Tuesday, June 30, 2009

Keely and Kelly Update
Boy, Have They Been Busy!
Hello Everyone!!!

So incredibly sorry about the ridiculously long hiatus in blog posts. We would like to officially blame it on the incredibly inconsistent power of late. For those of you who are not familiar with the inter-workings of Ethiopia, the city of Addis is prone to frequent power-outages. Finally, we have time to sit and write… and there is so much to tell!

There are two more adorable kiddos that we want to introduce you too. First is Addisa. She is (we think) about 6 months old. Her name, which we assisted in making, is Addisa Metesenot (which means “new wish”) She is a beautiful baby girl. She came to the orphanage about three and a half weeks ago. Upon her arrival, the caregivers brought her to our attention due to concerns they had with her health. We immediately noticed her frequent seizures and continued to be very concerned with her neurological condition due to overlapping suture closure in her skull. Kelly masterfully got her to relax and fall asleep on that first day. And we have learned since that she loves to be on her belly…it’s the only way she can catch some restful sleep.
The last week and a half, we have been very busy trying to determine the neurological ramifications of the abnormal suture closure. Thanks to the amazing support of Superkids, we were able to take her to the foremost pediatric neurologist in Addis, Dr Ayele. He referred us for
a CT scan. Kelly and our Ethiopian guide Yemamu took her to the CT scan on Friday. Little Addisa handled things pretty well all in all…but for Kelly it was a little nerve racking! We have grown so attached to this little girl. We have the results in hand and are awaiting our follow-up visit from the Doctor to learn about the potential options. For now, we are just going to continue to make her life more comfortable and help teach the caregivers to properly handle and feed her.

The second… Masquenaw aka Baletta. What an amazing spirit this little girl has!! Baletta is the kind of child that just immediately fills you with joy. When you say that her laugh is contagious…it really doesn’t do it justice. She sits in her crib, rocking back and fourth and randomly dies laughing!!! And we mean this is a full body shaking … sometimes she laughs so hard, it is silent and she is just sitting there jiggling! She particularly enjoys watching the two of us dance. She can sit up in her crib unsupported, but gets very little stimulation or even time out of bed. We have lots of ideas on improving her core strength and seeing what she can do.

Finally, a small correction…. Elshaday is actually a boy. Embarrassing as it may be to admit, gender is a VERY difficult thing to determine here in the orphanage. Pink it turns out… as well as every other color in the rainbow and ribbons and bows are actually gender neutral. A miscommunication (mistranslation) with a caregiver led us to believe he was a girl, until we observed a diaper change about two weeks ago. So sorry about that!

We spend a lot of time throughout the weeks working individually with these kids… but this week was a little different. And very exciting!! We completed our caregiver education program and it was a HUGE success. Over 35 caregivers, axillary staff members and government
employees attended the 8 hour training session. We performed the program on Tuesday and Wednesday so that all could be in attendance. The director of the orphanage, Asenake, was thrilled with the information covered and we were thrilled with the interest and sincerity with which everyone approached the program. We can’t wait to share all the videos and pictures of these amazing days with all of you!

The morning began with the didactic session. We lectured on motor and social development with an emphasis on age appropriate sensory stimulation, positioning during sleep and play, language development, sharing, feeding, hygiene/illness prevention, bone health, and body mechanics during lifting. We also did a great role play activity to teach behavior modification with an emphasis on positive reinforcement. So much laughter and lots of learning too. After a
delicious lunch and coffee ceremony (oh and of course a morning tea) we continued with our hands on learning session. In this session we brought several infants to the classroom and allowed the participants to practice swaddling, infant massage, positioning and play
techniques, and oral stimulation prior to feeding. Following the afternoon tea break, we finished up with a group conversation in which we encouraged caregivers to develop a consistent schedule that incorporated many of the recommendations including “out of crib time”,
frequent repositioning of infants, outside time and lots of play. They were amazing participants and we had a lot of discussion, brainstorming and problem solving to arrive at an agreement that we are all very proud of. Next, the caregivers were encouraged to list the key elements learned during the class and discussion of how they want to try and implement this into their day. We were so impressed by their dedicated responses. The plan now is to create a white-board
with recommendation reminders, schedule, and a place for caregivers and nurses to write notes to improve communication about children. Like we mentioned, an overwhelming success. We definitely want to thank our translator Bisrat and of course our backstage man Yemamu for
making everything run so seamlessly, it could not have been better!

And what was even more exciting were the two days following! We walked in to observe increased caregiver interaction with the kids. Lots of singing and talking. There were infants out of their crib on the floor mats in all different positions and several of them were given massages…. and toys!!! The toddlers were taken out to play in the morning according to the developed schedule (which we had NEVER seen them do prior to the education program). We saw lots of toys (which also means lots of tears….sharing is REALLY hard with all these new
exciting toys). But we were overall impressed with the attempts of the caregivers to address all these behaviors with several of the strategies we taught them in the program. We also saw improved positioning of feeding and oral stimulation for the children that have difficulty feeding. WE ARE SO PROUD!!!!!

Let’s see, the last big project. We are trying desperately to get ankle foot orthotics made for Elshaday, Baletta and Yordi. Our goal is to provide them with braces that will help prevent deformity and also allow weight bearing to improve the joint mobility, muscle extensibility and bone health. And hopefully…with time increased functional independence. The process is slow, but we are very hopeful that Monday we will finally have all the steps in place and be able to
visit the orthotist for our official assessment.

We can’t believe our time is almost through!! The time has really flown by. The “to do” list is exceptionally long including: finishingour supportive feeding chairs, creating infant positioning devices, making positioning pillows for the kids with disabilities to decrease deformity, continue to work with caregivers to implement new changes and create white board. Oh, and of course the big “movie night” we are planning for all the older kids the night before we leave… complete with popcorn and everything.

Everyday is an amazing experience. We thank all of you for your continued support throughout all of our projects. We couldn’t have done it without you! We are so blessed with this opportunity. We promise more pictures and videos when we get home. Until then….

K&K, DPT