just two more sleeps to go....
Well, I think that it is only fair to first offer an apology for my overly pessimistic outlook following the devastating fire, which pretty much destroyed the entire MoH complex and several ministry vehicles. Amazingly the staff in the accounts department managed to get everything back on track within a couple of weeks; including processing my own reimbursements. An impressive task when you consider that most of them are now desk sharing in someone else’s office. What this has meant is that after re-submitting some request letters I got to finish my placement on a bit of a high…. I completed all of my outstanding visits to the regions as I had previously planned; a trip to Bartica and Suddie on the Essequibo Coast as well as some last minute education sessions and workshops…and as luck would have it they were some of the most enjoyable to date.

Michelle and I did our last joint coaching visit together, this time in Linden in region #10. We facilitated another of the resource making sessions, which are great because we get to leave behind the activities that are made for the rehabilitation assistants to use after we have gone. We also had a really nice training session at Cheshire Home, which is a residential home for young people and adults with profound and multiple learning disabilities. I facilitated a session on creating sensory stories; I used the children’s story ‘we are going on a bear hunt’ to illustrate some of the key concepts, though thanks to Michelle’s brilliant idea we decided to make it a little more Guyanese relevant and called it ‘we are going on a jaguar hunt!’. We spent the morning going through the principles behind sensory stories and then in the afternoon sat back and observed as the rehabilitation assistant and nurses delivered a really nice sensory story session to around 6 of the residents…they got really into it and I hope that we encouraged them enough that they will go on to develop more stories in the future.

I also did two sessions with the Rehabilitation Assistants working in the Palms on ‘Epilepsy’ and ‘Stroke and Talking Mats’. The Talking Mats were resources that had been kindly donated and I had for ages been meaning to facilitate a training session with this particular staff group, so I was really pleased to have done it before I left.

I also facilitated a session at Ptolemy Reid on designing AAC (Alternative and Augmentative Communication) systems with children. This was really fun and confirmed to me that I had finally got the hang of using participatory approaches in training. We did lots of interactive activities, including giving messages using symbols, which I believe helped the rehabilitation assistants get a better understanding of some of the principles we were trying to put across.

The feeling that my placement is finally coming to an end has been reinforced by the timely arrival of a new Speech and Language Therapist from Belgium. I have really appreciated the opportunity to hand over the programme to someone else and have great confidence that the projects I have started will continue and develop further under her watchful eye. That said, it is still a little surreal to think that I will be leaving in what is now just over two weeks time. Officially I now have four working days left. I just have a couple of last minute reports to complete relating to work and my VSO placement; I have almost completed my seventeen (I know!) page end of service report…which gives me some faith that I achieved a few things during my time here!

Obviously me leaving Guyana is associated with many different emotions. I will be sad to leave behind both VSO and Guyanese friends and to some extent my responsibilities, but at the same time I can’t help but wish my last days and hours away since it means I am nearer to becoming Mrs. Lewis and returning home to all of my friends and family.

So I think that is finally it, my two year blogging experience is coming to it’s natural end….my time in Guyana has been one that I will always look back on with great appreciation. I have learnt so many things and met so many wonderful people and one person in particular that I had no idea I would be meeting when I started out on my VSO journey…(though a few people hinted that it was always a possibility!) so for those that have followed this story from the start it is time to say goodbye…and in case it is not yet obvious to say that this was one story that definitely had a very happy ending…..

ps I will make every effort to post one more picture before my final farewell! - check back after the 25th September 2009....

64 days and counting and a big kick in the teeth for health services in Guyana....around 3 o'clock this morning we received a phone call from Wayne's boss to tell us that the Ministry of Health building was on fire...as it was just one street away we went out onto the balcony to see flames ripping into the night sky...bearing in mind we are three stories up you can imagine how high the flames were.

