Kenya Child Life Program Spotlight Continues: Liz Kabuthi

 

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Liz Kabuthi prepares children for surgery using a book of photos

Last week, I spotlighted the work of Child Life Specialist Jayne Kamau at the Sallie Test Pediatric Centre at Moi Teaching and Referral Hospital in Kenya. This sustainable Child Life program is one of a kind in East Africa. The Child Life staff and founder Morgan Livingstone are especially proud  this year to be working with Courtney Moreland of  Child Life United to offer child life practicums in Kenya.

This week, we hear from Liz Kabuthi, who I had the pleasure of meeting when she represented her country as a delegate at the Child Life Council International Summit on Pediatric Psychosocial Care in 2014. Her reflections on her child life journey and work are deeply moving, and give us a glimpse at how this profession influences and betters our lives even outside of the actual hospital work.

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Liz prepares a parent for her child’s surgery

LIZ KABUTHI

What inspired you to become a CLS?

Mine was by default. I had never heard of Child Life prior to 2010. I was looking for something new to do after working with mothers for a long duration. I came across the advert and had  a training in psychosocial care of pediatric patients. I applied and never thought much about it. In fact I did not know I would manage to work with children. This is the best decision I have ever made.

 

What was the biggest challenge to attaining your goal?

The Child Life Certification exam was a great challenge for me. Preparation required intense  revision which made me feel inadequate to take the exam.

What do you enjoy most about your job?

My job has made me a better mother to my children. I am able to exercise more patience and I allow expression and verbalization of feelings. I play more with my children and provide daily opportunities for outdoor play. My nieces and nephews have severally crowned me as Best Aunty since I play and get silly with them and always seize every opportunity to play. Child life has equipped me knowledge on child development and favorite play resources for different ages.

 

What do you want people worldwide to know about your program?

Kenya Child Life program caters to the psychosocial needs of the mainly poor majority in Kenya. In resource poor settings, we use our skills to work with children and their families different from  the use of technology and toys. The use of outdoor play time is an integral part of Kenya Child Life. In my culture a playing child is deemed less serious and with no potential for future success. Child life has taught me about play being a medium through which children learn about life and explore their environment and that  a playing child is a normal child. This has made me create awareness amongst families and in schools on the importance of play for children.

 

Can you share a brief story about a child who taught you something?

I met Peter almost 8 years ago. He had been rescued from an abusive home environment. He was mentally challenged, could not walk, was mute and ate like a dog.  His grandmother used to chain him all day in a dark room as she went to fend for her family. Peter could not eat from a plate, he would spill the food on the ground and munch away on all fours like a dog. He was a terrible sight!

My work rota provided that I work with Peter 3 days a week. I needed to make sure that Peter was cleaned and fed. This was a very difficult task for me and I would detest the days when I had to work with him. It made me feel awfully frustrated. We had to diaper him because many times he would eat his own poop! It reached a point where I made a decision to get a changeover to another unit or resign in order to stay away from Peter. Despite my frustration I kept at it, forming bonds of friendship little by little.

One day as I contemplated this decision, on my usual day at work, I walked in to the Sally Test Paediatric Centre to the sound of Peter calling my name. He was joyfully crawling towards me. I could not believe my eyes or ears!…..it tore into the deepest  part of my heart… the heart of a mother! At that point my heart changed and I started seeing Peter differently.

Peter taught me that truly love conquers all. We managed to take care of Peter till he found a special school that would teach him basic skills. On the day that Peter left, I cried because I had lost a friend that had taught me a most simple lesson on love that has huge benefits in life.

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Liz with a patient who acts as a prefect, assisting other patients

Sustainable Child Life Services in Kenya

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The Sally Test Pediatric Centre in Kenya is proud to have the first sustainable child life program in East Africa. By sustainable, I mean that rather than mission-based services that come and go, it is staffed by citizens of Kenya who have obtained child life certification through the Association of Child Life Professionals (ACLP). Morgan Livingstone of Toronto, Canada, saw the need of such services and has worked tirelessly over the years to train and support the staff at Sally Test.

Over the next several blogs I am spotlighting the work of the child life specialists in Kenya. The team has faced many challenges in becoming child life specialists, and they are doing extraordinary work to humanize medical treatment for children and families in their care. A special thank you to Morgan Livingstone and the Sally Test Child Life team for taking the time to answer my interview questions and send along great photos.

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Jayne Kamau

 WHAT INSPIRED YOU TO BE A CHILD LIFE SPECIALIST?

