The Tree of Life!

Shortly after moving here I decided to start looking for volunteer opportunities to help keep myself busy. I put a post out on the Child Life Council website to see if there were any needs for a Child Life Specialist here in Pretoria. My post connected me with an organization called OPSSA or Organization for Pediatric Support South Africa. Through OPSSA I have met many people who have a passion for Child Life and who hope to see it as a career here in South Africa. In June I was asked to present at a small seminar for health care professionals. I spoke on providing pre operative support, and also got to stay for the other presenters. One of the presenters, Megan is another American and former Child Life Specialist currently living in Jo-Burg.
Megan has spent the last several years living in Nigeria. As a missionary in Nigeria she worked with children in a photography program called Through Their Eyes and started doing photo workshops with the local children to give them a voice in their community. The pictures from the project were absolutely amazing. Having the children photograph their world was truly empowering for them, and helped others see how the children in their communities view what's happening around them. With her workshops she talked with the children about their roles in society and how their voices can make a difference. She then focused on parts of photography and the importance of point of focus when telling a story. The workshops helped bridge communication barriers between adults and children, and helped to show the children that they can be a part of change. The workshops had themes for the children to work with one for example being "I am Nigeria". The pictures the children took turned out amazing, and it's inspiring to see them tell their story through a camera. You can read about the Through Their Eyes photo project and see some of the pictures at www.throughtheireyesphotos.com
Over the last two weeks I have had the opportunity to help Megan with a special workshop here in Pretoria. Megan was asked to do a holiday workshop with children here that would then become part of the cities 'Feast of the Clowns' festival which is an annual celebration focusing at social justice issues. For Megan's workshop she combined a narrative therapy called The Tree of Life along with the photo workshop portion. The theme she was given to work with was "Un-Shackled" which goes along with the fact that this is the 20th Anniversary of the end of Apartheid.
The Tree of Life therapy has children look at their lives using the model of a tree. During the therapy children draw a tree with all it's standard parts. They discuss all the parts of the tree and then start paralleling it to parts of their lives. Starting at their 'roots' they discuss where they come from then move up the tree to discuss their skills and knowledge, their hopes and dreams, and the supportive people in their lives. Once the children have drawn their tree they then discuss how storms affect trees and what 'storms' they have in their lives. They then are able to start discussing how to protect their trees from these 'storms'.
I was able to help out with Megan's project on four different days. The first two days I was able to help with The Tree of Life portion of the workshop. We worked with 30 children ages 10-12. As expected some children took the project seriously and some did not. For those who did however, it was pretty impressive to see what they drew and expressed. I enjoyed talking with the children about their trees and the storms they face in their lives. To hear them talk about their storms with such casualty was at times unbelievable. These children discussed many hard issues such as bullies, violence, physical and sexual abuse, and parental neglect. I was proud of them for not being afraid to share their stories. It was also good to hear them talk about facing their storms and things they could do to overcome these issues.
On week two Megan started her photo workshop with the kids. They learned about using a camera, and importantly their points of focus. We talked about the theme of shackled vs unshackled and related it to their storms and the Tree of Life. They brainstormed ideas of what they could take pictures of to help tell their stories. They then were able to go out on the streets and start taking pictures. I didn't have the opportunity to walk with them out on the streets, but I helped a group of girls start to think about titles for their pictures they had already taken. Some of their pictures were really fabulous, and it was amazing to see their point of view and how it related to the over all theme.
The next step for Megan is to have their photos printed and then displayed for the festival. Some of these kids will be able to attend and it will be wonderful for them to see their work displayed for the whole city to see.  I can't wait to see the finished product!

Here are a few pictures of the workshop: 

Example of a Tree of Life Tree. This was an example Megan brought, I wish I had taken a picture of the children's work

Working hard on his tree

Working away on her tree

On the last day of the first week a tree was planted in the school yard  as a reminder of how strong our trees can be

Megan and some of the kids

practicing taking pictures and finding a point of focus

Photo Courtesy of Megan Ribbens
Out taking pictures

Photo Courtesy of Megan Ribbens

Photo Courtesy of Megan Ribbens

Photo Courtesy of Megan Ribbens
The Creche The program was held at

Photo Courtesy of Megan Ribbens

Megan has started brainstorming how to make these concepts work for children in the hospital setting, and I am excited to try it out! I love the concept of children using cameras to tell their stories. I think these two things combined would be empowering for children with chronic illness or long hospital stays.

