Saturday was supposed to be a day to relax for the students, but we were offered a chance to go on some home visits with an outreach program through Pazapa. This outreach program seeks out children in the rural villages around Jacmel who have disabilities and try to meet their need. These families have no way to travel to Jacmel where Pazapa is, so Pazapa sends out their workers to work with these kids once a month. Jeff, Carli, Maggie, Katie, and I all went together today. It took us an hour to drive to the village up in the mountains, after which we had to hike about 10-15 minutes after we got out of the truck as there was no road. We rode for the hour, standing in the back of a pick up truck up rocky roads, trying not to fall down, and we picked up a baby goat along the way which we had to deliver to a family later on. The poor goat was having trouble balancing too and kept bleeting to the other goats we passed for help. When we got to the first house, we were greeted by the family of the little girl we were there to see. She was being cared for by her uncle and some other family as her birth mother we were told had mental problems and could not care for her. They brought out a bamboo mat for us to work on, and laid it on the ground in the shade of the palm trees. They changed the little girl's dingy dirty clothes into a sweet little dress (which was probably the best thing they owned) and put some underwear on her as she wasn't wearing any. The little girl was unsure of us at first, but started warming up to us as time went on. Her impairments were stroke-like in which she had a weak side which she didn't use and facial weakness which caused her to have difficulty with drinking and eating. She didn't speak.
Another little boy who was at the home who was probably a little over 1 year old kept consoling her when she would cry. He didn't have any pants on and was so dirty. It was so sad, but he was so cute.
After we saw our patients, we went to deliver our goat friend (who we named Billy) to a family with a deaf child. Pepe who was with us all day, works at Pazapa and teaches the children who are hearing impaired. He was going to try to talk to the child's family into allowing him to move to Jacmel to come receive an education and learn sign language at Pazapa. This 8 year old boy had been living in this remote village with no means of communicating his whole life. If his parents agreed, he would go live with another family while he went to school. His parents agreed after talking with Pepe and the little boy will start attending school starting in September in Jacmel, which is over an hour away from their village. Pepe is the only sign language teacher in Jacmel. This will be great for this little boy to give him a future and a way to communicate in his world. We came home exhausted, but happy. I'm so proud of all of the students for being so flexible and ready and willing to take on anything. This is truly turning out to be such a life changing trip. 
Jeff and I assessed her walking and standing abilities and noticed she was trying to initiate stepping on her weak side but was unable to bring her leg through due to foot drop. We added a wrap to her leg to assist her with holding her foot up, and she was able to advance her leg and step on her own. It was awesome! We taught her uncle and the rest of her family how to work with her on using her weak side and how to help her stand and walk with her as much as possible. The students got to do so much handling and practice new techniques. It was great.
Next, we hiked a little more and came to our next family. This little girl was five years old and appeared to have spastic cerebral palsy. She did not walk, talk, stand, or feed herself. All four of her limbs were affected. She was able to sit on her own and move herself around by scooting on her bottom. She was amazingly doing quite well for never having received any medical or therapeutic intervention. Her father says he just tries to make her walk and stand, moves her legs and arms, and helps her move her arm to feed herself. In the picture below, you can see how her father helps her move her legs forward with his toes!
We educated the family in very simple terms about the injury to her brain being the cause of her problems and told them how they could help her by keeping her mobile. We taught them range of motion and stretches to maintain the motion she already had in order to prevent muscle contractures.
We also taught the family on how to better position her body in a chair to feed her as she had very poor core and head control as well as strengthening exercises for her trunk. The family was very happy and glad we came to see them. People from the outreach program at Pazapa will continue to check in on them and implement our suggestions.
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