Sunday 19 May 2019

Blog 38: Back home, reflections


Manyanye picks me up from Phelisanong and takes me back to Maseru. I meet up with Justice and Thato and we head out to Ha-Sekantsi village for the weekend. It’s the remote Basuto village Justice’s mother grew up in. We went there together last November and I enjoyed meeting the villagers and the breath-taking scenery. On route we stop at another village to take medicine to one of the village elders who I met last time, he has cancer and is being looked after by relatives.  He lies on a mattress on the floor, his body shrunken by the ravages of the disease. He recognises me and smiles and makes a joke, the body may be frail, but his spirit remains unbroken.  


We continue our journey and by the time we meet the ponies taking our bags to Ha-Sekantsi the sun is setting and we walk to the village by a sliver of moonlight. The village children are very excited to meet us and all of them want to help me pitch my tent. This turns out to be rather complicated in the dark and because I haven’t pitched it before. I bought it in the UK because it was light, rather than user friendly. I spend an uncomfortable night under its saggy canvas. It’s also freezing as it’s now winter and cold in the high mountains. 
I’m glad when the sunrises bringing clear blue skies and a comfortable 24 degrees. We have a quick breakfast and start up Thaba Chitja mountain (round mountain) which rises above the village. Its not very far but I’m feeling rather dizzy from lack of sleep and general exhaustion after the last three weeks at Phelisanong. The path leads up around the back of the steep mound and the herd boy guides us up to  the top and beautiful panoramic views of the wild Maluti mountains. I play my native American flute and its natural tuning seems to suit the raw beauty of the scenery surrounding us.

On the way backdown the herd boy takes us to the cattle post he use to stay at under the sheer cliffs while his herd grazed what vegetation they could find. He lived there for three years with nothing save his blanket and a small wall built from the rocks laying on the ground to protect him from the elements. I tried to imagine him sitting there at night, huddled in front of a fire, looking up at the spiral galaxy of the Milky Way laying its thick cosmic trail across the spectacular night skies. After a rock fall the post has now been abandoned and the herd boy uses a safer but less dramatic outpost.

We get back and, in the afternoon, Thato gives out the school uniform to the children that she has been able to buy with a donation from a benefactor. The children walk a couple of hours to school and must have school uniform to be able to attend. Trying to find money for uniform is a big deal when you are trying to live off the land out here.  There is more good news, as well as the free uniform Thato has secured a grant that will provide sewing machines for some of the ladies. In the future they will be able to make their own clothes and have a potential source of income too.

After an evening by the crackling fire I go to bed and am awoken at sunrise as the sun send its rays over the top of the mountain straight into my tent. There is a gathering of local farmers who have come to discuss moving the animals to the winter pastures. Although this is going to happen there needs to be a collective mindset and general agreement before the animals can be moved. People take it in turns to speak and there is nodding and murmurs of agreement before the next person stands up to give their opinion. It’s a timeless, cultural thing which to an outsider wrapped up in the schedules of the Western world makes no sense at all. At last everyone who wants to speak has been heard and it’s agreed the animals will be moved.

We are on our way and walk back to meet the taxi driver, Sabbath, at the road. He returns us to the guest house on the outskirts of Maseru and a very different lifestyle to Ha-Sekantsi village. I prepare myself for the last couple of days at Saint Angela’s and on Monday afternoon I go with Thato to run a physio session with the kids. She’s done a few sessions with them while I’ve been at Phelisanong and has done well to build on the small about of knowledge from the training course I ran before leaving.

On Tuesday I round off that course, “Introduction to working with children with disabilities in the community”, with the candidates, before running another afternoon physio session with Thato. The kids here are so enthusiastic, and we manage to get the standing frames out and get a couple of them standing, as well as stretching, strengthening and core stability exercises with a host of other kids.

I fly home the next day and it’s the first time I’ve left Saint Angela’s feeling positive and that things will carry on after I’ve left. Thato has agreed to keep things running and run a couple of sessions of physio with the kids every week during term time. The retired physio on the course may also be occasionally able to come and join her which would be provide valuable experience and input. 

I’m so grateful that Thato has agreed to continue the physio. The children have not had a physio assistant or social worker for the last year. Thato has much experience in working with young people and will be a good advocate for them, as well as physio assistant. She has already been running a voluntary literacy program for some of them so will be able to build on the good relations that she already has with them. With finances being stretched Saint Angela cannot provide specialists in a single discipline, they need a good all-rounder which I feel Thato has the skills and experience to provide.

