TEAMworks in Rwanda

Fieldnotes from TEAMworks Rwanda Therapists, October 21st, 2023

Today we head home to the USA but, not before we say thank you to those who hosted us in Rwanda! For the care and kindness they showed us daily and how they took care of us like we were old friends!! 

Open Minds and Hearts

Thank you to the therapists who opened their hearts and minds to collaborate with us throughout the week. To the mutual meeting of the minds, we thank you! We cherish the relationships we have made over the past week, new friendships formed, and look forward to seeing where all of these new partnerships take us in the future! Until next time Rwanda!! ❤️🇷🇼

Fieldnotes from TEAMworks Rwanda Therapists, October 20th, 2023

Today was our last day working with the therapists here in Rwanda and it was bittersweet. 

Wheelchair Fitting

Kylie and Ashton were able to give out wheelchairs and strollers for a couple of older, non-ambulatory children whose mothers have been carrying them on their backs for many years. Using a variety of creative measures including velcro, fabrifoam, and velfoam, we were able to fit these kiddos well into their new chairs. 

A Discovery

Lynette has had the pleasure of seeing the same adorable little girl daily since we have arrived in Rwanda. Each day they got to problem solve just a little bit more to help out this cutie and today they figured out she could play with toys in a side-lying position, which is a major deal due to very severe athetotic movements. 

He said, “Ball!”

Janeshka was able to see a very timid younger boy with autism who was reported to be non-verbal when they met; however, after play, introducing PECS, and with Janeshka modeling much language during play, this little boy said “BALL!” His mom was so very happy and jumped immediately into modeling what Janeshka was teaching. What a rewarding experience!!

Therapy Tools, Toys, & Equipment

We were also able to leave many therapy tools, toys, and some equipment with the occupational therapy and physical therapy departments. Connie truly enjoyed going through each item with the occupational therapy department, leaving them with so many feeding and oral motor tools to use when she is gone. 

Final Evening with Good Company, Food, Music, and Dancing

In the evening, we had the pleasure of dining out with the director of the hospital. The food was SO good but the conversations were even better! He is a kind and professional man with an amazing sense of humor. Later, we were able to join the staff for a small get-together including music and dancing.

The culture and people here in Rwanda are so welcoming and incredibly fun! We feel so grateful for the experience of working with so many amazing people and it is a bittersweet feeling to leave but…WE ARE HEADED HOME! 

Fieldnotes from TEAMworks Rwanda Therapists, October 19th, 2023

Today, we split up again between OT and PT where we are gaining more rapport and friendships with the therapists. 

Promoting Speech Therapy

Connie continues to teach on the benefits of speech therapy, especially in the realm of feeding. Today she was able to teach a family how to work on chewing using food in a cheesecloth. This allows kids to safely taste different flavors and work on chewing. 

Connecting with Child’s Love to Soccer

Kylie and Ashton worked with an adorable little boy on weight shifting through the use of soccer. He was eager to play and immediately started shifting over the previously avoided leg, PLUS, he had so much fun! Many giggles were shared! 

Gift of the “Aha!” Moment

Janeshka’s favorite moment was sharing an “AHA” moment with one of the physical therapists about teaching non-verbal children to communicate. It’s fun to share the verbal and alternate ways kids are able to communicate and “speak”. 

OT Training

Lynette was humbled to work with a mom who had a daughter with multiple disabilities and was very involved. She provided the mom with training and education about integrating reflexes but also how these reflex patterns can be used to interact with the environment around her. Additionally, a new OT returned from hospital training and was very hands-on with the learning process, jumping right in with Lynette.

Engagement in Pediatrics Means Having Fun with Kids

Kelly continues to enjoy building relationships and jumping in sessions with some of the PTs to model just how silly and engaging you can be in a session, even when the child is doing hard work. By the end of the session, we were all singing Old McDonald! The kids AND the PTs loved it! 

