I can't wait to go to Africa!

On March 4 Randi Burlein came to talk to our group about her trips to Ghana. This was the second time I'd heard her talk about Ghana. The first time was motivating as far as getting my paperwork to go in on time, this time, the second time was just exciting, now I'm ready go--- I can't wait to gorge myself on pineapple, to see our hotel, to see the market and most of all the meet some of the people she keeps talking about. Randi shared with us a video her department put together that had photos of the kids and adults they work with and of the students hard at work-- it was so great to put faces with names and to be able to give faces to the masses of kids I've been imagining meeting. The whole meeting was just great, it gave voices and faces to the people we hope to work with and an actually identity to the place I've been looking forward to visiting for the past several months.

Common Childhood Disabilities

In our fourth meeting our group discussed common disabilities and interventions seen in developing countries. The thing that left the biggest impact on me was the idea that an intervention that we take for granted here in the US, such as the placement of a shunt, would be ill advised in many areas in developing countries because the follow up necessary to properly carry out and maintain the intervention is available in such limited quantity or not at all in isolated rural areas that minor maintenance issues could easily become life threatening emergency care problems. It put into perspective for me just how different life is for some people and how vastly different the priority system for providing healthcare in such settings has to be. The reading for this week brings to light the importance of being able to understand the full circumstances and needs of the community and its individuals on their terms and shedding all of your assumptions and any preconcieved notions of who they are, what they need and what you can and will be doing in their community.

where to start?

In the face of challenges ranging from physician shortages and unequal resource distribution, to underfunded training and practice facilities and inadequate infrastructure, it's hard to recommend a starting point for improving rehabilitation services for the disabled population. Just making sure people have access to safe water and toilet facilities presents a challenge, providing rehabilitation services for the 95% of the disabled population in Ghana that does not even receive services seems like an issue too huge to address-- and in many ways thus it has been treated by the infrastructure. The government issued a persons with disabilities bill which appears to attempt to address some of the challenges the disability population faces in Ghana, though in reality it seems the government has been able to do little to put the bill into action. It has fallen to the community to adapt and fulfill its own needs-- as we saw in the example with the villagers who used donated motorcycles to establish a system that allowed a nurse and a medical assistant to travel through rural areas to administer basic services resulting in an increase in vaccination coverage to 75% from 40%. It is the ingenuity, resourcefulness and determination of the villagers and the professionals who stay (or return) to practice in their own country who make the difference in their communities. They are the ones who identify the needs and the opportunities for change and are able to make and execute plans for change that will get those needs met. When I first did the reading I thought, where would you even start, people don't even have clean water?! But perhaps I need to think less about that and be ready to just jump in where ever and go with the motorcycle riding vaccination team and the home grown birth attendant carrying her wares in a wooden box and let direction for the infrastructure come from the people to the government instead of expecting it to be vice versa.

According to Paul Wellstone, “successful organizing is based on the recognition that people get organized because they, too, have a vision.” In my mind, community based rehabilitation is just healthcare’s special phrase for community organization— the terms are really one in the same. In both cases, an organizer (community member or healthcare worker) joins a community to help that community identify their needs, organize, plan and take action. Key to both processes is the organizer’s ability to empower the community members, motivating them to take part in the process, and eventually take over the process, making the presence of the organizer no longer necessary. The goal is to establish a sustainable program that the community generates, will benefit from, can manage and will be able to support as long as it is needed. The hard part, as an organizer, is remember that you are there to be a catalyst—to get things going, keep the momentum going, and help to lay down the groundwork, not to do the work for the community or direct or dictate anything. I think the most important thing to remember is to go in to a community ready to learn as much as you teach with humility and patience, curiosity and determination, empathy and compassion. It’s too easy to go in and assume that you’ll be teaching people wonderful things and they’ll just be begging to learn everything you know and you’ll be saving them from their horrible fates. Thinking like this discounts all the resources the community has to offer and presumes its members have less to offer than you. This imbalance inhibits the community building process, creating obstacles to establishing resources instead of removing them. I have so many hopes for our trip to Ghana—I hope we are able to help, to do something that will help someone in some lasting way, I hope to connect with some people in the community. But I expect on this trip that I will learn more from the people I meet than they will learn from me. In our reading this week I think Haig said it best when he wrote, “never go into a region with heroics in mind. Instead, think of a strong and sustainable business plan.”

Some sites I found

So, here I am waiting for the new episode of Bones to come on and I thought, why not see if I can find anything interesting to add to my blog?! I believe I have told just about everyone in the class about Anthony Bourdain's trip to Ghana--here's a link to a clip from the episode, unfortunately the whole episode isn't available online. I also found a project PBS has called Global Cafe. They've spotlighted a few countries, interviewing peace corps volunteers and students from the country being featured. The focal point it education. I thought it was interesting and enlightening given our discussion of education earlier the week and my own limited knowledge of the education system in Ghana. Also, I don't know if you guys are into following the news in Ghana, but my favorite place to check from time to time is a news site call Worldpress.org. It's a nonprofit that collects and translates (when necessary) world news. You can search news by world region or country, the site also provides maps, and has CIA stats. Their url is just http://www.worldpress.org.

YAY I'm going to Ghana!

Okay so apparently I was supposed to say a little something about myself before I did my homework! :D This is my first time blogging too-- on my own blog anyway. As part of our program I'll be post here periodically responding to readings/discussions and just posting my reflections on our experiences as we prepare to go to Ghana and then take off for Ghana (woohoo!).

I am a Grad II student in the entry level OT program at VCU. I have studied abroad before in Chile and Germany, but have never been to Africa before and am very excited to go. I love traveling and trying new things. I'm looking forward to this trip as well because I'm getting to go with several students from the Grad I class-- so I get to study with four students I wouldn't otherwise have class with! :)

Response to "Child Development in Developing Countries"

It's hard to imagine the amount of need there is in the world, even with all the numbers and statistics the articles we read provided it's hard for me to really wrap my head around just exacty what the all the numbers mean. It is easy to see though that while progress has been made towards meeting the UN Millennium Development Goals, there is still a lot to be done. The authors noted on more than one occasion the lack of available information on the subject matter-- given this, the amount of information they provided and the detail in which they provided was impressive. The articles really gave me a better idea of what is going on world wide with children's health. I found the authors' discussion of characteristics that made programs successful (p. 234) and suggestions as to what research still needed to be done (p. 239) particularly interesting and useful. I am hoping these lists will help me be able to more effectively assess programs I encounter once in Ghana. Given the the severity of cognitive, social and motor impairments that results from stunting, it's strange to think of the difference interventions as simple as providing iodized salt or introducing more stimulation in home environments could make in a child's development.