Delhi, Amar Jyoti etc. - A Quick Update

This post is a) overdue and b) small.
This marks our last day at Amar Jyoti. Our stay has been short but a really amazing one.

Internet access is hard to come by in the area where we are staying so our blogs have been sparse however, not to worry, there are blogs to come.

We have updates on some touring and sightseeing we have done around Delhi as well as some posts about our time here at Amar Jyoti.

Tomorrow we are using our final full day in India to recharge, organize our things, pack and get ready to head back to Canada as we fly out on Friday.

The blogs about Amar Jyoti and Delhi will be posted soon after we return to Canada on July 31st so stay tuned for those.

We can hardly believe our time in India is finished and that we'll soon begin the journey of choosing and mentoring the next group of students who will form the IHI 2011 team. We once again want to extend our thanks to all of you who have made this journey possible for us and we look forward to seeing you all again very soon to tell you all about our time in India.

We miss you all.

Jeremy, Kayla and Pranavi

ps. Marissa had to return to Canada early last week for a family matter and she has made it home safely but we just want to say WE MISS YOU PRETTY FACE!!!

Contributions to ASSA

Despite the very short amount of time we spent at Amar Seva Sangam, we all felt like we learned many valuable lessons and skills that will help us become better health care professionals. In the previous blog entry, we mentioned the parents’ manual that we were asked to develop. Similar to Canada, the therapy staff at ASSA only see their ‘clients’ for a short portion of a given day, while the parents of these children have at least 23 other hours to care for them. The point of the manual is to provide guidance to parents of children with disabilities in order to help them manage the challenges they face in the home. Unfortunately, we received the proposal for this project the day before we left Canada, so we completed most of the manual while in India. Due to our time constraints, we chose to focus the manual (thus far) on challenges faced by children with physical disabilities, as well as tips for managing these challenges at home and increasing independence for the children. The topic areas we have covered so far include communication challenges, eating/feeding challenges, learning through play, managing delays in physical abilities, increasing independence in self-care activities, managing high and low tone to prevent contractures, preventing pressure ulcers, and seizure management. We hope to continue working with next year’s IHI team to expand this part of the manual, and begin another section for children with cognitive delays and behavioural challenges.

In terms of donations, we were able to leave two suitcases filled with various medical supplies, including different types of gauze, specialized dressings, compression stockings, disinfectant solution, syringes, etc. These supplies were all donated by Not Just Tourists and Grand River Hospital in Kitchener-Waterloo, and were left with the Spinal Cord Rehabilitation Unit. Other items requested by ASSA included a blood pressure cuff, a thermometer, various strengths of Theraband, a Spirometer and 50 Spirometer mouthpieces, all of which was purchased in Canada prior to our departure.

After purchasing the supplies mentioned above, we were able to leave a $1,500 donation to be used as ASSA sees appropriate. After meeting with Sankar Raman (ASSA’s Chief Secretary) and Saravanan (Head Physiotherapist), we learned that they would like to put our donation towards a long-awaited project – a Sensory Integration initiative. The therapists at ASSA hope to provide child-directed therapy to the students at their special school using Sensory Integration. Interventions based on this type of theory aim to help children reach their optimal state of arousal (the perfect balance of being calm and alert). Once the child is at their ‘just right’ level of arousal, therapy interventions will be more successful. For more information on Sensory Integration theories and interventions, please feel free to visit the CanChild website from McMaster University through the following link:

http://www.canchild.ca/en/canchildresources/sensoryintegration.asp

Volunteering at ASSA

Our first day started early, as we accompanied some of the ASSA children to their morning physiotherapy session. Starting at 7am, a number of kids already dressed in their red and white school uniforms took over the PT unit and we watched as they played together and did their exercises with the staff. We each played with the children who were waiting to receive therapy, throwing balls and playing clapping games. Soon everyone was up and off to breakfast with the other children, fitted with their callipers and orthotics, or wheeled by their friends. The lively ASSA morning routine continues with busloads of staff and children arriving at the main gates to attend school.

During a couple mornings, Kayla and Marissa observed the intimate classrooms at the Special School, where teachers were paired with no more than 10 to 15 students each, arranged in inclusive semi-circles where everyone could get the attention they needed. Here, students of all ages with varying developmental delays progress through grades based on ability and also learn activities of daily living, language skills (Tamil and English), and vocational skills for some of the more senior students. The students also receive regular physiotherapy at the school. Here, we met another volunteer from Denmark, Marianne, who was just wrapping up a three month stay at the school helping with English lessons.

Just across from the special school is the Spinal Cord Injury Rehabilitation Unit, with its friendly group of patients sitting outside in their wheelchairs, waving to passersby. As Pranavi and Jeremy attended morning rounds at the unit, they learned that each patient had met with an accident that drastically changed their lives and that this chronic care facility is meant to help them adjust and gain the skills necessary to live independently again. The unit has a 12-patient capacity and people stay and receive treatment and training for 6 months to a year. Here, patients get a well-fitted wheelchair (in fact, the unit serves as a store house for the several wheelchairs that ASSA provides to people in need throughout the district), counselling, medical care, round the clock orderlies to help with activities of daily living, vocational training or continued education, and daily physical therapy. ASSA’s field workers also visit the homes of these patients before and after they have moved out of the facility to ensure a smooth transition to life on their own.