A Trip to The Doctor

A few people have asked me what the medical care is like here in South Africa and if we have noticed any big differences. While for the most part our medical care is pretty much the same here there are a few differences I can share. For those with insurance or for those willing to pay out of pocket going to a doctor is easy and for the most part the same as it is in America. Not more then a few weeks here and Chase was the first person who needed to see a doctor. We chose a clinic in our neighborhood that was recommended by the other American expats in the area. The general practitioner Chase saw at his first appointment has now become our family doctor and has seen all of us for various reasons. Much like in America you call when you need an appointment and get in fairly easily.  We have really started to like our Doctor here, she is friendly, the kids like here, and always is sure to ask if we are still doing well with being so far from America. Doctors here don't hold back when it comes to writing prescriptions. When you leave the doctor it's not uncommon to leave with a script for four different things. For example, the last time I went to the doctor I got a script for penicillin, a pro biotic, a nose spray, and a pain reliever.  The last time Spencer was sick he had breathing treatments, a liquid steroid, an antibiotic,  a cough syrup, a pro biotic, and a pain reliever all prescribed. It felt odd loading him up on so many medications and we only used some of them as needed. Picking up prescriptions is a fairly easy process as well. The doctors can't call in your prescription to the pharmacy so I have to take the slip and wait in line, I've had to wait in line for 30 minutes before. It's kind of a pain with a two and five year old, and does make me miss the luxury of the drive through pharmacy.

I was also worried about finding a good Rheumatologist when moving here. I have been seeing the same doctor for the last 7 years and having a good Rheumatologist has been key to keeping my Lupus under control. I found a list of local Rheumatologist and picked a name on the list, hoping they would meet my needs. Thankfully, my doctor back home agreed to continue with my care over seas as long as I found someone here to be a contact and to write me prescriptions and lab orders as needed. My doctor here in Africa agreed to work with my needs and has been very accommodating and helpful in my care. I gave her a list of labs my doctor back home wanted and she has my lab results translated into English from Afrikaans and sent to me via email so that I can forward them to my doctor in the States. He quickly responds with his opinion and we continue from there. I go every couple months for lab work and have found our across the world communication to work out pretty well.  The blood lab here is just like any lab back home pretty simple, easy, and quick. I've been lucky to find a doctor here who is willing to be so flexible with their care.

When Spencer was put on all those medications we also had our first trip to a hospital here. One evening as Spencer was sleeping he was showing signs of breathing difficulty. He was experiencing a lot of heavy labored breathing and wheezing. So, after watching him for a few hours we decided to take him in to an Emergency room. I put a Facebook message out to some of the expat moms who have been here for a while to find out which hospital I should take him too. There are no children's specific hospitals here in Pretoria so I needed to know the next best thing. Several mom's suggested the same hospital so I went with that, and at 1:00 in the morning I loaded Spencer up in the car and headed off to a hospital I had never been to before. I was pleasantly, surprised when I arrived. We were quickly checked in and seen in no time by a doctor. Spencer had x-rays to rule out pneumonia and a breathing treatment then we were sent home. We were there less then two hours, it was fast and efficient.

The cost of medical care is different here as well. Our insurance isn't recognized at most of the hospitals and clinics here in Pretoria so to pay for medical care and prescriptions we pay out of pocket and then submit a claim to our insurance company. Before I submit the claim a doctors appointment will cost me anywhere from 30 to 60 US dollars and Spencer's trip to the Emergency room including his X-rays only cost me about $70.00. My prescription's each month are about 5 to 10 dollars. So as you can see medical care in general is less expensive, and really not any less quality.  My monthly prescriptions are the exact same and less then half the cost of what I pay after insurance back home.

Now, if you can't afford to go to the these clinic or a private hospital. You are given government funded medical aid and there are government run facilities you can go to when sick. I haven't been to a government hospital here, but from what I have been told there is a huge difference in care, cleanliness, and what resources/ tools they have available to use with patients. Elizabeth (our housekeeper) said that she avoids going to the hospital as much as possible and often there are sick people laying on beds in the middle of the halls. She did however have both her children in the government hospital and her youngest was born as a premie at 26 weeks, kept in a warmer in the hospital for 2 months, and has no lasting affects from being born early. I was pretty surprised after what I had heard about these hospitals. They must have some good resources to be able to provide for such a young infant.

There are times we miss our doctors back home and our big fancy Children's Hospital, but for the most part I really can't complain about the medical care we have received. It's been one less things to worry about while here.