Sunday 30 April 2017

Blog 21 Was it all worthwhile? Part 2

…and so, my final day in Lesotho and at Saint Angela's dawns, and in a way, it epitomises the contrasting emotions, hopes, despair, laughter and madness of my stay here over the last eleven weeks.

I go with Christine on a social outreach visit to the home of one of the children at Saint Angela’s, John, who has brittle bone disease. His mother died a year ago and Christine went to his home, a small round hut shared with his father, a herdsman, his two sisters, who also have brittle bone disease, and his brother.

The hut is dark, the walls black with soot from the open fire in the middle, a wall is falling down and braced with a plank. The family of five sleep on bed made from a door with a few thread bare blankets. When John returns in the holiday he is unable to negotiate the high mud step with his wheel chair, and get in and out of the hut.

Next door is a much better building owned by the grandmother, which for reasons of family politics was not being used. Christine told them this is ridiculous and insisted they let Johns family move into it. She is not a lady to be messed with so this has happened, but the problem of the bed and wheel chair access remain. Our mission is to build a wheelchair ramp and improve the sleeping arrangements.

I spend the last of the donations given to me on a couple of mattresses. Spare blankets are found in the cupboards at Saint Angela’s and we scavenge the grounds for bricks, breeze blocks and even find a broken bag of cement to make a ramp. The two care mothers join us with bread and soup and we set off in the Buckie, deep into the countryside outside Maseru.
We arrive and the driver, Kaneiloe, and I start assembling the building materials into something that looks like a wheelchair ramp while the care mothers sort the bed. John’s little sisters skip around and various relatives turn up, his father, grandmothers, nephew’s, and join in the construction work, bringing earth and mixing cement.
Everyone pitches in and there’s a holiday atmosphere. It’s a strange thing because John has been without a wheelchair ramp for all these years, and it would have been easy to build one out of mud and stones. Christine says it’s why the outreach program is so important, because sometimes when you live in abject poverty the obvious things to be pointed out.
The wheelchair ramp costs nothing, it just takes someone to initiate it and community action does the rest. This is what gives me hope in Lesotho, the community spirit is there and the desire to improve things, it just needs people like Christine to harness these positive aspirations.
The ramp may be the only one going into a private dwelling in the whole of Lesotho, certainly I’ve never seen a hut with its own wheelchair ramp before. It’s even set at the right angle and has a safety curb running at the side. It feels really good looking at it is knowing how much independence it will give John.    
We leave and not far down the road the Buckie is playing up. Kaneilo gets out and pulls something out from under the bonnet, which I think is the starter coil covered in melted plastic. I contribute tools from my first aid kit, a pair of pliers and scissors. Christine does some minor surgery on a plastic bag, and ties it round the wire, Kaneilo plugs it back into the engine, shuts the bonnet and turns the key.
The engine roars back into life and soon we are hurtling down a hill, with me wondering what other parts of the Buckie are being held together with a plastic bag. Also, the thought that the future of a country must be bright when there are young people who can fix an engine with a plastic bag, build a wheelchair ramp and bring a community together in the course of one day. Surely anything is possible with their enthusiasm and imagination.

So, was it all worthwhile? Yes definitely. Going back a second time and working with the same children meant I could build on the work I did here a year ago. I was able to research the children's problems and what treatment would be most suitable. Also, what equipment was needed. The equipment all worked well and there’s nothing I would change about what I took. It was a godsend being able to take 100 kg of specialised equipment on the plane. Thank you Dolen!
The walking frames worked well over the rough terrain, the donated 9 pairs of specialised orthopaedic boots all amazingly fitted the children they were given to, with one pair left over. The therapy balls were the right size, the kids loved the Duplo and it helped their motor skills. The blenders and special spoons helped the children with eating difficulties, the Lecky corner seat supported a couple of children who needed help to sit up. The water filters mean there is always clean water to drink in the dining room at Saint Angela’s.

However, the biggest blessing was the physiotherapy assistants. This was not planned, it just transpired. Christine happened to start on the same day that I did and turned out to be a talented physiotherapy assistant and social worker. When I went down to Phelisanong, Sylvia and Malineo just appeared and I grabbed them with both hands. Having six pairs of hands made a real difference to the number of children we could treat.

