Yellow House

Two Nations: One Large, One Small

by Martin Nafukho, Occupational Therapist

Mumias Educational Assessment Resource Center

One day, Bea Staley, my close friend and workmate for the last four to five years out of the blue simply said "Martin, can you come to the United States next November for the American Speech and Hearing Association convention?" My immediate and instinctual answer was "no." 

Back in 1998 after writing an abstract and being accepted to present at the World Federation of Occupational Therapists conference in Canada, the roadblocks I met in trying to get approval to attend, then the support for air fare and accommodation were many and steadfast. Back then I could not even get a passport as I did not have money to bribe someone to get it fast. They were the days when getting a visa for nations like America or Canada meant living on the precincts of the embassy, lining up every dawn for interviews that never seemed to yield fruit. This was back when only Nairobi managed to offer fax services at exorbitant prices and I recall spending 3 quarters of my 3400 ksh salary just trying to fax my abstract to the conference organizers! When Bea mentioned a US trip, my initial reaction was a chill through my spine, and thus my immediate "no."

I had ultimately ended up in the office of my chief occupational therapist who said, "son you will never get support for that kind of thing. How can we send you to a professional conference when here in Kenya we do not even  have Malaria medicine in local dispensary?" Beaten, I shelved my abstract rightly named 'Tackling the Global Handicap' that had earned a 15 minute scientific slot with  the programme organizers, as it dawned on me that the need of that Kenyan handicap was perhaps much larger than the Global handicap I anticipated to show the way of tackling.

So it is 2012, and it has been 10 years since the conference abstract debacle, where I had returned from Nairobi with a fresh determination and concentration for Tackling the raw Kenyan Handicap at home. In those years since Kenya has changed drastically in many many ways. Technology for one, the ability to connect for another. We are no longer as isolated or as far away as our small town had seemed a decade ago. 

In these past years, I have been working along side volunteers from other nations with a variety of skills and calling. The Speech Language Therapy professionals of late have become my closest allies and friends and together we have formed a team with visiting volunteers from Australia, England and the United States helping to develop our protocols. Training assessment teachers and the community in Mumias, Western Kenya we have managed to make progress in the identification and treatment of children with communication disorders. We have built this community focus making it possible for many young children who were born with disability to receive assessments. We have also counselled, established school programmes and shared lots of key health information.

In a society where disability has been a secondary thought, where prioritizing the well being of children with disabilities due to stigmas is difficult, we started by supporting surgeries for children with cleft lip and clubfoot. This was done by encouraging  individual sponsorship both in Kenya and abroad, which could be as little as $10 for fare to reach a surgical camp at Nyabondo or as much as $150 to pay basic hospital hospitalization for a week. As people were able to see significant changes in specific children for the better only then did they start to have hope and believe that their disabled children had finally found a place to be and receive rehabilitation.

This kind of seeing is believing is good but as a professional occupational therapist, to still have to try and convince my community of hidden disabilities like sensory awareness is an ongoing battle. The inability for many children to survive independently in  a society where it has been normal to rely on relatives for activities of daily living puts them at risk for poverty, abuse and neglect. Often small children are hidden or sheltered so  one would never know a child had serious social, communication and/or physical needs as long as they stayed home among relations. The day they go to school however, and the teacher notices that child is not communicative, cannot go to the toilet independently then the concerns arise. Often when the child’s hidden disabilities are revealed, the child is too old and it can be too late to effectively intervene. The precious and critical early years when the language centers are malleable and stimulable have long passed. 

Have transgressed much from my theme, in which intended to show what are my learnings after visiting the USA by the support of my friend Bea Staley, Chris Merkley, Lauren Bienek and Joanne Fry, let me return to my initial point. The trip  that seemed the unattainable dreaming of a rural OT back in 1998, became real in 2012 and here I was in one of America's largest universities with a student population of 80,000. Here I was, poor me, armed with long years of experience of struggle to influence my community to see that a child's development must be shaped in the formative years of life and these formative years require the participation of the whole family if not whole community.

With the input of a friend on the early development of human life, these musings formed our presentation (with Bea) at Columbus convention Center…and of course the reason that made it so easy for me to seek permission from my government and employer and was given, because as it turned out the Malaria  problem of the late 90’S and early 2000s has left big scars, worrying scars of about 5 percent of Kenyan children with disabilities warranting the need for recognition for rehabilitation professionals.

To be continued...