We spent the rest of the week out in the field, participating in ASSA’s amazing Village Based Rehabilitation (VBR) Program that serves over 330 village communities within a 100 kilometre radius of the Sangam. We visited two of the six PMRC (Parent-Managed Respite Centre) special schools that this program supports. These schools of between ten and twenty kids each, provide physiotherapy and special education to children with developmental delays. We couldn’t help but notice what a warm and home-like environment these places were for the children and we loved getting to know the boys and girls at each school until they shared auto-rickshaws home at the end of the school day. We also accompanied the Sangam’s field physiotherapist and community rehabilitation worker during home visits, which was a one-of-a-kind experience for all of us. For those children who cannot attend the PMRC’s or the special school at ASSA, the VBR program identifies children with special needs and arranges regular home visits to provide physiotherapy and to train families to best manage their child’s condition at home. It was for this purpose that ASSA had asked this year’s IHI team to create a parents’ manual of practical tips for managing various physical limitations that children may face on a daily basis. While we visited people’s homes, we saw what a far-reaching impact ASSA has had in these villages, as children had custom callipers and other equipment available at home and their families were able to ask questions and learn how to care for their child with a special need. We hope that next year’s IHI team embraces this opportunity to learn about how various physical conditions are managed at home and how organizations like ASSA and their field work team has helped.

PS - Pictures hopefully to come! Technical difficulties...

Welcome to ASSA.

We arrived at our second placement on Sunday and we knew right away that there was going to be a lot to explore at this large facility. Amar Seva Sangam Ayikudi truly is what its founders set out to create: a “haven” for the differently abled. Past its gates, you see plenty of wheel chairs, hand-operated bicycles, callipers, people walking or crawling with different gaits and rhythms – essentially, you see people finding their own unique way of getting around independently. It all fits very well with ASSA’s mission statement:
“To empower the disabled citizens by establishing a “Valley for the Disabled” as a Rehabilitation and Development Center for the region and to develop models for self-help initiatives by integrating the disabled individuals with the society for improved living conditions in the Village.”
The compound is six kilometres away from Tenkasi, the nearest city, and is surrounded by a serene landscape of wind turbines, open land, and distant mountains. It being a weekend, things were relatively quiet when we arrived, except for the sudden torrential downpour that lasted about an hour (it is rainy season after all!). After that, we took a quick tour of the facility. We met the children who live at ASSA first, as they congregated for a midday snack and greeted us with smiles and hellos. The children’s home is for those with physical disabilities who live, attend school, and receive physical therapy and ongoing care on site. ASSA also has a hostel for disabled youth and vocational trainees. The Sangam’s several services, however, are open to hundreds of people from the surrounding area that live off-site. These include physical therapy and medical screening, vocational training (we visited the tailoring and handicrafts workshop, the book binding machinery room, the typing workshop and the computer labs), an integrated primary and middle school for children with and without physical challenges in the area, and the newly constructed School for Special Children attended by 50 children in the area. This is all in addition to the field work done by ASSA in its several neighbouring villages. With all of that and a small dairy farm on the premises, it was a lot to see in one tour!
Since then, we’ve had quite a busy week and have tons to share with you! We’ll be updating the blog over the next few days with the details so stay tuned.

Adventures in Kerala!

We have just returned from a lovely, five day vacation in various parts of Kerala, a state adjacent to the home of our first two organizations in Tamil Nadu. We began the vacation with nothing short of craziness, as we got up at 3:30am to catch a 5:30am train from Coimbatore to Cochin (a.k.a. Kochi) and nearly missed our train! We asked for direction from a staff member at the train station, only to find ourselves literally launching our bags through the door of the departing train...a train that turned out to be the wrong one! Luckily we met some very nice, English-speaking people on the train who told us when to get off to meet the proper one.

Despite the early-morning drama, we arrived safely in the main city of Cochin and were greeted by some very friendly residents who happen to be “friends of friends” of Pranavi’s family. They were amazing and arranged our entire five-day Kerala accommodations, travel, and sightseeing! We stayed for two days at the Abad Metro Hotel in Cochin, very nice accommodations for us! We were so excited to have comfortable beds, nice pillows, a hot shower, flushing toilet, and TV to watch the World Cup! Our second day in Cochin, our friendly driver, Shaiju, took us sightseeing around the city. We visited the old Cochin Royal Family palace in the morning, before spending the afternoon and evening in Fort Cochin. We visited many museums, learned some Indian history, and finished the day by watching a Kathakali Dance performance.

Our Kerala friends also arranged am overnight houseboat trip for us in Alleppey. This was the highlight of the trip for us so far, as we enjoyed our very comfortable float down the Kerala backwaters. The staff served us three full, Kerala-style meals, complete with prawns we bought in a village along the river. The houseboat dropped us off the next day at Rice Village, a resort run by a family in a village that’s only accessible by boat. The owners two young daughters took us on a little tour around the village, which was complete with many nerve-wracking trips across rickety wooden plank bridges. All around, the stay at the Rice Village Resort was a very relaxing one, and everyone took great care of us~! We completed our evening by watching the Indian version of “Deal or No Deal” with the owner and his daughters.

This afternoon we arrived at Amar Seva Sangam, our second organization in Tamil Nadu. We will be here until Saturday morning, and hope we can see everything in the short amount of time we have to be here! Stay tuned for details!