Hopefully training the physiotherapy assistants means the physiotherapy will be sustainable.  Christine has now been appointed as the social worker and physiotherapy assistant at Saint Angela’s, while Sylvia and Malineo are on the payroll of Sentebale as physiotherapy assistants. With a bit of luck the physiotherapy house will go ahead at Phelisanong and add to the physiotherapy resources there.
Now I am back in Wales exhausted. For various reasons the trip took a lot out of me but I’ll bounce back. I made a video of the eleven weeks and it looks like it was one long party. It wasn’t, it was just I tended to get the camera out when there was singing and dancing happening, and there was a lot quite a lot of singing and dancing. Here is the link on You Tube.

https://www.youtube.com/watch?v=GYcv5W8QgsY
Thank you to everyone that supported and encouraged me and made donations of money and equipment. It was all put to good use, so know that your contributions helped some children in Lesotho have access to physiotherapy and a little more independence, have a chance to walk, sit up, be fed upright, have clean drinking water, take part in Taekwondo lessons, train three physiotherapy assistants, also train a bunch of teachers and care mothers in hand hygiene and that somewhere in a small house in the Lesotho countryside, there is a family sleeping on a comfortable mattress tonight. It was definitely all worthwhile.             


      







  

         

 


Friday 21 April 2017

Blog 20: Goodbye Phelisanong


Last week was frenetic, but thank goodness Sylvia and Malineo returned to help me through it. I have another meeting with the care mothers, the main point being to introduce the concept that when I leave they now have two physiotherapy assistants that will continue the work. The problem is that that Sylvia and Malineo only started here a couple of months ago and already they have risen to a more senior position. It’s a delicate situation where longevity of service counts for a lot.

I hope I strike the right note and finish the presentation with certificates and a video to try and show what an excellent job both the physio assistants have done. The previous day they had a test which went on for hours, as I got them to show me the exercises we have been doing with the children and grilled them with questions about it. On Thursday, they will have to do it all again as the parents are coming to learn about their children and how they can best help them during the holidays.    

About 20 percent of the children here are orphans, or have been abandoned. The majority do have parents and have been placed here either because the parents can’t cope at home, or its their best chance to go to school, with the school being right next door. The children with parents will go home for the long winter break, it’s too cold to stay here over July and August. While they are home hopefully the parents will encourage them to continue their physio and become involved in their rehab.

Thursday dawns and chooses to bless us with unremitting rain, not ideal for the children trying to show how well they are doing with their walking frames. Myself, Sylvia and Malineo tear up and down the pathway with umbrella’s over heads, sloshing our way through puddles, trying not to slip and keep children dry. It’s a little taxing but the children rise to the occasion, even though some are a little overwhelmed to see their parents.  Kolosoa can’t even look at his mother at first and hides his head in his hands. He recovers and shows her how well he can do his exercises and walk with his frame.

Bokang loves to walk, but is rather wobbly and needs a frame to support him and someone to guide him. Bokang’s mother is so impressed with his progress she says she is going to give away his wheelchair. It is not quite the miracle of Lazarus, it’s just that there is little culture of physiotherapy here and the children only need a chance. The other problem is that volunteer physiotherapist’s come and go, sustaining a legacy is a problem. That’s why I have put so much effort into training Sylvia and Malineo and hope that a physiotherapy house will be built here. This might encourage more frequent visit of outside physiotherapists and hopefully maintain more consistent input into Phelisanong.

Touching moments continue throughout the morning. Loreto’s father videoing her lifting her head and following his movements. She’s only at the first stages of development, but she has great potential to go further with help. She smiles and loves company, but she needs help to sit up and stimulation to get her to use her neck muscles. It will be painstaking work, but rewarding, as she will gradually gain a little independence of movement if her physiotherapy continues.

The day ends with guiding Lithape’s mother with how to blend her food and feed her upright. I am a little anxious because Lithape muscles can go into spasm if she gets stressed or excited and exacerbate her swallowing difficulties. All goes well though, and Lithape mother agrees it is a much better to feed her this way, than laying her on her back. I have a spare blender to give her to take home and I pleased with how the day went, despite the weather. More parents are due to come tomorrow, but Sylvia and Malineo can cope without me. It’s time for a break and I head for the high mountains.


When Justice messages me about the chance of joining a trek in the remote Mokhotlong District, I jump at the opportunity. It’s an area I’ve been wanting to go to, but was unsure how to arrange transport to get there. There are seven of us in the group, including the tour guide, Stephen, and two 4x4 vehicles. Myself and Mathakane are picked up on route, in Leribe, as the others drive up from Maseru. As always things get behind schedule and by them time we reach the diamond mine, where we head off road, it’s getting dark.

We are at over 10, 000 feet and when the sun goes down its bitterly cold.  The mine is open cast and life must me very harsh for the miners that work here. We sign in, promise not to steal any diamonds, and start the descent to the small village that runs the campsite where we are staying the night. The facilitates were set up by the mine to try and provide the locals with some income. The mine is South African owned, as are all the best resources in this country. The other six people on this trip are all from Lesotho and we discuss why a country so rich in minerals, water, and beautiful scenery is so poor and is unable to exploit its own resources. Nobody has any answers.