As I sit at home in Wales writing this I am happy with the way the trip went and feel I achieved all I set out to do. I ran the training course at Saint Angela’s and established some useful links and support for the children in the surrounding community, especially Thato and the principle of the high school the children attend. Saint Angela’s is still on a financial knife edge, but things are definitely improving and the grounds and the gardens are the best I have seen them, with a verdant greenhouse and another greenhouse due soon. The first lady visited on the morning I left, with possible government support in some areas in the future. Things are definitely moving in a positive direction.

As for Phelisanong, I got the physio room and dormitory block working well together, assessed the new children and left Malineo with a clear plan of what she should be doing with them. I ran training courses with the house mothers and teachers and tried to establish some basic hygiene rules and child care principles. I attended a meeting with the strategic counsel and gave my opinions on future priorities that Phelisanong should focus on. In particular retaining quality staff. I feel Malineo is now well established as the physiotherapy assistant and the provision of physiotherapy at Phelisanong supported.

Overall I feel I was able to build on the last three years of work at Saint Angela’s and Phelisanong and the foundations have been laid for this to be continued and sustainable. Next year will be five years I have been coming to Lesotho and I hope to return and consolidate everything, maybe even look towards starting the outreach program at Saint Angela’s. For now though, I just want to sleep. On Monday I’ll be back working for the NHS, a different world with different concerns. 

 
                         

Friday 10 May 2019

Blog 37: The miracle of Limpho


My last week at Phelisanong and there still time for some surprises. Little Katleho, aged seven, arrived here last Sunday having, up to now, refused to walk unassisted. She tore up and down the path on a walking frame I gave her and obviously had all the right moves but not the confidence to let go. I decided to walk behind her and gently hold onto her hoody. A few days later, when she was still under the illusion I was doing this, I let go and the rest is history as they say!

Much more dramatic for me was Limpho (pronounced Dimpho). I don’t have any medical background about this child. She is an orphan, severely physically and intellectually disabled. The house mothers think she might be about five years old, but she looks more like an undernourished two-year-old. She lives in the baby house next door to the physio house and spends most of her time crying in her cot when she is not asleep. She has worn away her hair from lying down so much and has a sore on her head.

Her little body is rigid with extensor spasm and she is almost impossible to feed as she gets so distressed by the experience of trying to swallow. If she was in the UK, she would have a peg and be tube fed directly into her stomach. This not being an option I have tried every sort of position and technique I can think of to feed her and only succeeded in getting a few teaspoons spoons of porridge into her in the course of hour. No wonder she is so undernourished.

She does stop crying when I lift her from her cot and one afternoon, I was giving her a cuddle and talking a load of baby nonsense to her, when she suddenly smiled at me, followed by a little chuckle. Honestly, I was so taken back I nearly dropped her, but a greater shock was in store. The following day I decided to try feeding her again and put her in the small Panda seat that I have brought here.

I’ve tried this technique before, tilting the seat back to recline her at a comfortable angle, while I gently assist her to open her mouth and take a small spoonful of Weetabix. This normally results in her  clamping down on the spoon and the food just staying in her mouth to dribble out at the lips when the next spoonful is fed. To my surprise the food is gone, and she opens her mouth to receive another spoonful and another, until suddenly there’s nothing left.   

The whole cup full is gone in less than 10 minutes. I can’t believe it, neither can the house mothers. Limpho starts crying, but only because we have stopped feeding her. The house mother quickly makes another cupful which Limpho consumes even quicker then cries for more. After the third cup I stop, this must be the largest meal this child has ever consumed in her lifetime and she is starting to look at little uncomfortable. I pick her up and gentle cuddle her to encourage the food to go down in her little distended stomach. She gives a large burp and then a smile as if to say, “just messing with you.”

I can’t really explain what happened. Maybe it was just that I felt very relaxed about the feeding which made Limpo relax and her muscles correspondingly relax. Maybe the angle of the Panda seat was exactly right, or maybe it was a miracle. The head house mother hugs me with delight, hopefully we can repeat the experience at every meal.

I put Limpho back to bed and prop her up in her cot so she can look around, wedging a blanket under her knees and between them. She has a dislocated hip, not uncommon in immobile children with cerebral palsy. Limpho doesn’t seem bothered by her hip and appreciates sitting up and looking around her, as does Bokang in the cot next door to her.