To put the devastation into a bit more context, for those of you less familiar with the Guyana system, imagine that the NHS headquarters existed in one building and then imagine that every system, including accounts, personnel files, minister's workplans and budgets existed only in paper form, and are usually found sitting in piles on a variety of desks. All gone. Imagine then there are now no records centrally of national health workers working in Guyana, no records of budgets that have yet to be spent for the remainder of the year, no records of the contracts that have been passed to facilitate works to be done or activities to be completed, no records of the fact that I am owed 10,000 dollars (£35.00, a 1/5 of my salary) from activities already completed (OK OK probably not really a priority but I was looking forward to that being back in my pocket) but seriously this is a huge blow for the countries health service...it is any ones guess how long it will take for the ministry to get back on it's feet and working at the same capacity as it was only yesterday. There are already the obvious conspiracy stories...police have been quoted as saying that "devices" where found in the building. Corruption 'charges' are not new to the government or the ministry of health and last nights events have quickly fuelled more persons to believe that something was not quite as it should be within the ministry walls. Even if these previous allegations were untrue the potential for things to go horribly wrong now is very real...I can just hear it now " that was lost in the 2009 fire ". I wonder how long that will be used as a legitimate response to requests of accountability. Something I heard today was that the auditors were due to go in...it does make you wonder, but as I say all hearsay at the moment so who knows.

What it does mean for me is that it is more than likely that my last minute plans for activities may not now happen. I really hope that this is not the case but I guess and accept that the Ministry have plenty of other priorities to address. I was wondering today if this may be one of those awful lessons in life that may actually have a silver lining...maybe Guyana you will use this opportunity to move away from paper based systems and start over in the 21st century...only a thought.

65 days and counting! Well at least that was what it was when I first started to write… it would seem to some like I am wishing away my last few days and weeks in Guyana and to some extent I guess I am…there is a reason that VSO facilitates two year placements. In hindsight I now fully understand that it needs to be this length of time, so that you can acclimatise to all of the new experiences and expectations of a new country, job and culture. It is only when you have acclimatised that you can start to make a realistic, relevant and valued contribution. That said, two years is equally about the time when most of us start to really miss home and want to enjoy again some of the luxuries that we left behind; and I for one have no apologies about that. Over the last few months I have received a number of emails from perspective volunteers who are considering coming to Guyana…my more recent “summary statement” is as follows; "I have no regrets about coming to Guyana and doing VSO but I am now ready to go home!” It is very difficult to advise someone about their decision to leave home and come and work in a country that is usually very different from their own. I have made a promise to myself to try and stay objective when talking to people who are trying to make such decisions. It really needs to be the person themselves who makes the decision and if you need another volunteer to persuade you or to give you reasons to come then you probably should consider doing something else. It is definitely not easy and in truth it is not always the idealistic experience that some people might have about volunteering in a developing country. That said, I do believe those who make the decision to do VSO and see the experience through to the best of their abilities will be more fulfilled as a result…and as I say “have no real regrets”.

So as for me, how have I been occupying my last few weeks? Well, I had the notion that maybe it would be time to slow things down a little in preparation for my leaving but as usual things just didn’t seem to work out that way! The beginning of June was mainly about preparations for rehabilitation week. I made a few regional visits to various departments to support them in preparing presentations for our professional summit and putting together leaflet sets for awareness raising activities.

One visit took me to Berbice (region # 5/6) with Michelle, where we faciliated a workshop about the assessment kits that were developed with the aid of the VSO ABLE project. Each of the four departments received a bag to aid the work they do during outreach visits.

I have also visited again Cheshire Home and with Michelle did an educational session on running group activities for persons with disabilities. Finally, I got again to visit the teacher training college where another VSO has been working, to talk to student teachers about Speech and Language Therapy and disorders, with the aim that when they eventually graduate they will be more able to recognise children needing extra support and in some cases refer them onto rehabilitation services.

We had a really nice activity at one of the special schools last month. Sometime last year the parents and teachers decided that they wanted to prioritise our services and therefore applied for a school improvement grant to build a purpose built room for rehabilitation. We had a lovely open morning with speeches, songs and dances and the grand cutting of the ribbon. It was such a great example of how some of the service users are really valuing the work being delivered by the people that I have been helping to train and support.

