Spreading the Word

My last afternoon in Kenya, Nduta and I visited two medical clinics in Kibera, the largest slum in Nairobi and one of the largest in Africa. Our original purpose was to leave patient communication materials for people with communication difficulties, materials that were sent to us by Harvey Pressman and Sarah Blackstone of the Central Coast Children’s Foundation(CCCF). Nduta used the opportunity to open a much-needed dialog about people with special needs in Kibera. While her main love is AAC, she has recognized that these kids need to be identified first. She's making it her mission to make sure that these children are not only identified, but referred and served.

The reactions were interesting. 

 - The Tabitha Clinic (operated through Carolina for Kibera) - at first, the doctor we spoke with didn't think they had any patients who could benefit from the visuals, since “these people would come with their families, and the families can tell us what's wrong with them.” Under Nduta's questioning, he and the medical officer who gave us the tour acknowledged that there might be people in the community who have communication problems, but their outreach workers don't specifically seek them out. Nduta made it clear that people with communication issues needed to have a way to communicate independently, that she felt it was the clinic’s responsibility to find and refer these people, and that she would be happy to work with them to make sure this happened.

The walk to and from the Tabitha Clinic was  . . . challenging, even for able-bodied people. It’s a very narrow, winding 10-minute walk/climb from the CFK office over uneven terrain, around shacks, under laundry, through muck, trash and sewage, a jump down to cross the railroad tracks, then back up and more of the same. I learned later that during the expansion of the clinic – it’s now a 3-story building - all building materials and hospital equipment had to be carried along that same path from the CFK building.

 - Chemi Chemi ya Uzima (also in Kibera) – Initially, clinic workers couldn't think of any specific people in the community with communication difficulties. Then Rose, one of their outreach workers, mentioned one, and then another child with special needs the she “didn’t know what do with.” The last time Nduta wrote she said she and Rose were going out to visit four families that Rose had identified with special needs kids. 

The walk to Chemi Chemi was a different experience altogether. We had a large (it’s all relative) lot just outside Kibera, then around some local government offices, in the back door and out the front door of a tiny small bar/café (tables, one customer and a single TV), down a well-traveled dirt road, and over to the clinic compound.

I also left patient-provider communication visuals with the Nairobi SLPs, who were having their monthly meeting that morning at the Aga Khan Hospital (another post, I promise!). While they already had some good hospital visuals (mainly for describing procedures), they were happy to have a broader selection.