It’s another routine I hope the house mothers will pick up on, instead of lying children down with a blanket over the head to keep them quiet, giving them no chance of social interaction or developmental progression. Bringing about this change in routine would make a big improvement in the quality of life for children like Limpho, but it’s not easy changing the mindset of the care mothers.

It’s been a very emotional morning. In the afternoon I have training with the teachers, covering three areas; infection control, nutrition and epilepsy. The whole course takes less than two hours, but I find it exasperating at times, particularly trying to make it an interactive session. After talking about epilepsy I get them to have a go at putting someone in the recovery position. All the teachers have experienced pupils having major seizures as many sufferers are not on medication, either because it is too expensive, or their condition is undiagnosed.

The teachers are particularly coy about doing the recovery position and eventually I lose patience and tell them that they are not leaving the room until everyone has done it. Finally, it’s done, and class is dismissed. The teacher whose classroom it is chats to me as I tidy up. She shamefully admits to me that she was told that you could catch epilepsy from a person if they were convulsing and their saliva touched you.

I realise that the teacher’s bashful behaviour over the last two hours has been because they were worried about looking ignorant in front of their peers and were reluctant to say or do anything in case it was wrong. Also, they come from a tradition of chalk and talk, so participating in discussion was rather alien to them. Well tomorrow it’s training for the house mothers turn and I will certainly have to turn it down a notch.

The following morning training with the house mothers goes as expected. Mamello translates for me and Mme Elizabeth also attends, the new administrative coordinator. She understands the necessity of good hygiene and the need for hand washing, cleaning products, wipeable changing mats and hygienic rubbish disposal. I give her my notes on a flash stick so she can read them at leisure and produce some basic rules for the house mothers. I also point out to her the need to constantly monitor the situation and follow up any systems she puts it place.

I show her the current rubbish disposal system, which is basically a wall by the river where hundreds of festering nappies are piled up waiting to be burnt one day. She is outraged that her instructions haven’t been followed, I shrug my shoulders and tell her to always check with her own eyes that what she has instructed has been done. She gets my point. Its one thing paying lip service to any training I do, its another putting it into action. That’s why I keep going back to Phelisanong to reinforce everything I have done and slowly things are changing for the better.

Thursday morning and its goodbye again. It’s a cold misty morning and hundreds of people are crammed into the school hall singing, dancing and shaking my hand. I find it emotional and embarrassing. Mamello gives a speech and one of her favourite stories about me and a little boy who was bought here unable to walk. He was born premature and his mother died in childbirth. He spent a long time in hospital and the doctor said he would never walk.

When I saw him it was apparent to me he had delayed development and would walk given the right encouragement. Sure enough he did. It’s not the first time I have made such a prediction and for me they are unremarkable. It’s something I would expect any experienced physiotherapist to be able to do.

The value of such predictions being born out, along with consistently returning and practicing what I preach, is that it adds to the weight my words carry here. Things that I have asked for have gradually happened and training has had an effect. The cumulative effect has resulted in Phelisanong seeing the value of physiotherapy and now have their own full time physiotherapy assistant, who I have trained, a physiotherapy house which I have equipped, a flat path around the center, allowing children with mobility problems a chance to walk to school, children with swallowing difficulties are not fed on their backs, children are being taken out into the sunshine to play, and by having opportunities of regular physiotherapy children have a chance of greater independence and quality of life.

Hopefully one day people will routinely wash their hands, rubbish disposal will be hygienic, children with severe disabilities will be routinely sat up and have a chance of social interaction, nutrition will improve, children with epilepsy won’t be stigmatised. These are some of many messages I try and get across, formally and informally. If I thought about the huge number of problems to tackle it would be difficult to know where to begin, but when I see the difference it makes to individual children like Limpho, I know the work is worthwhile and needs to continue.                          
                          

Thursday 2 May 2019

Blog 36: Its all coming togther ?