By now it dark and the track we are descending is a jumble of large boulders. One of the 4x4 has little clearage and there are lots of sickening crunches as we inch our way down. We have to get out and try out to make out the hazardous route inch by inch. The men do lots of manly shifting of boulders by flash light, but it still takes over two hours to go about a mile, until the track finally smooths out at the end.

There are quite a few 4x4 at the campsite who have all crossed over the border from South Africa. Everyone has gone to bed to try and keep warm by the time we arrive. An old man brings us some wood and lights a fire, while we chuck some food on the braai and put up tents. A very cold and sleepless night follows and it’s a relief when the sun comes up and starts to melt the thick frost on the tents.

Packing up and organising donkeys to carry the tents takes most of the morning. A third donkey is needed to carry our stuff and its decided that most of us should start while the search for an elusive third donkey continues. This leads to some navigational challenges as we head over into the next valley towards the Solane hot springs.  The sky is clear blue and the sun intense, as we sweat our way up to the col and down to the next valley to follow the river. The stark beauty of the area is magnificent, and the whole experience takes me away from the startling health facts about this country, instead focusing me on its unique geography and culture.

A herd boy and his dogs join us and guide us to the springs. The herd boys, are the only people out here. They spend their time looking after their animals as they graze through the summer months. They have nothing but a bag of maize, stick, blanket, and their dogs. They live at a “cattle station”, which is a just a small simple hut, build of rocks and grass. It’s a tough life, if they don’t keep a fire light at night they will freeze to death. Some of these boys are only primary school age and they get paid one sheep a month for their work. This means if they survive the rigours of life out here by the time they are a young man they will have their own flock.
The cattle stations are quite close to each other, for security reasons, as sometimes thief’s will try and steal the animals. The boys can shout across the valley to each other and normally have about half a dozen dogs each to guard their flocks.  At night, the flocks make their way back to the cattle station and spend the dark hours around the hut. The boys count them in and know each animal individually, if one is missing they will know which one. The sheep are kept for wool and by early May the boys will leave the cattle station and bring their flock to spend winter around the village. Most of the boys will have spent little if any time at school, I’m not sure what school could teach them anyway.

By the time we reach the hot spring we have made two river crossings and are deep in the mountains. The shadow has fallen into the valley, the steam is rising from the hot pool and the frogs are beginning to croak. The pool is swampy, sulphurous and primeval. Silver bubbles rise from a small hole and the stones are tinged with yellow, while strands of green algae gently waft in the ripples. We get the tents up, the fire going and the stars come out to witness our cooking and musical entertainment. I have brought my sax and the others improvise with spoons, pans and plates. It won’t be making the charts, but the music fits the occasion and we enjoy ourselves while the herd boys look on bemused.

The morning starts with a warm shower where the water from the hot pool flows over the edge of a small cliff. I sit on a stone showering watching the river flow by below me. While we pack up I learn more about the herd boy’s life, which I am fascinated by and we call by another cattle station on the way back. It is impossible to approach a cattle station without a herd boy or the dogs will tear you apart. The dogs are only fed pap, so are rather skinny, and are trained to go crazy if they scent a stranger. I peer into the hut, which is about a 6-foot circle, containing a small fireplace in the middle, a bed on brushwood and skins, some battered pots and pans, and that’s it.

It’s as simple and as close to nature as you can get. I guess it’s easy to romanticise, given the complexity of western life, and the trend for getaway retreats. There is no getaway for the boys out here, this is their life for half of the year. I’m sure it’s sometimes lonely and at times brutal. We have the luxury of viewing it from a comfortable distance. We leave them to it, walking back to our 4x4, admiring the views and taking pictures of a life we will never experience. We drive back to the tarmac via a longer, but much easier route than the one we arrived. Once we hit the road we make quick ground to Afri ski, the highest restaurant in Africa. Presently a motorbike and mountain bike playground until the snows come and the ski season starts.   

We have a quick meal at the bar. Inside it could be any ski resort I’ve been to in Europe yet, only some hours before I was standing beside a grass hut with an African herd boy. The contrast in life styles is incongruous, but it’s just another day in Lesotho.
I've made a video of the trip and put it on You Tube
https://www.youtube.com/watch?v=J4HH1oVY9LY

When I get back to Phelisanong the kids are in great form and Sylvia and Malineo have been carrying on like troopers without me. Mahali has moved all his stuff, apart from the wardrobe, into the clinic and suddenly the physio room appears twice as big. We celebrate with a slightly crazy game of football with myself, Malineo and Sylvia each holding a child upright. The kids get rather over excited. Their legs go all over the place and their trousers fall down, but every is having a good time. Lesojane has returned from a long illness and busting a gut to make his wobbly knees control his feet so he can kick the ball. 

