Note: I worked a short shift this afternoon as I had to return to Nuestros Ahijados to begin recording voice-overs for the training video with Ray, making it an ideal afternoon to describe for everyone. The shorter the afternoon, the shorter this entry can be for you all (your eyes will thank me)!
After enjoying my lunch crepe (filled with spinach, bacon, cream, cheese, and mushrooms, and an egg), I began walking from Luna de Miel (the creperie) back in the direction of La Merced. La Merced is one of the large, peach colonial churches in Antigua. Set near the edge of town, it makes for a wonderful reference point. I walked up the cobblestone street, passing locals and travelers alike. I was incredibly warm in my loose long-sleeved cotton shirt and shorts, but have tried to cover up a bit more as I've been getting roasted by the sun each day.
I passed La Merced and continued walking up the street towards Carretera San Felipe. I crossed over the busy road that forms the base of the triangular plaza near Corinne and Charlie's neighborhood, and waited on the corner. I waved down a tuk-tuk and hopped in: "Casa Jackson en San Felipe, porfa."
Luckily for my back, we were out of the cobblestones already, and the brief ride up Carretera San Felipe was a smooth one until we hit the dirt road for Casa Jackson. We turned left from the main road and began to bump and jostle down the dusty road, passing open ditches in the middle of the road and the men digging them (roadwork, but please don't ask me what they're actually doing). We pulled up to Casa Jackson. I hopped out and rang the doorbell. The tuk-tuk driver kindly waited until I was retrieved by the director, Silvia, before driving away (the road is not a safe one for lone gringas).
I locked my bag into one of the small lockers downstairs and donned my scrub top and mask. After a vigorous Purelling, I headed up to the second floor to see the babies. It was somewhat quiet, as the babies were still in the midst of waking up from their naps. Andrea had asked me to orient two new volunteers who had just arrived, so after a brief explanation of the schedule and how things are run and the requisite post-nap diaper changes, I got down to business: baby snuggling!
Laura, the incredibly frail little girl nearing three who has been in CJ since November (and will be soon receiving a medical work-up to determine if there is a reason why she gains almost no weight at all) was crying and reaching to get out of her crib when I walked into the room. I said hello to Alberto, Esvin, Sandra, and Javier (her "roommates"), and donned the white scrub jacket designated for picking her up. After a few minutes of cuddling, I put her in a walker in the central playroom and began bringing her "roommates" out for some playtime and fun.
Sandra had been chattering away since she heard my voice when I entered the room. I walked over to her crib and she erupted into giggles. I took the side of her crib down and leaned down to give her a kiss. She opened her little mouth wide and turned to kiss me back.
"Te amo, Sandrita! Duermes bien, chiquita linda? Tienes cosas que tu quieres digame? Hablas, chica, hablame!" (I love you, Sandra! Did you sleep well, pretty girl? Do you have things to tell me? Talk, girl, talk to me!)
Sandra smiled and opened her mouth veerrryyy wide as her arms went stiff and her little legs began to kick (a typical pattern for children with spasticity when excited). After a few seconds, she got it out- "Aaahho! Ahhh... Buh... Oohhh!" (My best guess? "Te AMO!" followed by "burbujas!"... that 'B' sound is coming out a LOT now and only stops when I blow bubbles for her). I tickled her and said, "Te amo tambien, Sandrita! Besos! Vamos, quieres jugar? Quieres burbujas? Siiii, yo se tu quieres!" (I love you too, Sandra! Kisses! Come on, want to play? Do you want bubbles? Yes, I know you do!)
After a few minutes of hug-time, I brought her into the playroom and sat her up on the mat with a lot of blankets rolled around her for support. I went back into the room to bring out Esvin, who for some unknown reason was in hysterics upon waking up from his nap. Happy hysterics. I haven't ever heard him giggle so hard for so long! I propped him up next to Sandra, and put some more cushioning around my little friend Javier, who had been placed next to them by another volunteer.
