January 21 to January 24th.
First of all, sorry this us really long post... It was a busy week!
Last week I began the first of my six week (one week a month) commitment to Kunming Medical University. Long and exciting story short, they are starting their FIRST speech therapy undergraduate program in August of this year and asked me to consult with them during their preparation for the fall. Speech Pathology has not completely hit chn yet. Special education services are also in the beginning stages, they are available but very sparse and really only available in the bigger cities. Children with special needs (physical or cognitive) do not go to school, leaving them with little opportunity educationally, socially and vocationally. It is exciting that this field is emerging here because their are so many kids in need of these services. Basically they asked me to help with three main things. One is that I go to an affiliate hospital about 1.5 hours outside of Kunming in Stone Forest township to train therapists working with children with special needs in the rehab department of the hospital. Second, they asked that I consult with them about the speech pathology program in general. Thirdly, they asked that I present at a workshop in March. This is all a big stretch for me professionally but I'm excited! It gives me the opportunity to not only give professional knowledge, but more importantly to model the idea that people of all abilities are made in His image and should be treated as such.
Last week I began the first goal, training staff in Stone Forest. The week started out a little rough... there was a miscommunication about where to meet me so the driver never found me and I ended up taking the train and arriving late. That was fine though and the rest of week went well. From as best as I can understand, the gvmt gave this hosptial funding to take six children with special needs and treat them for six months. If at the end of six months, those children have made progress, they will begin talking about continuing therapy with more children. This puts some stress on myself and the staff. In Chn there doesn't seem to be screening tools for speech and language acquisition. This means that children with mild to moderate delays are not being identified. All of the children that I have seen are children that are severly delayed. This is a difficult place to be because they are children, that given the severity of their disability and the lack of previous intervention, will most likely be slow to make progress. I believe that this should not exclude them from services. For one thing, even slow progess is progress and for another thing, I feel that their parents can benefit from both the advise and moral support of the therapists. The question is, do the holders of the purse strings feel that way?
There were two speech pathologists that I trained as well as one of the coordinators who translated for me. This week was probably the most cultural immersion that I've had so far because although I am working with local staff all of the time, the local staff with my oprganozation is more used to working with foreigners and I'm in an area that has some western food etc. This was not true during my week at the hospital. It is a pretty remote area and judging from the stares of everyone and the shouts of "foreigner" coming from people, there are not a lot of foreigners there. Cultural differences in communication styles prove a challenge when consulting cross culturally. It is very difficult to gage when a Chns person doesn't understand what you're saying. Cultural differences typically mean that they won't tell you that they didn't understand or that they don't agree. This is difficult and can be frustrating because you don't know that you need to clarify or find new ways to communicate information. Overall, there were so many cultural lessons. For one, I have read that here the responsibility to effectively communicate things such as scheduling details is the responsibility of the listener. In other words, if I want to know what is going on, I should ask. Western culture is the opposite, the person with the information is responsible for communicating that information to the listener. My question is how am I supposed to know to ask about something that I don't know about? It doesn't make any sense to me! I am working on toning down my high strung Americaness but it's not easy! Throughout the week I continuously pr@yed for peace (not knowing what's happening gives me a lot of anxiety, I'm a planner) and wisdom on how to communicate most effectively with staff and parents. Another big communication difference is the level of directness. I like to have direct conversations with people, it's efficient and effective. Not here... Instead there is a tendency to beat around the bush and take days (maybe weeks) to say what a typical westerner would have said in minutes. Typically my frustration is that I want the local staff to be more direct with me so that I know what their expectation is of me. This week I saw how easy it is for my communication to be misunderstood. I know that in Chn you have to be polite and careful not to offend so I am careful, I eat food that makes me want to gag and always tell people that I'm comfortable, happy, warm etc regardless of if it's true. I made a comment right before lunch about being hungry one afternoon. I had eaten something small for breakfast and was not at all complaining, more just making conversation. I guess the translator took my comment to mean that I didn't have any food and don't like the Chinese breakfast. I realized that had I (a westerner) been unhappy with the food, I would have said so. If she (an eastern thinker) had been in my situation and needed food, she may have made a "beat around the bush" comment to communicate that. It's so complicated sometimes, I have to put myself into someone else's head and then talk. My little comment resulted in this sweet women going to the store and buying me two loaves of bread, jelly and milk. Again, I'm blessed by peoples kindness! My first night eating by myself in the cafeteria was awkward. I went in and stood in line with the masses, when it was my turn, about three people pushed past me in line. One of the staff members was very sweet to me and took the time to help me get food, I'm always thankful when there is someone who treats me kindly. The next time I write a resume, I am going to put "sideshow actress in the circus" as one of my experiences because that's how I feel sometimes. While I was eating, I looked up and there were at least twenty pairs of eyes on me. I'm sooooo glad that I've been using chopsticks since I was three! I'm giving all the rest of you foreigners a good name!
Another Chn moment came when I was asked to give a presentation to the hospital staff about American healthcare (not really what I was expecting), give an overview of speech pathology as a field to the therapy department and give a T.V. Interview. This is all in one week and on top of evaluating kids and training staff (I was soooo tired after this week and feel that I've earned my Chinese New Year break!). I hesitantly gave a broad overview of healthcare to the hospital staff and made it clear that I'm not an expert on the subject. Sometimes I'm asked to do things that are a stretch and I try to be very careful not to misrepresent my experience and talk about things that I'm not qualified to talk about. I declined the T.V. Interview, that was too terrifying! I really enjoyed presenting on speech pathology to the therapy staff, they seem to be a great group of people.
This experience showed me once again how complicated my field is. There were six kids and I had similar recommendations for two of them but very different recommendations for the other four. Speech and language skills are so connected to the brain which is a complicated thing. Some of these kids look similar to someone not closely analyzing their cognitive abilty, but are actually very different.
What I LOVED about this experience is that it allowed me to do EXACTLY what I felt I should be doing during my time here... training local staff. Chn has changed soooo much and while there may have been a time when foreign agencies needed to have a greater involvement in areas of development, we need to be very careful to not continue a model that may not be appropriate anymore. I feel that in this situation, I need to be a supportive role here and not the primary therapy provider. In order to make widespread progress towards greater opportunities for people with disabilities, the general public must begin to advocate, not only the foreigners.
In thinking about training staff, I'm reminded of an African saying that I read in a book, "If you want to go fast, go alone. If you want to go far, go together." I think that saying justifies community development programs that are committed to working with local community members. There are times when it feels like it would be easier to do things on your own... This isn't saying that you don't trust or respect the local staff, it's just less complicated to do things yourself than it is to put your knowledge into words that need to be translated into another language. However, I may go fast on my own, but I won't go far. To go far, the local community members need to buy into whatever community development program is being built. But this is good because I believe that we are all blessed by the differences in each other. It gives us respect for people who think differently and it makes as see that we have a creative creator. We are definitely not a cookie cutter creation, we are handmade by one who thinks outside of the box and nothing lets us see His creativity like working cross culturally.
The hospital. There are about 300 patients.
I was asked to give a presentation to the Dr.'s and nurses. I took this picture right after I finished.
One of the kids with his mom and two of the therapists.
The therapy team... I was really excited to wear a white coat!
