03 March 2011

Left Handwriting 101

One of the ongoing obstacles that we face here is a delay of treatment.  Often, our patients will come to the hospital after several weeks or months (sometimes years) of the onset of their illness or injury.  There are many reasons for the delay: distance, finances, hope that they will just get better (insha allah -- as God wills), and traditional medicine.

Traditional medicine in Niger can include herbal medicine, incantations, 'bone-setters', divination, and mediumship.  What we often see in the hospital are complications, infections, and secondary affects.

One specific example is a little guy of 11 who goes to school, has already lost the thumb and index finger of his right hand, and is in a wait-and-see as to whether or not he's going to be able to keep any of his hand and forearm.  He had a fracture . . . a pretty simple one from what I understand . . . and went to see a traditional healer.  Due to the resulting infection, he had lost all functional use of his right hand, had exposed tendons, muscle and bone and sat listening to us discuss his options while trying very hard to be brave.

When I met him,  my first thought was 'What does it mean for a boy of 11 to lose his right hand in a culture that considers the left to be dirty?'  Then they told me that he goes to school.

You see, most of the children that I have encountered in the hospital don't go to school.  I know this is a very foreign concept for us from the West.  That's what kids do.  Kids play and they go to school.  Not here.  So when I child in Niger has the privilege to go to school, we do everything in our power to help him stay there.  I stood with him outside of the operating room  and I asked him, 'Do you like school?'  'Oh yes!'  'Would you like to learn how to write with your left hand so you can go back to school?'  His face lit up and I imagine it was the first time he smiled in a while.

Now, I'll be the first to admit that I am no school-based therapist.  There are some OT's that are experts in all things related to pediatric education . . . thank you God for them so that I have experts to run to with questions!  I began by googling 'teaching left-handed writing' and have found all sorts of wonderful things like the proper position of the child's trunk, arm, wrist and hand as well as the paper he will be writing on.  Who knew!

In the wonderful world of childhood development, there's a happy place called Pre-Handwriting Skills . . . this includes things like scribbling and drawing shapes and lines.  There are also strength and coordination prerequisites that are necessary as well.  So, even though he's 11 and not 4, I thought we could start there.

In one of the articles I had read (written for parents of little lefties by a handwriting specialist) it talked about encouraging play with the left hand and specifically listed using drawing shapes with sticks in the dirt and chalk on the walls.  BINGO!  I would try to hunt down some chalk, but hey, if there's anything we have in abundance here, it's sticks and dirt (finding the perfect stick ended up being harder than I anticipated, but in the end, I found two!).

I went in to see my new friend as promised.  His face molded into a gianormous smile when I came in the room (if only all my patients loved me this much).  Feeling very proud of my efforts to get him back to learning, I held out the sticks and said, 'Come with me!' . . . wait . . . what's that?!?!?!  MINCE!  (Shoot!)  He had a wound VAC attached to his arm.  I had forgotten about that.  The big box that is his last hope at saving his arm sat at the end of his bed plugged into a voltage regulator (it's like a big bulky square surge protector).  He wasn't going anywhere.  No playing in the dirt for us.

Plan B.  Thankfully, the hospital's administrative office had chalk.  Looking around for something to write on, I opted for the floor.  Much to the surprise of his granny and the two others in the room (compliments of the little girls occupying the other beds), we sat down on a mat on the floor and began making shapes on the cement.

When I was here in 2008 I learned very quickly that Nigeriens love to laugh.  They have brilliant senses of humor, they love to help, and they are very happy to try to teach anyone language!  So, I figured I'd get everyone involved and turned it into a language lesson.  We started with shapes, then parts of the face, then animals (apparently sheep and cow stick figures look very different in Hausa . . . either that or I'm really lousy at Pictionary).  I'm not sure which was funnier to these old woman: my horrible pronunciation or simply that I was a bumbling adult unable to form their mother tongue.

I left him with the chalk with instructions to practice drawing and writing all day long . . . on the floor, on the walls, wherever the chalk would write.  I'm trying to hunt him down his very own little chalk board like they use in schools here . . . I'm sure our housekeeping staff would appreciate that . . . as well as a book or two in French so that he has something stimulating to do while he lays in bed waiting for the VAC to do it's thing.


Hazel said...

That's beautiful... hope he makes it.

Hazel said...

That's beautiful... hope he makes it.