Friday, February 27, 2009

The end of our time at the Orphanage

This morning was our last time in the Orphanage - no lecture at all, but time for final questions and pictures! The last few days have gone quickly. Torri finished up her portion of the lecture on behavior and play - many of the women really soaked up the behavior information, but are frustrated by lack of progress - especially because of the standards that are imposed on them. The women understand the importance of play, but are unable to focus on it because the emphasis is on developmental progress - difficult with teens who have significant cognitive delays. But Torri was able to be a sounding board for these women and helped to brainstorm many ideas of things they can work on - they seemed to be encouraged by the end of the afternoon.

While Torri was busy working with the behavior kids - Stephanie had a behavior problem of her own....in a grown man, who happens to be in charge of all the therapists. What a disaster! I will say that we had been warned that he searches for ways to argue and dispute anything and everything we say - especially new information. But I was not prepared for what was coming. I was working with a little girl who has hydrocephalus - she is able to roll, but has difficulty sitting on her own. So I was showing the women the importance of building abdominal strength through sitting and transitions. Lets just review what he had to say....
* That the weight of her head may break her neck if we put her in ANY other position than on the floor
* They are unable to work with her leg joints because she does not have proper fluid in the joints since it is all in her head
* She has low hemoglobin levels - they fix this problem by taking her outside where there is more oxygen. However, on rainy, cloudy days there is less oxygen so they let the children play rather than work hard. This is why we are all much more tired on these days as well - not enough oxygen for our bodies.
Those are probably the best of the arguments...but it all went on for almost 45 minutes! For all of you non-science people...all of those points above are totally FALSE!!! I was so frustrated and the worst part, is when I started to discuss with him therapy ideas (ignoring the incorrect information he had stated earlier) - he stood up, walked out of the room and left for the day. Unbelievable!

Although happy hour would have been the perfect ending to this day, instead we decided to culture ourselves by attending a ballet. Not even in the states do I do this...oh well. We saw the ballet "Giselle," not necessarily one I would recommend. Storyline was to say the least crazy. But the theater was beautiful and the orchestra was fun to listen to...Stephanie loved hearing the oboe!

By Thursday we had finished all our prepared material, but by request we put together some last minute lectures on two topics. We taught some basic signs for functional use with kids who are nonverbal - true it was ASL, but as long as they all use it...who cares, right?!? :) The best part was bringing down two kids and teaching them sign in front of all the women. Olishka (the cutie you will see in many of our pics) is so smart! He already has created some signs, but we were able to teach him: more, ball, thank you, shoes, want, all done, and please! All these in just a short amount of time and he even used some of them again today! Elkrin, the second boy who was brought down, is lower functioning and doesn't really use any functional communication. By the end of our time he did demonstrate 2-3 attempts at independently signing "more." It was very exciting not only for us, but also for all the caregivers to see.

The second impromptu lecture was on body mechanics, proper lifting (so hard for them to get) and some exercises for the caregivers to do for their own body. They loved hearing all this information and were shocked by some of the exercises! We provided them with a handout that included 8 exercises - with stick figures and descriptions in Russian. Not to shabby with just a little prep time.

Our cultural experience didn't end with the ballet - Thursday night we went to Tashkent City Bowling! Wow! Torri and I got to wear pink velcro shoes and decided not to wear the socks provided. Apparently learning bowlining in PE really did us good, because I think we were the best bowlers in the entire alley. Stephanie won with a whopping 95!!!

Leaving the orphanage today was definitely bittersweet. We are ready for some true relaxation next week, but were sad to leave the kids and caregivers! The staff was so appreciative of our work - apparently it was one of the first times that a group had taught at their level. So they could really understand and apply the information. We had so much fun teaching them and working with them! Today we were presented with Russian certificates (hopefully we'll find out what they say) along with framed artwork made by the kids! Absolutely beautiful. One last walk through taking lots of pictures and saying goodbye.

This weekend we will tour Tashkent and hopefully do a little shopping. No museums hopefully - we had our fill this afternoon! Our flight leaves Tashkent at 4:20AM on Monday - we have to be there 2 hours early. So not much sleep again for us! We will be flying Turkish airlines from here to Istanbul - so a few extra prayers would be appreciated....for our safety and our nerves! No wonder people clapped when we landed in Tashkent! No internet between now and Istanbul, but we should have wifi and hope to get lots of pictures uploaded! Till then...

