base, which hopefully can become a hub for spreading ideas into the surrounding area.

The week ends with goodbyes to Christina and Jeff, who have done such a great job helping the school with supplies, sorting out the chaos in the library and running music workshops. We are privileged to watch the children put on a show, singing and dancing, the boys kicking up a storm with their traditional gumboot dance on the dusty red earth. I feel reinvigorated by the ceremony and more able to focus on all the positive things that are happening around me. You just have to keep the faith and move forwards, one small step at a time, it’s all about the micro, not the macro.