Its Saturday and I decide to take a day off after working eleven days straight. Despite the joy and sense of worth I get from doing this work it is physically and mentally exhausting, especially given the endless rain and mud during my first week at Phelisanong and my primitive living conditions.
However, at last the rain has stopped, there are bright blue skies and a pleasant twenty degrees plus during the day. Its early morning and the day begins with me standing outside my hut in a washing up bowl treading my washing, while I take a phone call from Mamello. This confirms a meeting on Sunday with some of the parents of the new children I have been working with this week. 
After that I take a walk following the stream, passing at least a dozen ladies washing all the laundry for the centre. Lower down I find a place to play my flute, do some photography, and take a swim in a small pool by a waterfall underneath a willow tree. It’s been a busy week and it’s good to be able to stop and reflect on events and the changes that have been made since I started here in the bare corner of a hut in 2016.
The physio room with the attached dormitory block works quite differently to how I used to run the physio sessions. Previously the children had to be collected from their various houses to do physio, now they just crawl or stagger from the bedroom up the adjoining ramp. This means the logistics of gathering and returning children from physio are a lot easier but at the same time there is little control about who is in the room.
I have Teboho hanging onto my leg demanding my undivided attention, Bokang staring adoringly at me whilst endlessly repeating my name, Kolosoa always up to some mischief, usually dangerous, while the rest need noses wiping, trousers pulling up, taking in and out of standing frames, taking for a walk, or help using the therapy balls, wall bars and parallel bars. With sixteen of them it can be testing even with Malineo’s help. Sometimes there are other helpers around, but their presence is not always consistent.
As well as the children in the physio house there are many other children with complex disabilities and swallowing difficulties in the rest of the centre that need to be seen. I am the only person with any medical knowledge on site and I must be realistic about what can be done and the likely hood of the house mothers following up any treatment I suggest.
It was one of the reasons I burst out laughing when at a meeting a few days ago when a member of the consultancy team, hired to highlight strengths, weaknesses and the way forward at Phelisanong, suggested I should be recruited as an ambassador and fund raiser for Phelisanong. Like I haven’t got enough to do trying to organise the physiotherapy here and a paid job with the NHS I need to go back to and earn some money to live.
The consultancy team recruited by Phelisanong were ex Sentebale personal, the main children’s charity in Lesotho, headed up by Prince Harry and Prince Seeiso. When Prince Harry wants to fund raise he gathers his rich friends and has a polo match, probably bringing in a cool million. My fund raising has been focused around doing some talks, some kind donations from friends and busking on the street corner bringing in some hundreds, which has at least got the last two loads of physio equipment to Lesotho.
Most of the consultant’s report was in Sesotho but I was able to gather the main points which were given in English. Phelisanong was given top marks for providing a sanctuary for vulnerable children, the only centre in Lesotho which takes children with both physical and intellectual disabilities, autism, numerous orphans, albino children and children with HIV. Therein lies its great problem, there are too many children that need help and not enough resources to go around.
The government provides some bursary’s for students but doesn’t even pay for the teachers at the school. The centre leads a tenuous financial existence, reliant on a few NGO organisations and occasional gifts from private donors. The consultancy team bring to attention weaknesses in the quality of care and poorly trained staff. I agree with them but also there is no point in training staff if they can’t be retained. There is high turnover of staff here, particularly the care mothers. Apart from the consistency the physio assistant, Malineo, has provided, every time I come back here there are new care mothers. Any basic training I have done, like hand washing, must start all over again. Where to find enough money to pay the care mothers a wage which would retain their services seems to be an impossible ask, especially with cut backs from main donors like Sentebale.   
I tentatively suggest that every care mother should take part in some basic training when she starts. It’s known as mandatory training in the NHS, and infection control would be a great place to start. With the overcrowding in the children’s accommodation, people eating with their hands, coupled with the lack of hand washing and incontinent children, the situation is ripe for any germ to spread like wildfire. More money is desperately needed to pay and retain staff, once they have been trained, but I don’t think me busking on a street corner will cut the mustard. 
Sunday’s meeting with the parents is protracted in the glorious way that meetings are here. Everyone is dressed in their Sunday finest, wearing brightly pattern garments with plenty of glitz. I am feeling very drab in my physio polo shirt and blue skirt sitting on a raised stage opposite Mamello and Mamojoan. Mamello’s speech goes on for over an hour in Sesotho. I haven’t a clue what she’s saying but there is lots of nodding from the audience and murmurs of agreement. My speech is ten minutes and translated by Mamello. I try to explain to the parents what physiotherapy is and the importance of carrying on the physio at home. Here is an excerpt of that speech
“Physiotherapy is two words, physio and therapy which means we treat the whole person not just their legs or arms. We try to stimulate their bodies and minds. We look at what their strengths are not just their disability. We try to build on their strengths, improve their weakness, empower them and help them achieve the highest level of independence and function possible.
We also try to improve the environment around them and remove barriers so they that can join in with activities and be part of an inclusive community. This means not only improving access and making the environment around them easier to use and participate in activities, but also changing attitudes.