Steph & Torri

Tuesday, February 24, 2009

More pictures
















Samarkand & the start of week 2

Our weekend started very early - good thing for us our bodies have no idea what time zone we're in...so 5am was no big deal. We rode the train from Tashkent southwest to Samarkand - a 4 hour ride, full of reading, ipods and cross stitch. Unfortunately there wasn't much to look at out the window - some snow covered mountains in the distance and lots of dry, flat land in between. Natalia (our interpreter) and her husband Jon came with us on the trip - thank goodness! Natalia negotiated all over the place...starting with our taxi driver. Apparantely negotiation in Samarkand is even more necessary than in Tashkent!

Our hotel room was luxurious in comparison to where we are staying now - you can tell it was a tourist destination! Large room, intricate wood work, soft toilet paper and English TV channels - paradise! The only problem being that we never could figure out how to switch the shower on from faucet to overhead! Dang!

Our weekend was full of lots of great food - we had plofv (sp?) for the first time...a rice, carrott, meat dish which is very traditional Uzbek food. Stephanie had a lot of lamb...all very good! And Torri had lots of potatoes and bread :) It was nice to finally be able to walk around more and explore the city. We were staying in a very central location and Saturday was beautiful - lots of sun and clear blue skies. Honestly, we really didn't know what to expect as far as tourist stops in Samarkand - but what we found out is that most of the destinations were masoleums...a tomb for random people who apparently were important back in the day. But no one really knew most of them. Truthfully - they all began to run together at some point.

One of the more famous places is Registan - an old Muslim boarding house for young boys to learn koran, astronomy and math. It is a huge facility (hoping to get a picture uploaded for you of this), although most of it has been rebuilt over the years. The highlight was paying 3000 sul ($2) to climb up to the top of one of the towers - you climb a small spiral staircase, with tall steps and no more room than one person at a time. At the top you squeeze your way by wires that hold the tin roof in place and pop your head out the hole in the tin roof. There is only room for one person and it is a little nerve racking to try to turn and take pictures of the view on a small little step that you can't see. While at Registan - we also were apparently celebrities. Took our picture with The Oregonian travel section and our Blazer hat....then a few young boys who wanted their picture taken with us. Quite a comical situation :)

This week at the orphanage - it is Torri's turn to lecture on sensory processing, behavior management, and play skills. A challenging topic to explain in a short amount of time, with limited prior knowledge/experience. They all really loved the joint compression and distraction and seemed to really understand this. Not sure how that will translate into working with the kids though. They continue to bring us pretty challenging kids, mostly so that we can show them how to get response and developmental progress from kids that otherwise would be ignored. One of the biggest challenges has been as a child is brought in - especially behavior kiddos when EVERY caregiver needs to add an explanation or additional information, making translation and keeping up with the problems/needs very difficult. But we seem to be making progress - so we'll keep up the hard work!

Stephanie's wonderful mom is helping us upload pictures as we email them to her and she posts them to the blog. Apparently blogspot hasn't added the picture application in Uzbekistan...go figure! So hopefully we'll have some pics of the kids soon....Thanks Mom!!!!

Steph & Torri

Friday, February 20, 2009

Pictures!




We survived week 1!

It took some work (and forcing ourselves to stay up past 8), but we got through week 1! Everyone seems very interested in the materials we have prepared, and a few people have contacted the MTI office here to say what a good job we've done- that definitely encourages us to keep working!

Yesterday was more emotionally exhausting than anything, as caregivers were starting to bring us kids with very severe disabilities that we are unable to do much about at this point (e.g. 17 year old with scoliosis and seizure disorder). Sometimes we wish we had an MRI to know exactly what is going on inside kid's brains... Also, a neurologist to do seizure management would be great- right now they just heavily sedate the kids as soon as they have a seizure. Then the caregivers are surprised that the kids can't move for the next 3 days... Torri emphasized the need for being aware of kid's sensory needs so that we can at least keep them comfortable. So far I don't feel like I'm getting far, but I have explained that I will go into a lot more detail next week, so hopefully that will help.

This morning we got to work with one of the most outgoing kids we've seen yet:) He is 8 and understands both Russian and Uzbek, and has devised quite a system of sign language since he is non-verbal. Stephanie got him up and walking while Torri took video tape- later (for motivation to keep working), Torri showed him the video. We can't even put into words how awesome it was when he realized that he was watching HIMSELF on "tv"- he pointed out everyone he could see in the video and laughed and shrieked the whole time. The whole room started laughing and was happy to see such emotion! We wish we had been able to take video of that moment as well:)

At the end of the day, caregivers started asking about body mechanics for themselves when lifting children because ALL of their backs hurt! We had an impromptu body mechanics lesson, followed by strengthening and stretching. The women started asking for ways they could strengthen their own muscles (especially their abs- apparently it's a worldwide obsession). We found it interesting that until now none of them had even thought about doing any sort of exercise at all- women don't have any opportunities to exercise here (other than dancing). But, when we mentioned the idea of creating a 10 minute strengthening set the women could do at work, they all seemed interested. So, looks like we'll be leading them in exercises, too:)

One of the things that has struck us the most thus far is how invested the caregivers are in our teachings. They are always asking questions and want to try the techniques we have taught. Today they even let Stephanie demonstrate facilitation techniques on their bodies. It's very encouraging to see their positive response and know that we really are here for a reason.