The all important rehabilitation week ran from 21st – 27th June. I decided that I wanted to support some of the regional activities for the first part of the week so went to Suddie, which is in region #2. The staff there did two screening activities and managed to see 110 children and screened them for both hearing and speech and language problems. As a result around 42 children were identified as needing further input.

Back in Georgetown we saw our infomercial being aired daily on the TV, with two of our patients receiving therapy from rehabilitation assistants and yours truly doing the voice over! The add was really good except the same yours truly gave out the wrong telephone number to the station to put out after the add had aired…never mind it was rectified mid week!

Thursday and Friday we had our first professional rehab summit…which was a great success; we had presentation from all of the regions about their years activities. All of the presentations also included their “funniest moments”…these ranged from patients having to put up umbrellas inside departments when receiving therapy, rats eating out clinical notes, and finding worms in ears (not so funny if you ask me!) anyway a few laughs were had and other reminders were noted about how relatively lucky we are to enjoy the services and resources we have back home. I also got the opportunity to talk to staff about Autism in Guyana, which is something I have been really pushing since I arrived.

Rehabilitation week concluded with the ‘night of elegance’. A good night out where we all got the opportunity to dress up and relax after the weeks events. We also had a reward ceremony to recognise the achievements of the rehabilitation staff. VSO got a corporate award in recognition of the support they have given to rehabilitation services over the years…a nice touch, although unfortunately the award plate was actually made out to VOS! - you know what they say? “it is Guyana!”

The last week or so has been all about the paper work; 2010 budgets are now due and reminders are frequent about putting in requests and activity plans. As I mentioned before I thought that I would be ‘calming down’ at the same time as ‘counting down’ but I seem to have committed myself to a final strong wind…a few last visits, workshops and setting up a several more quotations for some last minute resources. All being well a new therapist will be arriving in August and then another soon after, all my plans are now being made with that firmly in mind. I hope that they will arrive and feel that they have the opportunity to now take the service in the direction that they seem fit…as for now my time is done! Obviously with a certain wedding pending to a certain man not so far away, Guyana will now always be a second home so I hope that I can continue to play a small supporting role from time to time…if only as smuggler of Velcro and stickers!

Anyway, for now it is bye again. Will there be another entry from Guyana? We will see, you may just have to wait until the next big event, which will be in Barbados late September…68 days away x
After our week long trip in Lethem and several other activities, which coincided with the end of the financial year, the plan was to slow things down a bit…or at least have time to write my blog a little bit more frequently! Anyway needless to say we are now approaching the end of May…enough said.

Just to get it out of the way I have to mention that unfortunately the Speech and Language Therapist who came recently decided to return home...on the positive side I still get to put put on my CV that I was the "only SLT in Guyana!"...all being well another will come out in August and another shortly after to continue the work that others and I have been doing.

The main activities since we last spoke (you know what I mean) included having a group of medical students on placement in our department. This was a good (if not a little bit of a squashed..) opportunity to raise the profile of rehabilitation services with those who will be referring the patients of the future. As part of their placement they were also required to complete a research project. Following our suggestions they looked into the work we have been doing with children presenting with behaviours associated with Autistic Spectrum Disorders and also looking at how we have been working with them and their parents levels of satisfaction. The students came up with some really nice information that concluded that the service that we have been providing is fairly unique in Guyana and that the parents note that their children have made steady progress in their learning and communication skills (smile and tick!)

I made a trip to Suddie (region #2) and Linden (region# 10) and presented the newly developed assessment kits…..its fun and like being Santa, the departments have received the kits really well and are really motivated to use them to support their work in the field.

In April we had a really successful day with three of the rehabilitation assistants making resources….(those who know me well will know that this is my dream..) a day of cutting, laminating and sticking on small pieces of velcro to hundreds of bits of paper! The results were really rewarding, I think in the end we made around 10 fishing games, sentence boards, flash cards, puzzles and lotto boards and gross motor exercise mats…the resources will be used in the special schools in Georgetown and the fishing games will be going to each of the regions around the country.

We have already used the resources in the schools and they have been a big success with the kids.

The day was so successful that the next plan is to do a similar day with parents so that they can develop resources to use with their children at home.