Phelisanong has tried to create a more inclusive environment for children with disabilities, improving access to education, the community and most importantly changing attitudes towards disability. You need to carry on this work at home at create a family and community environment  which includes your child. You need to educate the people around you because as yet, your government has failed to implement the convention of rights of persons with disabilities. The principles of this bill of rights is inclusion, participation and non-discrimination. These principles are corner stones at Phelisanong and should be in your home to, so perhaps one day the Lesotho government will implement these principles too.  
The last three years have brought great improvements to the physiotherapy department at Phelisanong. Now there is a dedicated room for physiotherapy, special equipment and trained staff to help your children. Phelisanong has specialised walkers and standing frames. It has the only posterior walkers in the country, which cost a lot of money and have travelled thousands of miles to be here. If you get a chance to borrow one in the holidays, please look after it. I can’t just buy a new one at Shop Right!
Physiotherapy is not a miracle cure. Do not think I have a magic wand and can “fix” your child. However, with practice everyday physiotherapy can help your child grow stronger, build on their strengths, achieve a greater level of independence and improve their quality of life.
This is why you as parents are so important. There is no point in your child doing physiotherapy at Phelisanong and then going home to do nothing. Physiotherapy needs to happen every day or by the time your child returns from holidays they have to start all over again.
It is not just about doing exercises with them but interacting with them and helping their minds grow. Many of the children here have learning disabilities and need your help to stimulate their mind as well as their body. If you leave them sitting in a corner there they will stay. They need to be nurtured to grow as people. With your help your child can reach the best level of development  and independence possible…”
I finish and ask if there are any questions. There is a stunned silence. Maybe I didn’t pitch it at the right level or maybe I covered all bases and any questions are superfluous. Later the problems of communication continue as I meet some new children. I don’t speak Sesotho, and neither the parents or Malineo’s English, is good enough to give me a history beyond the child’s age. It’s a taxing day and I’m glad when it finishes sitting out in the sunshine with all the children playing with the toys. It’s something I try to do with them every day, especially now the heat of summer has gone. It’s ironic that that in a country reckoned to have around 300 days of sunshine a year I reckon many of the children with disabilities have a major vitamin D deficiency. With mobility problems they can’t take themselves outside and nobody else thinks to do it.  
The other houses are also starting to bring their children out. They’ve been told to copy what I do which could lead to some interesting situations, but I hope that it leads to better standards of hygiene and care. There is a tendency with the severely disabled small children to leave them in the cots all day with a blanket over their head to keep them quiet. It’s no wonder baby Bokang looks so surprised when she is taken outside to have a cuddle in the in the sunshine.
She’s two years old weighs little more than a new born and can barely hold her head up. Her hands are tightly clenched all the time so I gently push two fat crayons between her fingers to keep them open so her hands can be cleaned. I don’t need to worry about her putting them into her mouth because she has no movement in her arms. I’ve also brought a baby seat with me which she can sit up in as she is rigid with the high tone in all her muscles. Sitting up was making her sick, maybe it was because she wasn’t used to it as up to now she has spent most of her life in a horizontal position. As she gets more use to being vertical the sicknesses seem to have stopped and hopefully she will have a chance to develop a little beyond her current level.
With Bokang, as with all the children it takes daily repetition and lots of patience to make progress. Every day they need to be sat up, stood up, walked, played with, do exercises and repeat skills at whatever level they are at. Most importantly  it all needs to continue and be sustainable when I’ve gone.
On Monday I need to go to Hlotse which is about 40 mins drive away and I get a lift with the Phelisanong vehicle. I hope it’s not going to take long but after an hour in the bank I nearly lose the will to live. Eventually I escape to the delights of Shop Right and some variety in my diet.
An hour later I am still outside Shop Right waiting for the Phelisanong vehicle to pick me up. Fortunately, I spot a Chinese business man from Pitseng and beg a lift back with him. He is too busy to take any notice of me and he spends the entire journey shouting down his phone at various callers telling them he “employs many people”. His Basotho driver drives on in silence. All the shops in Pitseng are owned by Chinese and I sense I uneasy relationship between them and the Basotho they employ.
We get back to Pitseng. I thank the Chinese man for the lift, and he tells me he “employs many people” as I extract myself from his car. While one taxi driver shouts abuse at him from the safety of his vehicle, I jump into another taxi for Phelisanong. When at last I get back there it is a vision of joy for my physiotherapy heart. There are children sitting outside the houses playing on the grass and inside the physiotherapy room there are children in standing frames, children constructing things with Duplo and other children rolling around on therapy balls. Down in the bedroom area some children are dancing to some music with a house mother. This hive of activity is all happening without me driving it, Hallelujah!
I don’t think things can’t get much better but that evening I get pictures from Saint Angela whereThato has been running a physio session with the children. Tummy time, deep breathing exercises and stretching, it was all going down. I can’t believe she absorbed so much information in the three-training day course I ran there two weeks ago. I go to bed with a smile on my face. Maybe it’s all coming together at last 😊 
...