It’s difficult to believe I’ve now been at Phelisanong six weeks, but my last day dawns here and I walk down the track for the last time. I walk the kids to school, then go down to house 8 to play some music and dance with the little ones down there. School ends early on Friday so we gather up the hard-core physio crew from house 5 and take them to the physio room. I present them all with a small rucksack and a lollipop for their brilliant efforts over the last six weeks.
I tell them that Malineo and Sylvia will now continue their physiotherapy and to keep working hard at their exercises. Then it’s party time, I’ve brought my sax, Ashton is on drums, while the children bang on the table. Joyous music follows before we walk them back to their house. I was going to see them all later on in the afternoon, but suddenly I can’t face any more goodbyes and I slide away. Everyone was on a high and it seemed the right moment to go. I’m going back to Maseru on Saturday and will check in at Saint Angela’s, for a few days to see how they are getting on, before flying out next Thursday. My time in Lesotho is drawing to a close.

                                     

               

     

              




Saturday 8 April 2017

Blog 19: The long road

As I approach Phelisanong on Saturday morning there is a pile of rubble outside the gates that looks familiar. Puzzled I continued past it, and it is only when I get to the physio room that I realise the rubble use to be the retaining wall which had Mahali’s boxes stacked behind it. Without this wall these boxes are now precariously balanced in the corner. “Hey what happened to the wall,” I ask Mahali I ask as he comes in. “I don’t know,” he smiles brightly “the men just took it down.” I decided to seize my chance for more space, “do you think it would be a good idea to put your stuff in the container?” Unfortunately, there’s no deal, Mahali says there’s no room in the container. 
   
The morning continues and by the time the kids go for lunch there is a distinct buzzing sound, accompanied by a growing posse of bees in the room. “What’s with the bees Mahali?” I ask him as he passes by “I don’t know, he replies cheerful, “I’ll fetch the Doom.” He arrives back with a can of Doom which is empty. He squirts it anyway just to pacify me, as I’m getting a little hysterical about the bees. By now there must be over a hundred in the room and the focus of their attention is Mahali’s padlocked wardrobe, which he opens several times a day to get things out of.

“They’re building a nest in your wardrobe, I tell him.” Mahali denies it and opens it to show me I am wrong. I point out where they are entering a hole in one of the boxes, and insist he takes it outside. Mahali open’s it to show me they are merely interested in some bees wax he has stored there. He agrees to hang the wax in a bag in the trees and the bees gradually start leaving, following the intoxicating smell of the wax out into the garden. By the time children come back there is only a dozen disorientated bees flying around the room and the only person who’s been stung is me. I mention this aside to show how quirky life can be here, and how you just have to roll with it.

On Monday morning, I spend a ridiculous amount of time getting cross over one of the few remaining wheelchairs whose seat won’t fold out. I haven’t got the right size alum key for it and resort to my hammer. Even this technique does not bring results and it is only when Nelson brings some calm to the situation that I notice two supporting bars that should slide, don’t, and some grease greatly improves the wheelchairs behaviour. The moral of the tale being that brains frequently trump hammers.

On Tuesday I walk some of the children to school and then go down to house 8 to find Keneoue is sick again. Mamello says she must go to hospital as she has a chest infection and diarrhoea and is not feeding. I go and do some physio until disturbed by the sound of horns and ululating. The noise announces the arrival of a convey of trucks stacked with wardrobes and cupboards and a ceremony of thanks giving. I go over to watch the ceremony where the school choir are singing in the midday sun and the principle is in her best orange dress, so it’s a serious affair. The man in charge of the wardrobes gets up to give a speech which goes on for so long if the children hadn’t been African they would have all have passed out with sunstroke.

I decide to go and see if Keneoue has gone to hospital and find she is still waiting. I notice a small boy who looks very sick lying on one of the beds and who I haven’t seen before, and when I uncover him to find he is desperately thin and has a fever. Upon further investigation, I find he has come from the baby house where three children have died in the last few days, possibly from the measles vaccine, but it is not clear. They just suffered fever, rapid weight loss, went to hospital and died soon after.
This boy had only been at Phelisanong a couple of weeks. His mother evidently went mad and ran off with him and didn’t feed him, which is why he has malnutrition. He was deemed too sick to have the measles vaccine, which might be a blessing for him, but he has still come down with fever and now is in house 8, waiting to go to the hospital with Keneoue. 

