Tanzania Physical Therapy Service, Day 3

| September 15, 2017 |

– From August 17, 2017 in Tanzania, Africa –

Time is moving quickly, and I’m trying to capture every moment with the students and teachers at SSLC. Though we’ve already made an impact with a great deal of knowledge exchanged, the potential is immense. To me, it seems as though we’re looking at a mountain—we have so much to climb, so much to gain, as a united team. Yet, we have to take it “step-by-step,” and embrace the process of growth. We’re learning how important it is to stay focused in the present, while keeping our eyes on bigger dreams. Life lessons in Tanzania. I haven’t had time to process all we’ve done so far, but my exhaustion at the end of each day is telling me I’m giving my all to teaching and learning…

Every morning, we stop in town to pick Bryson up with his brother, Simon. They’re driven on motorcycle to meet our SSLC van. We then drive past a shopping center where Rashid and Imran jump into the car (they walked from their home to meet us). Other children get picked up in a second round, or get rides from family members. This morning, Bryson was later than expected, but there was no blip in our day! Once he joined us for a ride, he made Meaghan beyond happy by saying her name in the car! When we pulled up to school, Nasra greeted us by sprinting to the car, her face relieved by our presence. Our tardiness had her worried! Despite our tardiness, our day started with a brief circle time of songs and greetings before diving into today’s work.

What We Taught

Since all initial evaluations have been completed for each student at SSLC, our treatment plans were in full effect! Meaghan dives into some more difficult facilitations with Bryson, Sarah teaches stretches to Azariah’s mother, Lo helps release Imran’s spastic hands, and Jamie teaches jaw-closing techniques to Nasra’s cousin. Seeing the Stony Brook students learning and applying knowledge immediately is also rewarding. They’ve been so willing to jump into ALL aspects of the evaluations and patient care, and I haven’t given a second thought to their chosen interventions. A benefit of working alongside Stony Brook Seawolves is that we come from the same education background. We’ve gotten into many critical discussions, and they contributed greatly to SOAP note discussions. It’s been fun to develop an evaluation based on what’s relevant in Tanzania and at SSLC school.

Today was a big day with the kiddos! Cascade DAFO (based out of Washington State) donated a large box of AFO’s and braces for us to bring to Tanzania. Bryson is a young boy diagnosed with cerebral palsy (quadriplegic athetosis) with immense potential! Since 2016, he’s begun speaking in more consistent 1-2 word sentences, and he’s been stretched consistently. In our sessions, we worked on rolling, head control, and range of motion techniques. Early on, Bryson stood up and walked with Meaghan. Despite his fluctuating tone and difficulty with movements, he is able to take steps when properly supported! When Meaghan supported Bryson at his trunk, Nasra’s cousin helped at his legs to keep them from scissoring, and the other kids helped in any way they could for Bryson to initiate movement. His limitation? His toes point inward (plantarflex and invert), which makes it hard to stay contacting the ground. Our solution? Trial some AFO’s from Cascade DAFO! Bryson was motivated, and with a few trials, we found the right braces for him… which led to him standing and walking even MORE! The smile on Bryson’s face, and relief from his older brother, Simon, was heartwarming.

Speaking of braces… Imran was demonstrating some difficulty with wrist/finger extension due to his posturing. His right thumb preferred to stay tucked between his pointer and middle finger, and he didn’t open his hand too often. So… we decided to try a Benik hand splint! Imran actually ASKED to try it on when he saw Nasra wearing it, and he absolutely fell in love with it! Immediately, he began clapping and weight bearing more frequently on his right hand. We didn’t have him go home with the brace today, and he was sad when I took it off, but I reassured him he’d get it back tomorrow!

As most parents will empathize, it’s hard work to care for kids! The stress of lifting, carrying, and caring for little ones often leads to low back pain. Without surprise, two of the teachers at SSLC have low back pain, so we spent time reviewing general back pain exercises such as pelvic tilts, abdominal drawing in, wall squats, and double knee to chest. We also discussed what neutral posture is. Sister Emma and Rogathe noted how much better their backs felt after doing just a few exercises. Next year, I think it’ll also be important to go over body mechanics with lifting the kids and equipment to prevent exacerbations.

What We Learned

Bibiana is the most natural PT, and remember those text books we gave them yesterday? Well, she went home… and studied. She asked if Azariah’s eyes resemble the condition “extopia,” where one eye turns out. Though not exactly the same as his nystagmus, her thought process was on point. She also asked to clarify which types of cerebral palsy each of the children had… again, on point with each thought. Each SSLC staff membe is driven by passion, which has ignited a deep desire to learn. Here’s Bibiana in action with Bryson and Simon (his older brother):

The learning has been reciprocal here. One of the most important things I’ve come to realize is there’s different kinds of poverty. The word “poverty” doesn’t always refer to sociological/economic poverty. Here in Tanzania, we may be exposed to economic poverty, but there’s an immense richness of spirituality, with deep connection to God and religion. In a lunch conversation, Rogathe and I talked about how America is God’s country and giving (with their time and money). She therefore loves when Americans come to visit Tanzania due to their kindness and service to various missions. For example, Bill Gates was just in Tanzania last week! But, she also notes we used to be a richer country, and are now losing God and, sadly, our strength. She says she would love to help us return to God, building our strength and unity again. I felt a deep, stomach-dropping feeling because I know she’s right. We’ve eliminated God from our Pledge of Allegiance and a great percentage of our lives, in fear of upsetting others, discriminating, and not being inclusionary. But in the process, we’ve sacrificed our strength. I could continue on this, but I’m going to lay this topic to rest. I am feeling a stronger connection to the divine here in Tanzania, and am beginning to define the Universal love as more God-like that I have previously. My spirituality is finally growing back into a space of religiousness. Our spiritual poverty as a nation will hopefully be restored over time…

Photo of the Day

Every day, we’ve been getting packed lunches from The Grill House. Frequently, these lunches include one hard boiled egg. Jamie has initiated the “No Hard Boiled Egg Left Behind” law, stating that NO hardboiled eggs should be left untouched. Naturally, we’ve donated all eggs we don’t want to her. She doesn’t complain when that leaves her with 4 eggs at lunch time… not one bit!

Swahili Lesson of the Day

“Hakuna matata” is “no worries,” as you may have learned in the Lion King. It’s a phrase many locals use frequently to express their stress-free lives. We also started saying “Hakuna shida,” which translates to “no problem.” This is more conversational, such as if you were running late, apologize, and your “rafiki” (“friend”) says “Hakuna shida.”

See? Lion King can teach you Swahili. Not going to lie, I’m dying to watch it. It’s the ciiiiiircle of lifeeeeee……

Laugh of the Day

Our trip mascot is Skippy the dog, our loyal friend at L’Oasis lodge. He enjoys laying on the pavement at the entrance, joining in shenanigans with other local pups at night, and being scratched… with a fork. No hands-on with this pup because we’re certain he’s filled with fleas, but why not grab a dinglehopper (@The Little Mermaid) and scratch his cute lil head?

To read more about Step-by-Step Learning Centre, the staff, and students (and/or to donate to their unique, passionate vision), please visit their website here: www.sslc-tz.com

With love and gratitude, Kristen “KConn”