Before you ask, it hasn’t been all work….Easter was all about the kite flying ( a big thing in this part of the world). We went for the home made version, got the frame and the tissue paper and got to work…unfortunately we had a black out during the blue peter bit of the activity so we actually made it in complete darkness, so I think we deserve an extra round of applause! Anyway we had a great day on the sea wall flying the kites and enjoying the fun with what seemed like most of the country.

At the end of April I completed one of two upgrade days in Speech and Language Therapy. I had six rehabilitation assistants and delivered training on adult neurology; we completed activities which looked to enhance their clinical skills in different conditions resulting from stroke. The second day is coming up next week and will focus on paediatric interventions.

Michelle, the rehabilitation assistants and I also completed some training with some of the teachers from one of the special schools. It was around this time that I realised that I was really really tired and needed a holiday….trying to convince my audience that punishment rarely works with children with learning disabilities failed (again) and really got to me, leaving me completely exhausted and defeated (again)…luckily I had my colleagues to laugh at me and tell me to chill a little and not to take it to heart…maybe a few more listened this time after all….(my less than professional head wanted to really shout in a slightly sarcastic way “if it works so bl**dy well then why are you still asking for our help!” …I resisted thankfully)

Anyway as luck would have it two weeks later Wayne and I were booked to take the week off and fly to Trinidad and Tobago. Trinidad was all about the shopping and Tobago was all about the sunshine and the swimming…it was just like I remembered it and was also just what the doctor ordered…of course it had to come to an end but it did the trick and we both returned to Guyana refreshed and ready…and with a wedding suit and some slippers!

I came back to the leavers forum on my first day back to Guyana. This is a workshop which is facilitated by VSO to support those who are getting ready to leave their placement (I know can you believe I am there already?) Anyway it was a really good day and opportunity to catch up with some friends and talk about what some of the challenges might be when we return home….I have to say I struggled to think about too many negatives….positives I was good at…on the list so far is washing machines, vacuum cleaners…oh and yes of course friends and family (love you!). You will also be pleased to know that we discussed the issue of the fact that people might not always want to listen to endless sentences that start with “in Guyana….” So don’t worry…my sentences will all start with “when Wayne and I got married in Barbados....!” Ha Ha…hopefully we will be able to reach a happy compromise.

Anyway now it is all about organising Rehab Week. We have several activities to plan, media and outreach activities and a professional summit (sounds impressive eh?) and a “night of elegance!”….anyway I will let you know how it goes next time. For now….x
So apparently January and February came and went and we are already heading towards the end of March. I can’t believe how time flies when you are having fun…am I still having fun? Well yeah, most of the time. The job and Guyana continue to present me with almost daily challenges but I certainly don’t regret my decision to come and do VSO.

So for those of you dying to hear the next instalment I will try and summarise the main highs and lows. Having left this task alone for almost 3 months I am thinking that I am probably responsible for setting my own challenge in this instance. The normal service type activities have continued as before, delivering Speech and Language Therapy in collaboration with the Rehabilitation Assistants within a number of different locations. I have also done my visits to most of the regions, as planned, for the first quarter. Visits included New Amsterdam Rehabilitation Department and Special School and Region # 5, where together with another VSO we delivered an early identification and intervention workshop to a group of health care workers.

On the social side of things Alex came to visit in January, which was great. Great in terms of having some time off but also in the sense of showing her around some of the places I have been mentioning over the last year and a half. She got to meet and ‘vet’ Wayne too, which was good….I think he passed with reasonable marks (well at least until the Ricky comment….don’t ask!). Alex being here gave me a good excuse to do a few more things as well, like visit Suriname. A few things to organise in terms of VISAs and transport and a slightly long journey but a nice change (for me) from Georgetown none the less. Suriname was quite similar to Guyana, but I would say quieter and cleaner (sorry guys but you still need to work on your compulsion to beep your horn for no good reason and throw everything over the sea wall!)….it was also very ‘Dutch’, though most places were very happy to give you an English menu and spoke perfect English. During Alex’s visit we also had a trip to Bartica; region # 7 and Kaiteur. Although I had already done Kaiteur it was again totally breath taking and I was really pleased to share the experience with Alex, Wayne and Othniel this second time. We should at this time all pat Alex on the back for getting on the (sardine can type) plane…she wasn’t sure on her arrival to Guyana but came good in the end.

