That's what it's all about: hugs, being called ma'am, and singing the hokey pokey

Sauntering down the street in the hot sun, cars and trikes racing past, the sounds of horns filtering through the sky and an anticipation for what the day would bring was the start of almost everyday in the Philippines. Each morning I was taken aback by this beautiful city as our team would make way to the first speech therapy site. Where am I? Am I really here? Who are all these people who have so easily made their way into my daily life as if I've known them for decades?

I know I've shared some information about the speech therapy process in general, but I wanted to share with you more details about the children we worked with and, of course, more pictures of their beautiful faces.

A series of bright smiles, hugs and eager faces welcomed us upon our arrival. The children would run up to us and say, "Hi ma'am Theresa, ma'am Betsy, ma'am Ellie and ma'am Kate". Some would even press their foreheads to the back side of your hand as a sign of respect. (I loved being called ma'am Kate, I may wear my name tag at the UNC clinic to see if it catches on!). Then the flurry of speech therapy would begin. Our team would simultaneously take turns working with the children. We would dig through our few bags of supplies and find a corner to work on his or her specific goals. We used anything from 'go fish' cards to bingo sets to good-ole-fashioned paper and pencils to keep the kiddos engaged. They worked hard. We demanded a lot from them and they delivered with smiles on their faces. One of my favorite parts was when we would end a session with a song or two. The children would gather in a circle and we would sing a joyous course of anything from the 'hokey pokey' to the 'baby shark' song. The more hand motions and bodily movements the better - I will never forget the rise of laughter when the children were asked to 'shake it all about' during the hokey pokey.

The children's family member(s) were often present during the sessions. Getting to know them over the course of the two weeks was an added bonus to the trip. We would invite the family members to observe the sessions and discuss with them ways to practice the goals between sessions. In a letter we received from the parents (pictured below), they mentioned that they saw their children grow in confidence over the two weeks... that they were no longer be afraid 'to show their talents'. I was inspired by many of the families dedication to helping their child succeed!

On our last day, we had a graduation celebration. The children, parents and the speech team all took turns singing songs, reciting letters of thanks, and demonstrating their various talents. We then called each child up by name, dawned them with a graduation necklace and congratulated them on their hard work. I've never seen prouder faces. Afterwards, we played on the nearby beach. Seeing the children run around, pose for pictures, swim like 'sharks', and splash each other are memories I will always treasure.

It amazes me how quickly these children seemed apart of my daily routine. It was no longer out of the ordinary to be bombarded with hugs each morning and afternoon. It became common place to sit face to face with these children and work on their speech. I feel grateful for the opportunity to meet them and will miss them dearly!

Restoring Faces

The speech mission is a small part of the larger mission that the International Children's Surgical Foundation (ICSF) organizes. It is an organization run by Dr. Jeff Williams, who travels year round to repair cleft lip, palates, and/or other craniofacial abnormalities. He travels to the same locations, which allows him to provide multiple surgeries to children who need it and to establish relationships with the communities. He is very unique when it comes to medical missions in that he spends extra time to make sure the surgery is done well. I will let you read more about this amazing organization from my friend Ellie's blog (elliemckinnonblog.blogspot.com and ICSFoundation.org). 

I had the privledge of observing two surgeries: a unilateral lip repair and a unilateral cleft palate repair. Both surgeries lasted around five hours! Dr. Williams is meticulous. He takes the time to ensure the lip and palate are not only functional, but look as "normal" as possible. We see his previous clients for speech therapy and you have to look closely to see any scarring. I 'nerded' out examining all of the tissues, muscles and cartilages that I have only read about. The human body is incredible! It was amazing to see how he worked with what tissues were present to create a functional palate and lip. I will spare you the details, but will share that he requested the artist "Fun" and "Tubthumbing" by Chumbawamba to play in the OR. The doctors, nurses and us observers were jamming out!  

Our daily routine.

Today marks the fourth full day of therapy. It feels like we've been doing this for three weeks with how much we fit into one day! We've settled into a routine and have already seen progress with all of the children! If you want the down and dirty regarding how the speech therapy aspects of this cleft palate medical mission, then this post is for you. Otherwise, stay tuned for other posts regarding the organization we are volunteering for, International Children's Surgical Foundation (ICSF), and other  adventures in the Philippines. 

Our group of two speech therapists and myself, a speech therapist in the making, see a total of 25 children. The children all have varrying histories and, therefore, therapy is a constant learning process for me. Some children received surgery for their clefts when they were young, others did not get surgery until they were teenagers, and a few have fistulas (holes in their palates). Therapy looks different for each of these children. It is a constant dance of working with what a child can do because of the structures they have and promoting proper use of their new structures. The ultimate goal is to give them the skills so they may speak effectively. 

I am amazed at how hard these children work. I wish I could bottle up their determination and use it around finals time. :) Each child receives intensive speech therapy twice a day (that is a total of 50 sessions split between the three of us each day!). We give them homework to practice between each session and they come eager to practice their sounds. We've seen so much improvement already. 

The two overarching goals are to treat resonance disorders and compensatory articulations. To treat resonance disorders, we help the children use their palate correctly in order for air flow to go through the proper cavity (oral and/or nasal) for specific sounds. Compensatory articulations are when a child has learned to make a sound incorrectly (at the back of the throat or at the level of the vocal folds). To treat these errors, we give the children skills to use the correct articulators (ie tongue). This can be simple or difficult, depending on how long a child has been using these errors! 

One of the unforeseen blessings has been to see how a child's confidence grows as his or her speech improves. They get it. They get that their speech is different than those around them. Although most of these kids have a long way to go, it has been amazing to see how their faces light up when they make improvements. I can't wait to see what confidence these kids will exude by the end of the week...

Below are some pictures of some of our therapy sessions... Enjoy!