I am concerned because who knows if he is contagious or not and he’s lying in the middle of a packed house surrounded by two dozen children. I go back to see Mamello and find the wardrobe thing still going on, which is a very difficult occasion to interrupt.  The wardrobe man has evidently decided to become a politician and seek election, and is practicing his skills on a captive audience. Eventually the message does get through to Mamello and she comes to house 8 and the boy with malnutrition and fever is taken outside to wait outside on the door step with a house mother.

I manage to find a packet of rehydration salts and mix them up with some water. He gulps down a couple of cups full. I try to get Keneoue to have some in a baby’s bottle, but she is coughing too much to drink anything. We are told the car is on its way to take them to hospital but this doesn’t give much of a clue of when it might arrive. The wardrobe people leave and the children are given left over snacks while they wait for a late lunch. Someone has put two biscuits in Keneoue cot and I don’t know whether to laugh or cry, trying to imagine her suddenly start munching on a biscuit. The taxi finally come at three and feels like it’s already been a very long day and fortuitous that I am doing hygiene training tomorrow.

At the training the next morning there are care parents from each house, and representative from the school and kitchen. I start by asking if the children get sick very often and they all say “yes often.” I ask them why they think this is and how they think sickness might spread between children. They suggest bad water and bad food, but there is no mention of germs or how they might be caught.

I think something invisible is difficult to explain. The glow dust on the doctored pen and paper that everyone signs their name on, helps illustrate the concept of how diseases might be spread when the UV torch reveals its trail. From our discussion, it is agreed that that hand washing is a good thing and I give out the last two plastic water containers I have for a hand washing facility for the outside toilets. The teachers and care mothers also say they will supervise lunchtime hand washing and I will do some further training with the children in school next week.

The following day I am in house 8 helping with the feeding. Once again Keneoue is back as the hospital said she was too complicated for them to admit. She returns to defy the odds with paracetamol, multi vitamins and another batch of antibiotics. The boy with malnutrition and fever remains in hospital. Malineo has had to stay with him and Sylvia has had to go home for the week so I have lost both physiotherapy assistants for the time being.

On the bright side, it is now possible to open and close cupboard doors in the houses, without them falling off, since the advent of the wardrobe man and his gifts. I am also pleased to watch the able children diligently washing their hands before lunch. After lunch I am called upon for the placing of the water containers for hand washing for the outside toilets. The ground around the toilets is a mess of rubble and junk, and as it turns out shit, which I discover as I try to assemble the water containers on a pile of rubble, an old tin can and table with broken legs. Surprisingly these feats of engineering work quite well and the children are soon using the taps. I flick away the encroaching piles of poo so nobody walks in any while they are cleaning their hands.

When I go back inside and watch from the window the house mother standing next to me assures me the water containers will survive less than 24 hours.  Well, we shall see but you have to start somewhere. Hopefully all the training I did on the hygiene and feeding will not be lost, as notes have been made and will be translated in to Sesotho to make a short training video which can be used to induct future staff.

Mostly the work I am doing here is building on a long term accumulation of consistent input, things do not change suddenly, however on Friday I am blessed with a moment where a simple thing brought an immediate result. It actually goes back to Monday when I was walking up the track with the social worker, Nthaza, and she stopped to talk to a teenage girl who comes up behind us. The girl was upset and spoke with her hands in her mouth, Nthaza was also stressed. The conversation finished and we continued, leaving the girl standing on the track crying.

I ask Nthaza what the problem is, she explains the girl is an orphan, very poor and lives with her grandmother. She is a good student, but has had to change schools and has no school uniform. Without school uniform, she can’t stay at school and will not be allowed to return after the Easter break. She has begged the social worker for a uniform several times, but all the bursaries have been used up and Nthaza has no money left to buy her one.

I tried to imagine what life must be like for this girl with no one to support her. There are probably thousands of children like her in Lesotho, but only one of them standing on the same track as me at this moment. It’s a no brainer, I tell Nthaza I will buy what is needed. It is such a small price to pay to give this girl a chance of a future. Nthaza goes to town and gets all the necessary things and on Friday the girl comes to get them and puts on her brand-new uniform, and yep, the look on her face... priceless.


I wish all fixes were as easy, but they are not. I watch Garry’s film the same morning, and the ten-year struggle that Mamello has dedicated herself to at Phelisanong. Against all the odds she has built something here that gives disabled children hope, a community and a chance of a better life. It’s been a long road, and with a bottomless pit of need, there’s no end in sight.  I walk out the gate, past the pile of rubble that use to be a wall in the physio room, and back up the track. Tomorrow’s another day.