On Alex’s departure I was obviously sad to see her go but it was eased by the fact that is seemed like only a little bit longer before I would be seeing her and everyone again having completed nearly a year and half of my two year placement. I also had plenty to be getting on with at work so I threw myself back into things to keep myself occupied.

Come February we had a new batch of volunteers, including a new Speech and Language Therapist – hurrah! This means for me that I will get to share my work load somewhat and so I hope be able to focus on a few last minute projects before leaving my placement.

A slight spanner in the works going by the name of ‘Denge Fever’ (also known as break bone fever – nice,) threw things off for a while around the weekend of Mash, a public holiday, so I was signed off work for seven days. Not much point in going into too many details but all I would say is that I wouldn’t recommend it! I have to say a big thank you to my next door neighbour, Michelle, who took excellent care of me, checking in and trying to tempt me with fruit ( I did try to eat a bit I promise!). Anyway I think I got lucky as by the eighth day I was pretty much back to my old self, which was great….Denge has a habit of hanging around for lots of people.

Having one week out meant I was a little behind with my planning and schedules, but I managed to get things back on track. I was involved in a workshop which focused on a newly developed Assessment Kit, which was really good. The kits have been developed for each of the regions and main departments, with the aim of supporting the rehabilitation assistants on home visits, particularly in those regions were patients cannot travel to the departments because of the distances involved.

March 14th and Michelle hosted a slightly early St. Patricks Day party. As is now tradition all attendees were obliged to wear green, white and orange/gold; which I could just about handle in terms of ‘dressing up’; Not a big fan of fancy dress as some of you will already know. It was really good fun and again Michelle persevered with trying to teach us all some Irish Dancing, I think for most of us we were probably better at the drinking part of the festivities but we gave it a go none the less.

Today I am writing from Lethem, Region # 9. Myself and Nicolette, another VSO have been here since the beginning of the week as part of a seven day coaching visit. We have been really pleased with the activity. We have as usual been working with the rehabilitation assistants and have done home visits, training sessions with parents and teachers and conducted some sessions to support the assistants in their professional development. Lethem is very different to Georgetown, on the border of Brazil and so with understandable influences in the form of meat on sticks (and really not much else!) and very cheap Havana flip flops! It is also very dry, hot and orange! As I say it has been a great visit and for me very satisfying since it now means that during my placement I have visited each of the ten administrative regions of Guyana and worked in all nine of the regions where rehabilitation departments and assistants are placed.

My other news is that of the now infamous wedding plans! After much to- ing and fro-ing Wayne and I have opted to get married in Barbados, a decision made after considering many different things including friends and families but also the legalities of the two of us being together in the UK. The plans are now that our (very) immediate families will be meeting in Barbados at the end of my placement to join us in a small ceremony over looking the beach ( I can’t wait!!)….Wayne will then, unfortunately, have to return to Guyana to apply for his UK VISA. We are hoping that it won’t take long and that in the mean time I will be able to return and settle back into life in the UK, hopefully quickly find a job and set up things with my flat. According to the current information it shouldn’t take more than 12 weeks so hopefully by Christmas we should be back together in the UK. We are aware that there are many of our close friends and family members who would have liked to share with us in our wedding celebrations, as would we; however we are very much looking forward to some belated celebrations to coincide with Wayne’s successful landing in the UK. We promise to share the stories and the photographs with you on our return and hope that you understand our reasons for going for this option….come on anyway….sun and sea and all inclusive accommodation, who wouldn’t?!

So there you have it an attempted summary of my last few months, activities and thoughts. I hope that you found it interesting. Love to you all….I know that for some the current times are frustrating and challenging in terms of work and funds but I hope that you are all still smiling as best you can and looking after each other….you can cut back and still have fun….I have been eating rice more or less every day for over a year and look at me, still mostly smiling!!!

Ps if you are going to invite me over when I return I would rather not have rice, Thanks…..Hannah x