Gratitude for Collaboration

Presentations were on Autism, Cognition, and Behavior. It was a lot of information and they hung with us well after so many days of education. At the end of the presentations, there was a mutual thanking of each group and Ashton was so touched by their kind words and gratitude. We exchanged gifts and took some fantastic pictures of our group!  

Fieldnotes, October 18th, 2023

Fieldnotes, October 18th, 2023

Connie, Janeshka, and Lynette spent the morning in the occupational therapy department. There Lynette paired with Connie and the local therapists to target oral sensory and oral motor skills. Lynette was truly impressed and humbled by their willingness to learn and pair with TEAM therapists to treat their kiddos. 

Auditory and Tactile Methods

Janeshka really enjoyed the spontaneity of treating children with diagnoses she has yet to be exposed to in the United States. Specifically, she truly enjoyed treating some sweet boys who were blind using auditory and tactile techniques. 

Speech Therapy Progress

Connie enjoyed working with all the children but, especially, made great progress with many who were imitating sounds and actions. She worked with a sweet girl with CP who was able to imitate all the vowel sounds and M and N sounds.

Learning and Engagement with Rwandan Therapists

Kylie was one of the major presenters today and truly enjoyed all of the engagement and appreciation all the therapists showed with their thoughtful questions and reciprocated conversation. 

Beautiful Smile of Gratitude

Kelly was able to hand out a few hand splints to kids who needed them for hand positioning and one mom in particular had the most beautiful smile of gratitude. It’s these moments that will stick with her once she leaves. 

Parent Connection

Ashton was able to work with a child whose mother spoke really great English. She was able to have a good conversation regarding treatment methods for carryover. The child and the parent were so grateful and sweet when receiving this information. Communication is often hard with parents, as the native language here is more difficult to understand so it was exciting for Ashton to share her knowledge firsthand with a child’s parent and be able to help them in the moment. 

Teaching on Neurological Conditions and Mobility Devices

Lynette, Ashton, and Kylie gave presentations on various neurological conditions and how we assess and treat them, as well as different mobility devices. Everyone was incredibly interested in these conversations and we are hoping to meet with the orthotics department here to discuss how some of the braces can be replicated in their lab. 

Fieldnotes, October 17th, 2023

It was orthotics day. Families were ready and so were we! 

Teaming up to Fit Braces

Lynette was part of the enormous joint effort to fit braces, with two memorable young girls getting braces that drastically improved their ability to walk with a good gait pattern. Before lending a hand to our work with braces Lynette spent her morning in the sensory room at OT and was able to work with a young girl who had self-injurious behaviors of biting and scratching using reflex integration techniques and oral input with a vibrating spinner to diminish these behaviors to essentially nothing. 

Multidisciplinary Teamwork

Ashton swapped locations and headed to the Occupational Therapy Department to demonstrate how we work best as a multidisciplinary team. She and Janeshka were able to team up while she facilitated gross motor development and strengthening. She was so grateful to have Janeshka as a partner to demonstrate functional play during difficult activities. 

New Walking Skills

Kylie spent the morning in PT and was able to fit a young girl who previously shuffled with extensive support from her mom with orthotics that allowed her to walk by holding one hand. We have had to make quick work of building trust and relationships with the kiddos and this one was no exception, initially crying and scared, Kylie was able to gain her trust and give her confidence and pride with her new walking skills. 

Positioning Key to Feeding, Learning, and Social Engagement

Connie spent the day in the Physical Therapy department showing how positioning assistance by physical therapists is so important for feeding, learning, and social engagement. She was able to position a precious young girl with significant hypotonicity and involvement in our tumble form chair. Kylie stepped into fashion supports from available towels and rags. 

Finding the Right Fit

Kelly spent the day in PT assisting with orthotic fitting, adjusting equipment, and providing appropriate toys for play. Orthotics day is always overwhelming but so rewarding! Seeing all the families desiring so much help and being a piece to the puzzle of those who can step in is an experience to be remembered always. 