We're off to Samarkand for the weekend, an Uzbek tourist destination- time for some sightseeing and shopping!

Stephanie and Torri

Thursday, February 19, 2009

pictures?!?

Sad news - for some reason we can't upload pictures using blogspot here. We will try again another day, maybe the computer is just being crazy. Otherwise - pictures might have to wait till we reach Istanbul. Just wanted to give you all an update.

We're headed back to the hotel now (where former communist leaders stayed) and then to the market for some food. Ate too much yesterday - so still digesting...

Wednesday, February 18, 2009

Adjusting to life in Tashkent

First off, driving as you can expect is crazy! The lines are for decoration only. Seatbelts aren't even available in the backseat. Never run a red light, because the other direction will have already started moving. Turning left means drive into the middle of the intersection and wait. Honking your horn is a necessity - to say get out of my way, or to claim your right of way on a narrow street. (or maybe a friendly greeting?!?) And always be aware of pedestrians - they never have right of way (unless you feel like giving it to them) but will cross the street at any given place and stand in the middle of the road until there is an opening.

Last night we walked to a small market down the road from our hotel (kind of like a plaid pantry). Funny thing is more than half of it was filled with sweets, desserts, candies, etc. And not one Coke Light to be found :) On our walk back - we saw one of the first American things in Tashkent....a 7-11! Although we've been told that it may just be a copy cat.

As for entertaining ourselves....there is absolutely no english channels on the TV. A few shows that are dubbed over in Russian - unfortunately you can't hear the english underneath. But we are educating ourselves on sports such as - rugby, fencing, biathalon (cross country ski & shooting) and of course hockey! But the best news was seeing the end of the NBA all star game this morning. Go West and B-Roy was awesome :)

Today at the orphanage started a little earlier, but we were also able to integrate more hands on application of the material. Most of the caregivers seem to be really invested in these kids and want to learn how to best help them. I think one of the hardest parts is that they want to bring us the most challenging kids for help - which is great, but sometimes we can't show them an immediate answer and the process may be slow - which is hard for them to understand. Many of the kids have serious orthopedic impairments - kyphosis, scoliosis, subluxed hips - making them very difficult to work with developmentally. There are definintely many barriers in explaining more abstract concepts when working with kiddos - especially with sensory processing or starting with head control before moving onto standing/walking. But they are all eager to learn, so we are hoping to work past some of these barriers!

It is very fun to be able to see results right away, or at least be able to demonstrate how to advance a kiddo's skills. This morning I (Stephanie) was talking about how to teach a child to sit and advance those skills to include trunk rotation and reaching across midline. The staff brought down a little girl this afternoon who could sit on her own - but do NOT ask her to reach outside of her base of support. I was able to show staff how to encourage her to bear weight through one arm while reaching across. She was even able to side sit and hold this position with hands free! It was great to show them each step of the process and tomorrow we will use these skills with her to work on transitions!!! :)

I (Torri) was able to work with Roma, the sensory kiddo from yesterday again. He calmed much more quickly this time, although still burst into tears as soon as he entered the therapy room. Roma is a kiddo who loves extension and reverts back to this position when he is startled or becomes upset for any reason. This afternoon, I was able to get him out of this pattern much more frequently - while trying to explain to caregivers how his sensory defensiveness impairs his ability to make progress motorically. The staff was able to try joint compression and feed how he responded to deep pressure input. However, at the end of the session they still very quickly picked him up and rushed him over to his chair. A task to address as the days go on....

For lunch today we went to a small house, where a family also runs a restaurant. Yulduz (one of the staff members) highly recommended it and took us there. Very good food! We had bread and tea (all of us). While Torri had lamb soup (without lamb)....not sure how that worked. While I (stephanie) had noodle soup with lamb and lamb kabobs - fabulous!!! All our food for $2 each or 6000 suls. Tonight we are off to Chineese food, being as we are so close to China - we're excited to see how this tastes. It's a very expensive local restaurant (which does serve wine & beer) - our dinner should cost roughly 15000-20000 suls or $10-13. We'll let you know....