With the little ones in front of me and a few children in walkers around me, I grabbed the Sesame Street "Bubbles, Bubbles!" book and began to read it to them. As I read, I encouraged Sandra to lift her head up and look at the pictures. I held the book in front of Esvin and helped him to turn the page. I had Zoila touch each body part named in the book, and I touched the noses, hair, and "piggy-toes" of each child as I repeated the words, "burbujas, burbujas, en mi NARIZ! Burbujas, burbujas, en mi PELO!"
After the book was done, we got to the REALLY fun part- actually BLOWING bubbles! Zoila and her mother (who is there every day and helps to care for the other children as well as Zoila) took turns blowing the bubbles and making sure each child was showered in a veil of bubbles at least once or twice. Esvin, as always, was having the MOST fun with this, and nurses changing diapers in the other rooms could be heard laughing at his non-stop giggle.
As Zoila's mother continued blowing bubbles for the children, I began to change Sandra's position to side-sitting. With some stabilization, she was able to work so hard and not collapse when putting most of her body weight over one arm or the other-a nice surprise considering her right arm is so much weaker than her left! It was incredibly challenging for her, but the bubbles were a great motivator. It was so wonderful to see her succeeding in a new position. I was beside myself with glee when she began to tip to the left side and actually put her arm down and pushed back up slowly until she was almost upright. She did this a number of times over the next ten minutes. Very exciting stuff!
I laid Sandra back upright against the blanket/pillows I had set up and brought Esvin to the edge of the mattress. I stacked several blankets underneath his bottom to lift him so that his knees were bent at about 90 degrees, and played with books and toys with him to work on his postural control and endurance. He was able to stay upright for about three minutes before sinking slowly back to the mattress. He needed a rest- this is a little fellow who VERY rarely is forced to hold himself upright- but I was pleased to see him fighting gravity as much as he did!
I took all the shapes out of the shape-sorter and helped each child take turns to hold a shape and put it into the right space. My goal in this was not necessarily to get children doing it independently, but simply to get them truly engaged in an activity and using their hands for play. There was a lot of hand-over-hand, but a few of the kids were able to push them in once I lined them up. Still great, considering the three and four year olds at CJ aren't able to complete a shape-sorter due to a lack of exposure to those types of educational play activities!
After some more bubble-blowing fun (Zoila kept asking me in her deep little voice and Sandra periodically got out a "buhhh" while staring intently at the bottle sitting next to me), it was time for bottles. I sat on the mattress, my back against the wall, with my knees bent and legs almost upright. I sat Sandra on my stomach facing me, her legs on either side of my torso, her head resting against the front of my knees. I put a folded blanket behind her head to keep her fully upright and prevent her from dropping her head back to swallow, as she's so fond of doing. I waited until she opened her mouth and put the bottle in. We went verrry slowly, waiting for her to finish one gulp before putting the bottle back in to take another.
As I fed her, one of the nurses came over and instructed me to lay her down for feeding. "Ella come mejor. Necesitas hacerlo." (She eats better (that way). You need to do it.) I tried to explain to her that if I laid her back, she wouldn't be able to swallow safely, and the milk would drip into her lungs. I tried to explain to her what I was doing and why, but she shook her head. After another minute of watching me, looking annoyed, she went into a neighboring room. I heard her complain to Juan Pablo (one of the administrators/caregivers who is extremely receptive, interested, and supportive of my efforts with the children with special needs there) that I wasn't listening to her and that Sandra wasn't eating because I was feeding her wrong. Much to my delight, I listened as Juan Pablo explained (much more fluently and naturally than I had) the difficulty Sandra has swallowing, why my technique was safer, and how important it was to use it to prevent Sandra from getting sick. A moment later, the nurse reappeared and smiled apologetically. "Lo siento! Yo entiendo ahora." She told me that Juan Pablo had explained to her what I was doing, and that she understood now. Sandra finished her bottle slowly and safely.
Ray arrived to walk me back to Nuestros Ahijados, and I reluctantly hugged Sandra and returned her to sit on the mat. With an affectionate tousle of each child's hair and an, "Adios, chicos! A mañana!", I was off. We walked back up the dusty dirt road, turned right, and traveled along the busy Carretera San Felipe until we reached the lush, ivy-covered gates of Nuestros Ahijados, where I finished out my afternoon.
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