Despite my overall optimism I still have to stay on my toes as  events can still surprise me and present unforeseen challenges. The following Sunday is particularly testing and a case in point.
I start the day early in the physiotherapy room with over a dozen kids. I’m glad Malineo is there to help as there is also a pack of boys outside the door hassling me to use the physio tools to try and fix the bikes they were donated a couple of weeks ago. I have barely got things under control when Justice calls me. He urgently needs me to transfer some money I owe him because his dog is dying and he needs take it to the vet.
I send Malineo on a half an hour walk to find someone who can transfer the money by phone, but the person isn’t there. I try to find another way of sending the money but the dog dies on its way back from the vet. It adds to an already stressful morning as I am supposed to be meeting Mamello at noon to go and pick up a boy who has been recovering from being badly beaten by the special needs teacher a month ago.
The teacher had some sort of breakdown and beat the child ferociously with a stick, such that the boy had to spend a week in hospital. After that he went back home to convalesce and now after a month he is well enough to come back to Phelisanong. Mamello has asked me to accompany her to go and pick him up. I know this boy and have given him crutches in the past. He is a very gentle boy and would never do anything to upset anyone. He lives with his grandma and I can’t imagine how she feels about it all.
At 2pm there is still no sign of Mamello but a driver arrives to pick me up. He doesn’t speak English and I presume we are picking up Mamello on route. Half a dozen orphans pile into the van and I wonder if these are the boys friends, or just coming along for the ride. We set off with loud music blaring and pass Mamello’s house. One of the older girls in the back speaks English and I am able to establish that Mamello is ill and not coming so I am in charge of this mission. I feel a little concerned by the responsibility.
I don’t know where we are going, and no one else does, except the driver, who says vaguely we are going somewhere near the South African border but doesn’t know how far away it is. The traffic is a nightmare and we nearly get hit twice by reckless drivers Eventually we leave the main road and drive for miles down a dusty track until we finally reach the house. The boy is sitting outside in the back garden with his Grandma, where they are attempting to clean his crutches, which are broken. Fortunately I had anticipated the situation and have brought new crutches for him. I examine the wound, which to my relief is clean and nearly healed.
The grandma demonstrates how she has been cleaning the wound and gives us spare bandages and ointment as well as the boys medical notes. We don’t speak each other’s languages but I think she is reassured by my bringing him new crutches and that I am happy there is no infection in the wound.   
We set off with the boy and I give out the lollipops I have brought, luckily there are enough for everyone and the trip taken on a rather jolly atmosphere, like a school outing. I think we are on the way home but instead we call in at a large Catholic school, where one of the girls wants to pick up some clothes she left. We are surrounded by dozens of children and time goes by until I insist we leave as its getting dark.
It’s night time by the time we get back. I deliver the boy safely to the house mother, then fall over the spare crutches I have brought and nearly break my leg. I am consoled by the kitchen staff who give me a large fat cake they have just cooked, which is hot and delicious. I get back to my hut and heave a sigh of relief that the boy is at least physically okay and I didn’t have to face the complexities of making peace with the grandma or explain to her why this has happened to her grandson.
It’s been one of those days which required rapid pragmatic responses and I did what I could to get the best outcomes in the circumstances. Hopefully tomorrow will be a bit more “normal” although I’m never sure what that means in regard of Lesotho healthcare.