Teaching Presentations on Sensory Processing and Reflexes

The presentations today were given by Kelly and Lynette. Kelly presented on Sensory Processing and Lynette on Reflexes. The interest in these topics were so high and the therapists enjoyed the demonstrations and hands-on learning aspect of them.  We took a page out of all of our continuing education courses and passed out chocolate for good attention, questions, and engagement! You know what is not available in Rwanda…Reese’s Pumpkins! Watching their expressions and reactions to all the sugar was priceless and reciprocated engagement through the presentations was quite high!

Parents left saying, “God Bless You.”

Janeshka also jumped right into the mayhem of fitting orthotics and enjoyed the fulfillment of taking part in allowing a child to walk. An unexpected and great feeling of working so closely with our colleagues of differing disciplines is gaining new knowledge and experiencing a true partnership between team members. It was so rewarding to experience this, especially when the parents left saying “God bless you.” 

Fieldnotes, October 16th, 2023

After our long journey which extended late into the evening last night,  we were thrilled to be able to connect with children, parents, and Rwandan therapists today. We’ve detailed some of the highlights from our day below.

Reflex Integration, Transition Movements, and Large Movement Activities

Lynette spent the morning in the occupational therapy department working on reflex integration, transitional movements, and more large movement activities. Her last child of the day was a young girl who had recently had a seizure leading to hemiparesis. Her sweet demeanor and gratitude really touched Lynette’s heart. 

Modeling Interactive Gross Motor and Strengthening Techniques

Ashton spent the morning with the physical therapy department working alongside the physical therapist and modeling interactive and playful gross motor and strengthening techniques. One little boy went from upset to happy with the presence of Ashton and a Pop Toob. 

Functional Communication

Kelly spent the morning between the occupational therapy department and the physical therapy department. Paired with Janeshka, the two went into problem-solving mode for the best functional communication for some of these sweet kiddos that would accommodate both their language and motor skills. Later in the morning, she spent a good amount of time in the sensory room finding creative ways to use the available equipment to give all kinds of sensory input. 

Teaching Motor Skills for Improved Saliva Control and Feeding Success

Connie spent the morning with the head occupational therapist teaching him and his parents basic oral motor skills for improved saliva control and feeding success. One little girl, in particular, participated in all of Connie’s instructions and was super excited to see her progress in the mirror. She was able to imitate oral motor movements and made the “mm” sound with pride. 

Working Alongside Gatagara Therapists

Kylie spent the morning in the physical therapy department working alongside the Gatagara therapists. She was able to work with an adorable little boy on ascending and descending the stairs. She demonstrated how she would facilitate this activity and the little boy was proud of himself yelling “Bravo, Bravo” after each time. 

Promoting Language and Engagement

Janeshka spent the morning in the physical therapy department discussing language and engagement with each kiddo during their PT sessions. Her favorite moment was with a young boy who was just so full of joy as she played with him during his session. He was so engaged he grabbed her hands and sweetly touched his forehead to hers, it was truly a precious moment.

Speech Therapy not yet recognized in Rwanda

Connie and Janeshka provided the educational presentations for today about Speech and Language Development and Oral Motor Development. Speech therapy is not a recognized profession in Rwanda and we were excited to give them the basics and how it can be incorporated here in Rwanda. They were so receptive and had excellent questions and great discussion. 

Fieldnotes, October 15th, 2023

TEAMworks OT’s, SLP’s and PT’s Arrive in Rwanda!

Our six-person team of therapists including Kelly, OT, Connie, SLP, Janeshka, SLP, Kylie, PT, Ashton, PT, and, OT, ARRIVED!!! After a rather smooth day of travel through the multitude of airports, our adventure truly started when we arrived in Rwanda…minus a bag…and then proceeded to get stuck in the mud only a quarter mile from our destination but, Rwanda friends to the rescue!! We were pulled out of the mud and were treated to a very late dinner they so kindly saved for our late arrival! We are so excited to get started tomorrow! After a good night’s sleep of course! 

Before we boarded we shared the following prayer intentions with our TEAM back in the United States: