Saying goodbye, and hello

In  the last week or so we have said goodbye to two kids from the redcross orphanage,

Den,  this cheeky little munchkin is heading to Canada.  I met her new parents and her new big brother (a four year old from the north of Vietnam) at the orphanage on Thursday. 

Interestingly Den is usually a very outgoing and active kid. 

In fact when I arrived on Thursday and they told me she was leaving she was laughing and gave me a big hug.  Once the parents arrived she became very withdrawn and quiet.  She wasn't scared of them at all....  But it was obvious that she knows something big is happening,  and they are involved.  Their first child was adopted at 5 months old,  so the acclimatisation will be very different this time around!

This little lovely has also gone this week.  That day was crazy!  The carers were fussing about giving here a bath and dressing here in the new clothes and saying goodbye,  her parents arrived with two kids and all the other kids by this point were starting to rebel and demand attention.....  Then we turned up with half a dozen wet sandy kids we had taken to the beach and needed to wash and dress.  So a lot of chaos that day!

Then,  I walk into the physio room and discover a teeny tiny baby.  I am told he is 4 weeks old. 

He mostly hangs out in the physio room so they can lock the door and not have to constantly stop curious children from waking him,  or poking him in the face. 

Sometimes I just can't tell if some of the new babies who arrive here are small for their age, maybe due to being born early, being sick or not having enough food..... or if Vietnamese babies are just little compared to the Aussie babies I am used to! 

At the da nang baby orphanage I had to say goodbye on Friday.  Very hard! I just love these kids. We had a fun morning of drawing,  playing in the ballpit (they are not scared of it any more!) singing and cuddles. 

 I noticed a couple of babies sleeping on the baby bed but didn't look to see who they were until the carers pointed them out to me.  Turns out they were new babies.  Twins!  And only 10 days old,  so teeny tiny. 

Catching up with the kids - Da Nang baby orphanage

Here is the line up of kids at the Da Nang baby orphanage, and how much they have changed while I have been here! 

This little guy is about 4 or 5 months old now. He is the little baby who was found at the gate in May and looked a little yellow and jaundice-y when he arrived. Luckily the carers thought he looked a little yellow and took him out for plenty of sun - which did fix him up quite nicely! Now he is happy and healthy, rolling over and starting to sit up (with help).

Here are the three babies in January. On the end is Thắng the little boy. 
In the middle is Hạnh. She must have been about one month old in January. When she was found she was a tiny little premmie baby. Apparently the doctors and carers didn't expect her to survive because she was so little, but the carers her nursed her back to health and now she is doing amazingly! 

at the bottom is Duyên. Another girl, maybe 4 months ish here? It is hard to remember ages of the kids.... especially as often the carers are just guessing a bit when they arrive. 





This is Thắng, the boy who was so flopsy back in May, sitting up yesterday.
He is rolling, creeping around on the floor and enjoying sitting up (with some support). He must be around 10ish months old now, he was a tiny little baby when I arrived in January!

He was very much enjoying sitting up, but has a tendancy to push himself backwards and expect someone to catch him so that ha can be lazy and lean into support..... luckily donks on the head don't hurt too much on that soft mat!

Here is Hanh and I enjoying some cuddle times! She might have had a rough start, but now she is rolling and crawling around, sitting up on her own and exploring the room and even standing with her hands held. Taking steps is a little challenging yet, but I think soon she will be racing all over the place! 

And Duyen, She is walking around and is almost one of the "big kids" now! While I was away for two months she developed a deep distrust of strangers (or of strange looking people!) and starts to cry if I get too close now! And we use to have such nice cuddles! I think slowly I am gaining her trust again, but not sure if I will get a cuddle before it's time to leave! I didn't take any photos of her today as even looking at her too long makes her scared!

This photo is from a couple of weeks ago

"The shy girl", Thanh is still sometimes more a watcher than a doer. She often enjoys just sitting with me outside laughing at the kids who were pushing each other around on the toys rather than playing, but is getting right into the ball pit and liking to be pushed around in the balls.

She also has gotten more brave at sticking up for herself.... not more just letting kids take toys off her. She is probably more likely to do the taking these days! But then when someone takes her toy crying until someone comes to fix it is her default reaction!

She is also much less shy with new people. When some friends brought a collection of toys from Australia and visited the orphanage earlier in the year she was quite happy to go over and plonk herself down in a lap to get a share of that attention!

This one is yesterday, the look of amazement when
she discovered that the puzzle makes noises

She is enjoying cause and effect toys and things like puzzles and drawing. So I am trying to take lots of those type of toys and activities to help up her skills a little bit.

Having fun with drawing

I am not 100% sure of this little ladies name (I meet a lot of children every week - give me a break :P)! She is walking around very confidently, playing, kicking balls, and drawing.
These kids just grow up so fast!

Here she is in Jan

This little dude (yes he is a boy, apparently everyone but me think he looks like a girl - I don't see it, what do you guys think?) is new. He arrived while I was in Cambodia, I am not sure of his age, or name (need to confirm these details on Friday!) He likes drawing, and throwing a ball with me. He can also be a bit of a bully, typically he wants whatever toy someone else has - and will just take it!

I was told yesterday that he is getting adopted by an Italian family and should be taken to Italy in about 3 months time, so he might not have to spend too long at the orphanage!

It seems I don't have photos of the other two children - There are 9 all together at the Da Nang Baby orphanage at the moment. Another new girl arrived while I was away, She is 4 or 5 (different people told me different ages!). Apparently she is also going to Italy in three months. If not I am going to look at supporting her to go to Kindy so that she can learn all those pre-school skills and interact with kids her own age.  

The baby orphanage is an interesting place to go, There are less kids here than the red cross orphanage - a maximum of 10 at one time. So the kids seem more well looked after - It is much easier to keep track of 10 kids and get them all through the bath each day! The carers are on top of nappies, so we never do that, and feeding is a breeze with a couple of volunteers there to hep and doesn't take long at all. 

As such if you just sit back and watch everything ticks over quite nicely. Because of this I think it can be harder to feel immediately totally useful compared to the Red cross - where total Chaos always seems to be a hairs breadth away. I think for some of the volunteers they are not able to immediately see what needs doing (play always needs doing if you ask me!) so find it a little boring.

Taking new toys from our stock so they have something different to play with, helping the kids to colour and draw (trying to do more advanced shapes with the older kids), showing them cause and effect toys and puzzles and watching/helping them problem solve how to work them, kicking or throwing a ball with the kids, supervising so they can go outside into the new play area out there and putting them into an out of the ball pit (I need to get a ladder, they always change their minds about being in or out!). Helping the babies get some tummy time, or sit up, or singing songs to them. 

There is so much to do! I love visiting this orphanage, I think a lot because the kids are just so sweet and happy, and keep to play and interact and partly because I can relax my physio brain and just play with the kids! 

Last projects

One of my last projects for the red cross orphanage, building security gates.

Kids playing in the gated room

To put this into context I need to explain a bit about the orphanage system. So the red cross has 24 kids. 4 of these kids have cerebral palsy and are unable to sit up, or participate in self care activities like feeding themselves.
4 of the other kids also have disabilities, but are mobile and able to get around the orphanage. This means that they can get into all sorts of mischief!
3 of the other kids are around 3 or 4, so they are also quite mischievous and really want to have lots of attention, plus all the older mobile kids can easily steal toys or treats from the younger kids.
The rest of the kids are under 1. Only two of the kids are toilet trained, so the rest need to wear nappies. To look after all these kids are 3 to 4 carers. They work 24 hours a day, 7 days a week with 3 or 4 days off a month.

Slightly more controlled madness 

Because they are so overworked, and a lot of the kids are able to climb out of the cots, they tie the kids into the cots with a rope made of handkerchiefs tied together. When we arrive in the morning at around 8am we untie the kids and because we have the extra supervision can let them run around and play. I believe they get re tied up at lunch time when we leave.

When asked why they have to be tied in I am told it is to stop kids getting into the bathroom and burning themselves with the hot water, or getting into the kitchen and hurting themselves. I am sure a big part is also around them making messes in the storage areas that the carers really don't have time to clean up. Some of their reasoning about safety doesn't really make much sense though, frequently the carers don't shut the door to the bathroom which would work just as well to prevent burns, or shut the gate out onto the road!

I negotiated with the carers around trying to stop the tying up of kids. As well as stopping them from being allowed or able to play with each other, or socialize, it also is often tied very tightly and looks painful, and can cause rashes and skin infections. So I decided to pay to get gates put on the main room and so as long as the carers shut the gate, and shut the bathroom doors than the kids should be safe and able to be free!
The gates are a lot higher than normal baby safety gates, but these kids are really good climbers!!


So the first day that we arrived once the gates were completed the kids had all been taken out of cots when they woke up (which I'm guessing is pretty early) and were playing and running around freely!

Talking to the carers they said they really like the gates, and it is a lot easier as they can now move freely between the kitchen and store rooms without having to watch the kids as much.
Definitely a success!!

Where are they now.... red cross kids

So, this one is mostly for past volunteers who want to know what the kids are up to.

Ha and Thanh

feeding time

As you can see both these girls are feeding themselves now (remember back in January when getting Ha to hold the spoon would be a battle Sally, Now she won't let you take the spoon off her when she is done!). Thanh is still a bit messy, but practice makes perfect I say! I am also an advocate for shirtless lunch times. That way even if I wasn't here to supervise..... the carers might see, and follow suit, and have one less reason (cleaning them, washing more clothes) not to let the girls feed themselves. At least we can keep practicing everyday I am here!

Ha playing with other kids

Thanh is also walking all by herself. She will grab at anything possible to hold on to, but she will walk across the room alone as well! Such an improvement! She does still throw toys - a lot..... but she will also play with toys (particularly if someone sits with her to show her how!)

Ha's play skills are improving too. She enjoys playing with other kids now, often riding on the cars with them. Even more of an improvement though, she will play on her own and be quite happy. Bouncing on the "roger" horse things, riding around on the cars or sometimes pretend play feeding dolls. From the girl who would just follow you around with a sock asking you to put it on her, then taking it off and repeating the cycle, or wandering off out the gate if no one plays the sock game with her - it's a pretty big deal!


Nga

practicing drawing

Nga is a totally different little girl to the kid I met in January. Well, mostly different (we have occasional lapses into I'm-going-to-explore-this-medicine-cabinet moods if she feels ignored).

Nga loves to interact and does so much more productive play now! I try to give her jobs to keep her part of whatever we are doing (putting the dirty clothes into the washing basket when changing other kids nappies, I know Phuc has been getting her to help him while he does physio with other kids too). She does demand high 5's and much praise for each baby shirt safely delivered into the washing basket....... But that seems a small price to pay for happiness!

Nga giving herself at thumbs up after finishing
another puzzle

Nga quite enjoys drawing so today we worked on doing purposeful lines (up and down, sideways, circles, x's all those pre-prep groups watching OTs is paying off) instead of giant scribbles. When she gets it and gets a high 5 her whole faces lights up with pride and joy, it is amazing to watch!

Puzzles are still her favorite activity, and I am working on sign language while doing these. She seems to understand that different signs have different meanings, and get her what she wants! Teaching her more, and teaching the carers is the next step. The puzzles are getting more and more complex, from simple peg puzzles, which she needed lots of guidance to find the right hole and turn the pieces to make them fit, a few months ago to picture puzzles today - which she did amazingly at!

Deep in puzzle concentration

I am trying to think of a way to allow her access to the puzzles and building blocks, which stops that other kids being able to get into them. The difficulty is that most other kids are so young that they just want to pick up whatever toy someone else is playing with, walk around with it for a while, scream if you try to return the puzzle piece to the puzzle..... then drop it somewhere never to be seen again.

I am not totally sure how much she would enjoy the puzzles or blocks without the constant attention.... but as she gets more settled I am trying to lessen the high 5's for every single piece put in place - just for finishing the whole puzzle, or building the tower so high it falls down. Hopefully I can wean her off a little of that praise! Get her enjoying the game itself! But any suggestions of how a very tricky 9 year old can get into the toys..... but a collection of 3 year old can't, would be appreciated. I am thinking of going with height, but these kids are pretty good at playing stack-em-ups


I have ranted for quite a lot about Nga here....but to be honest I would say she is the child at red cross who has made the most changes. And who has gone from having basically nothing expected of her, to learning skills and problem solving. I am really happy with all the changes :)

Tam lifting her arms 

Tam is looking well. Her chest is mostly clear at the moment, and her cradle cap (or whatever it is that was happening on her head!) is almost all gone. These two health concerns clearing up have to make life a bit nicer for her! She adores the ramp and being taken for a walk outside in her chair. Bumps and lumps to go over have her laughing hysterically!

Tu and I work on a lot of standing when he is feeling up to it (he lets me know if he isn't!). He has such tiny little bird bones, I figure some weight bearing has to be a good thing for him!

helping to pack away toys

Thao (aka Spidie) and Phuc work on lots of standing and trying to take steps. She is still convinced that her craby crawl is the best way to get around. And she certainly does get around mighty fast! Hopefully seeing Thanh walking more and more will help motivate her a little.



The three (very cheeky) amigos are getting into just as much mischief as ever, but I don't expect (or want - I love their spunk) them to change any time soon! They really are only as crazy as I would expect any group of toddlers to be. Especially ones with minimal supervision!

"helping" to clean something up
(I'm not really sure anything needed mopping anyway :P)

I am trying to motivate them to do some drawing. They are always very excited to come and start, actually putting pencil to paper, or sticking with it for more than a minutes is no so successful. I have so far had no success in trying to teach one that the point of pencils isn't to bite off the end - then hold it out asking for a new one because yours wont write..... But with time, maybe they will come to enjoy colouring, or scribbling.

Trying his hardest to steal my camera! 

summaries of a new disability centre, and moving on

Our last two weeks in Phnom Penh have been spent at the Veterans International Centre (VIC) where people with disabilities can come to get wheelchairs/prosthetics/physiotherapy/etc.
We moved to here because with our lack of nursing skills, Nancye and I found that we aren't super helpful in a nursing clinic. And not so many people with disabilities were coming to the clinic as we expected.

The VIC was much more fitting with our experiences and busy!

There are a couple of dorms where people from out of town can come and stay. It seems people stay for around 3 weeks, then head home for a couple of weeks "holiday" and if need be come back.

The centre is pretty varied. They seem to see a lot of kids with torticollis or club foot. Lots of Spinal cord injuries (one from a bike accident, one who fell off a house and one who got shot in the spine by police while walking home from university, past a protest). Quite a lot of prosthetic leg making, some from mines, some from bike accidents, plus remaking them as people need new ones.

So we got shown around and introduced to everyone, then shown to a person. The physios here all talk at least reasonable English. But the difficulty is that they are all always busy with their own patients and not really able to translate for more then 30 seconds at a time. So there was a lot of smiling, and pointing at myself saying Lucy, pointing at the child and trying to guess how to pronounce their name. Luckily for us the notes are written in English and a lot of the people we saw had been seen by a previous volunteer from America.

The interesting thing to see it that the physio's seem to have very very specific areas of speciality. Like, rather than specialising in paediatrics - specialising in clubfoot only. So there seem to be a lot of gaps for people who don't fit into one of those categories.

some of our highlights:

Organising Heung to have a splint for eating made. Heung had a traffic accident and now has incomplete spinal cord injury making him a quadriplegic. Before we got this he was using both hands to try to hold a built up fork and scoop at rice. We didn't actually see any go into his mouth so in practice I don't think he ever actually tried to feed himself - just had family do it for him. with the splint he can get the spoon in his mouth with one arm (sometimes using the other for support). He had a really beautiful smile on his face once he got the splint working (it probably wasn't until then that he actually worked out what the heck we were all doing! We weren't able to remove the spoon from this. So we made a second one that he can use while he practices writing, using his phone etc.

Seeing a little girl come back two days after her initial appointment....
 Initially we were told that she has CP. But when we did the initial assessment it didn't seem like she actually has any diagnosis. At 1 year old she isn't standing or walking and her parents are getting worried. she can sit perfectly well (great posture actually) when placed in sitting. But refuses to stand. My diagnosis...... not tummy time. This kid started screaming when she was put on her tummy, even when she laid on Mums chest. Every time she cried or screamed she got picked up again. We tried to explain that she is crying because it is new, and hard and she isn't actually getting hurt (so leave her there!) but we weren't really sure how much got translated, or whether the parents would let her cry. Two days later she comes back. We actually didn't recognise her because when we looked over she was lying on he tummy playing happily. Amazing! Unfortunately most of the young kids were scared of us weird white people and would cry if we picked them up, touched them or sometimes - looked at them too long! This little girl was definitely in that category! So we had to use a teddy bear to demonstrate to mum how to help her roll over, or sit up by herself. Mum did really well, but it is so much harder without being allowed to touch the child. And without being able to speak the language!
It was a pity that we only saw her for the first time at the very end of our trip. I think if we had been able to see her more than twice she would have gotten use to us (we kind of got a smile out of her towards the end!) and we would have had her crawling! She picked up new skills so fast once she got tummy time!

The even more rewarding part of that session and trying to explain to the physio translator how very very important being on tummy is for babies came later that day. We weren't really sure if the physio understood what we were trying to explain about the importance, but then later thast day I looked over and saw him with a little baby on it's tummy. He was looking at how well it could hold it's head up, and even using a rattle to entice it to look. That was great! Hopefully they will continue to fight the tummy time fight. I think culturally here kids don't spend enough time just being on the floor, rolling around or whatever. Every time I go past a house and notice babies they are carried, or in a hammock.

Tam Ky - Dioxin centre

Tam ky is about 1.5 hours drive away - it is a bit far to go on motorbikes regularly, but while the physio students have been here we have been going down in the van every Wednesday.

Kids dancing

The Dioxin and unfortunate children centre is a fairly new school and vocational training centre for kid with agent orange based disabilities (dioxin), and any other disabilities as well. The school is a bit bare at the moment, with one teacher, a nurse and the director. But it is a really nice place, they are all really happy to have any help at all and work with suggestions or ideas we provided. The kids get lunch there, and it is actually a nice looking lunch! (as opposed to the gruel that is served everywhere else!) meat, rice, vege. Good looking food!

Showing me how to use the incense making machine

At the moment they are not able to accept kids who need wheelchairs as they don't have enough staff to support those children, which is unfortunate.

The young adults also work together to make incense sticks. Which these gentlemen told us they love doing, I get the feeling they didn't have a role in their lives outside of the centre. Now they are in charge of the incense production line, teach the kids (and random foreigners who come sticky beaking like me) how to use the machines and get to sell their products to help support the centre and pay for lunch etc.

The fellow in the photo above has athetoid CP. So his left arm is constantly writhing and moving and throws him off balance if it is free. It is hard to see in the photo - but he has a piece of plastic twine tying it down. Which does work to stop his arm moving too much, but also bit into his skin!

The students got some leather in Hoi An one weekend, and we got out cook here to sew us a belt with a little loop for his hand to slip into. This is nice and stiff and stops his hand from moving around too much. Plus it is a lot thicker and softer than his twine, so now more cutting into his string! Sometimes, the littlest seeming things - like getting some leather and making a belt - can make the biggest difference. Now, if our belt eventually breaks at least he can take it somewhere and get a new one made to the same design!

We are pretty sure that the fellow in the background of the photo on the left is now also acting as a teacher. He seems to boss around the kids often, and sometimes the other teacher. If he is, what an amazing role model for these kids. Showing that just because he is missing a foot doesn't mean he can't do anything he wants! He also drives around on a cool three wheeler motorbike and was really keen to come to another centre (a place we were thinking about buying incense machines for) and teaching the young people there how to use the machines.

He also sold me 80 000 dong ($4) worth of incense..... which is actually 10 giant packets that fills up a shopping bag!! but it smells nice!

The very beautiful and photogenic kids of the Dioxin centre!

 The kids always get excited when they see a camera get whipped out and start posing, smiling, giving peace signs and generally doing entertaining things. If the camera is being held and not used..... constant tapping on shoulders and pointing at the camera to ask you to take their photos!

 It is hard to know exactly what the kids usually do during the day. It seems they get lessons and have books to write in. But there isn't a chalkboard in the classroom. So I guess everything is taught orally. One of the teacher's main concerns for physio was that the kids all have messy writing. I was amazed that half the kids could write at all! But Vietnam does have a big emphasis on neat writing. The kids we teach English too have such neat writing it makes me ashamed of mine!

 They also have a karaoke machine in the classroom. Because every kid should get to karaoke machine..... instead of a chalkboard! They do love it though. On our first visit we were hoping to get to see what the kids usually do.... but instead we got sung to by various children.





Including one (on the right) who apparently can't actually speak - but loves to sing and just make noise. It was actually quite tuneful singing too.
While playing with some beading I had her copying the colour names (in Vietnamese). Seems if you spend some time giving her the language she can copy and pick it up! But the only teacher doesn't have time to sit and do it all day, I guess her family is probably too busy working to spend the time. But it is so sad to see someone with so much potential who just doesn't have people with time to teach her.

dancing fun

 We decided to try to get some physical activity into the kids day. A few of the kids are on the bigger side, and tend to sit around all day not really running around and playing. So we started with the macarena - you can see in the photos that they are having a great time dancing!

teaching the kids the macarena

We had a great time teaching them. We also went through the chicken dance, and then a simple version of Gangnam style..... as soon as the music for gangnam style started playing the kids were laughing and getting more and more excited!

The only problems were the heat - which was getting intense towards the end of the 5 weeks! the weather here is really heating up!

Hopefully the school will keep going with the dancing, and hopefully they can do so early in the morning when it is slightly cool. The kids absolutely had a ball dancing, in the last week they were even singing along to the songs.

We also taught the kids how to play tunnel ball and bought them some balls to keep so that they can play soccer, tunnel ball, generally throwing or kicking the balls around.

over the top tunnel ball

intense tunnel ball action