Sorry for the therapy talk in the middle - but gives you a good picture of our day :) You can tell we had plenty of time today on the internet....

Steph and Torri

Tuesday, February 17, 2009

We are here!!!

So we have made it to Tashkent and finally have some time (and energy) to update our blog. It is Tuesday afternoon, just a little after 4pm local time - which makes it 3am in Oregon. We had quite the experience getting here - here's a few short tidbits....

* European airplanes at night are LOUD and bright (all the lights are on). They also serve full meals no matter what time of day and everyone buys the duty free items as the cart passes. Needless to say not very easy to get some sleep.

* We spent 18 hours in the Istanbul airport...we were so tired that Torri couldn't even update her facebook status correctly. We really slept at gate 207, not C-17 :) Oh well - we were very sleep deprived and thankful to at least have free internet to poke around and do useless things! Also very expensive - $8 for two cups of Lipton tea. CRAZY!!! But we did catch the last few minutes of the slam dunk contest - dubbed over in Turkish of course.

* Our arrival in Tashkent went well - just really early! Our flight finally landed at 3am - passport control, getting our bags and going through customs took about an hour and half. We made it to our hotel by 5am and were very ready for showers and a bed!!!

* Yesterday started around noon with a visit to the MTI office and a short tour of the orphanage. All the staff was great and very helpful. It was definitely tough getting going as we were so exhausted - but finally getting to see the kids was great! We both had huge smiles on our faces as we got to say hello to many of them. Can't wait to get started!!! We headed back to our hotel around 5pm and forced ourselves to stay awake till 7 - when we washed our face, brushed teeth, took our Ambien and went to bed!!!

* Today went really well. Our first official day in Tashkent and at the orphanage. Our hotel has free breakfast - which at first seemed impossible since the menu was in Russian. Fortunately we were able to communicate (and our looks probably helped) that we needed an English menu. We both had Rice cereal (not baby food), bread and cheese. Still a little wary to try coffee or tea for fear that it is made with local water and not bottled. We were picked up at 9am and headed to the orphanage - it takes about a half hour to get there. But we got started quickly once we arrived. From 10am-11:30 we lectured - starting today with typical development, how to control tone and starting in on facilitating motor development. We were able to work with some kids before lunch at 12:30. Then the afternoon was more hands on work. We had so much fun working with the kids and showing the staff how to facilitate their movement. We also had the chance to meet our first total sensory kiddo - definitely a hard concept to explain to the staff. But he was able to calm so nicely to some sensory techniques - I think the staff is starting to get the idea. Hopefully with more time, this will help.

Well - there's the update for 3 days worth of time. We did take some pictures today and hope to get them posted soon! Till next time we get to access the internet....

Torri & Stephanie

Saturday, February 14, 2009

End of day 1 traveling...



Well it is 6:30pm in Amsterdam and we have explored a bit of the city this afternoon. Really forcing ourselves to leave the airport and not just find a bit of floor to crash on. Needless to say, although the Ambien probably did help a bit - it was not good or enough sleep!!! We were lucky and each had 4 seats in the middle to ourselves to sprawl out on - but it sure isn't a bed! Oh well - few more hours and we board yet another plane to Istanbul, arrive at 1am and hoping to find a lounge or hotel to get a few hours of sleep before our 16 hours of waiting!

Here are a few pictures so far....


(above) Along one of the beautiful canals :)


(below) This one is just for Yasmin....





Checking in at Portland Airport - hoping our bags make it all the way to Uzbekistan!!!

Sunday, February 8, 2009

Preparations and Prayer

Uzbekistan here we come....

Torri and I leave this Friday - February 13th. Our flight leaves Portland at 3:50pm. And FINALLY arriving in Tashkent, Uzbekistan on Monday morning - February 16th at 2:30am. We have plenty to do before then and would love to ask for specific prayers as we get ready.

1) Pray that we might be able to get through this week as stress-free as possible. Get everything done and feel ready to leave on Friday

2) Pray for our traveling safety and energy. We have 42 hours of travel - including a 9 hour layover in Amsterdam and a 16 hour layover in Istanbul. We are a little nervous about all this downtime in airports, especially in the middle of the night.

3) Pray for teaching time/preparations. All our material is in and being translated. Pray that the material would be clear, helpful and that we might be able to communicate it to the caregivers/staff.

4) Pray for our time with the kids at the orphanage - that we would be able to pull all our knowledge and help them!

I know we will have more specifics as we get there, but it's a basic start. Thank you all for your support and we will try to keep you posted on our trip!

Love,
Steph