Back To Work! (with appropriate breaks for lunch and mandatory napping)

We completed Day 2 of surgical screenings at Can Tho General Hospital. I am proud to say that the bureaucratic process that I set up (which probably shouldn't have been as much fun to set up as it was... have I chosen the wrong career?) held up with 50 more patients to register and screen, limited lighting, liberal usage of bullhorns by the Vietnamese nurses, and wilting humidity! The surgeons have decided on around 35 patients as viable surgery candidates, ranging in age from under a year old to adults in their mid-50's.

If you'd like to keep tabs on these surgeries and some more photos of some of these patients' orthopedic and podiatric malformations, take a look at the project's Facebook page: https://www.facebook.com/extremityproject and the project's blog: http://extremityproject.blogspot.com/. These sites also feature commentary from the surgeons and nurses. We have some really accomplished (and some professional) photographers that are accompanying us this year, so I will also post some of their photos as I get my hands on them (yay, Dropbox! boo, slooooow internet speed!)

With the surgical screenings completed, Stacy and I got started on our "real job": Working at the Can Tho Pediatric Hospital, seeing particularly challenging patients, doing some direct teaching with therapists, and working on home practice plans for families. As with potential surgical candidates, many Pediatric Hospital patients come from far distances to Can Tho (the largest city in the Mekong Delta region), and do not return for regular therapies; we try to develop some home practice plans for those children and model them for their families.

Stacy and I are never quite sure what we will see at the Can Tho Pediatric Hospital. We usually expect a number of children with cerebral palsy, but it seems like hypotonic CP is more common here than a more spastic hypertonic type. We also end up working with kids with undiagnosed seizure disorders, more rare brain and genetic disorders, and kids with significant cognitive impairments. It is a bag of medical mysteries, which is a good professional challenge for both of us.

There are aspects of working here that are very similar to what we do back in the US, but the lack of consistent and good-quality intervention for kids here means that 6, 7, or 8-year olds here are often functioning at levels we would typically associate with a 2 or 3 year old in the US. All the kids are wonderful, of course, and meeting and working with their parents is also a great pleasure.

Entrance to Can Tho Pediatric Hospital

Walking into the Pediatric Hospital, big box of donations in hand!

This baby appears to have something similar to a Bell's Palsy on her right side,
we were trying to get a sense of her movement and strength in her body and her face

This 1-year old boy still has a significant torticollis-- his head tilt also affects his vision. 

This little girl's mother has been working on helping her stand with the support of the wall. 

We often ask the local therapist to demonstrate how they are treating a patient, then try to help them problem-solve and think of some additional strategies. We often find that the local therapists have different expectations about how "aggressively" to treat children (for physical and speech issues)--
 we spend a lot of time demonstrating how to "try this in a stronger way" in order to get better results. 

We really enjoyed working with this boy, below. He has cerebral palsy and his mother wanted to understand more about how to promote his speech development. He was shy with us, but once his familiar therapists started talking with him, he really opened up!

The cases we see at the Pediatric Hospital in Can Tho are intense, and we are rewarded with terrific lunches. 

Hotpot with Mekong fish!

These are known as "custard apples"--
 they turn into a creamy, sweet milky mush when you get it into your mouth!

Translator Hoa in the yellow shirt and glasses! Thanks, Hoa!

Rambutan fruit-- a real treat! Peel off the spiky hard outside to reveal a marshmallow-y center.
Couldn't be better, really!

After lunch is a mandatory naptime. Really! We lie down on the mats in the treatment room, all the doors are closed, and we are expected to rest. The local therapists usually do these same, or they go home to shower and change during that period. It is hot outside during the midday and there is no air-conditioning in the hospitals, just a couple of fans-- too hot to work. Sometimes I sleep, sometimes I read-- I'm kind of getting used to it!

We were so happy to share the therapy equipment and training materials with the Hospital Clinic's director, pediatrician Dr. Phuong. THANK YOU for your donations that made these purchases possible, everyone!

Yes, you are supposed to take off your shoes in the treatment room. (not always to the most lovely conditions...)

Of particular interest this year on the speech and language side are materials related to working with children with Autism and cognitive impairments/intellectual disabilities. But more on that in my next post... 

This is my way of reminding myself to use short and clear sentences
so Dr. Phuong can translate the technical stuff-- I shut my mouth!

Two last motorbike/scooter photos for the day (it's my sweet spot...):

Child bamboo scooter seat. Happens all the time!

One of the streets close to the hotel was closed off by a stage for a New Year's  dance and vocal performance. This is the audience, just pulled right up to the stage. A drive-in!