I had worked in pediatrics unit as a social worker and was so comfortable and passionate with the children and their families. I had not heard about the Child Life profession until when Morgan Livingstone (CCLS Canada) came to Kenya for a one day workshop and introduced the concept of Child Life. An interest was triggered there and then and my mind and heart were in agreement that this profession though new to me was what I wanted to do. I started doing my own research about the profession and what qualification was needed to become a certified child life specialist.  So when the program was set up in our hospital and people were called for interview, I was among the very first to apply and now here I am.

WHAT WAS THE BIGGEST CHALLENGE TO ATTAINING YOUR GOAL?

Integrating  Child Life as an integral part of  medical team in the management and care plan for the patients and families was not easy and till today it is challenging . Due to the fact that Child Life is little known in our set up being a valued team player of the larger health care management was not easy. Convincing the staff that pre procedure preparation, play, psychosocial support, among other activities had health benefits was tough. Recognition by the clinical staff for easier referral and collaboration was and still is hard.

WHAT DO YOU ENJOY MOST ABOUT YOUR JOB?

Being able to bring a smile to my patients and hope to their families is a feeling I really treasure. The journey from admission to the day of discharge is one which is filled with beautiful memories, courage, learning and mastering of daily routine of a totally new environment which calls for a lot of adjustments. Even at the most difficult situations, just being there for the child and family, to listen, empathize and advocate for their needs makes me happy.

WHAT DO YOU WANT PEOPLE WORLD WIDE TO KNOW ABOUT YOUR PROGRAM?

Kenya Child Life program empowers children and family to cope with a diverse challenging experience related to hospitalization. Being the only Child Life program in East Africa, the Kenya Child Life program is working to ensure that these very valuable skills also go to other hospitals. International and local internship programs are what we are working on now. Despite all the challenges we meet in the line of duty, we have a strong commitment to support children and family during hospitalization and reduce negativities and trauma that many children experience during their hospital stay.

 

PLEASE SHARE A BRIEF STORY ABOUT A CHILD WHO TAUGHT YOU SOMETHING.

A six year old patient taught me how to treat everyone as equal and how to build rapport. Our first encounter was not a great one because he was having his cannula (IV) fixed and I tried many tricks of distraction to no avail. After the procedure was over, I followed up with play to bring everything to normalcy. In his room there were other patients and he called all of them to come and play. The first thing he did before we all engaged in play was to ask all of the children to introduce themselves and me too,….As we continued with the game we were all like old friends and we could call each other by our names, laugh and high five each other. This was a big lesson for me because I realized when I came to distract him I was not so connected to him like I was here in play. The first thing I do now is to always introduce myself and get to know a little bit of the patient and family and this has always made my entry point more easy thanks to my six year old patient.

Thank you so much, Jayne, for all that you do for children and families at Sally Test. You are part of something so important, and your role modeling is inspiring for us all.

 

Spotlight: Child Life Intern in Community-Based Practice

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This week, I will spotlight a Canadian career changer as a guest blogger.  Kim Zink is  currently completing her child life internship in a community-based practice with mentor, Morgan Livingstone, a CCLS based out of Toronto, Ontario. Kim left her position in the school board to focus and refine her scope of practice to assisting children and families facing challenging life events.   She sensed the need for more psychosocial supports and greater visibility of child life services in the Ottawa region. So, with the support of her husband, two children, and extended family, she is chasing her dream!

 

This internship has been the perfect fit for me.  My mentor has been working in her own practice for many years, so she has a broad network of community resources and wealth of knowledge in many areas including global health, retinoblastoma, and traumatic brain injuries. She also wrote an incredible parent guide for families affected by breast cancer (including metastatic disease).

 

My internship has been full and rich. My first rotation took place at the Shoe4Africa Children’s Hospital and the Sally Test Pediatric Centre in Eldoret, Kenya. Morgan has been developing a self-sustained child life program there for many years. It was invaluable to see the robust program which now includes a number of child life specialists, teachers, playroom monitors and child life assistants. The team endearingly refer to Morgan as  ‘ our mwalimu,’ which means teacher in Swahili. Morgan served as an example of how to be patient-centered and culturally sensitive in global healthcare, no easy task.

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While we were there, I was invited to sit in on an oncology meeting. It was deeply moving and inspiring to hear the doctors speak so highly of the child life staff to the families. The doctors spoke of being a team and that families should refer to child life with any questions about their child’s developmental, social and emotional needs. The child life team has built an advanced practice and a great interdisciplinary approach. Unfortunately, in some areas, the pain medications and ideal supplies are not available, so I had the opportunity to offer distractions through games on a tablet and meteor storm toy to bring the child’s  attention away from the burned areas and bandage changes during procedures. It was a proud moment for me when the doctor told me that the best bandage change a particular boy had ever had and that I was welcome back anytime.

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The hospital sees over 300 children every day, and sadly many of the children are not brought to the hospital until their illness has progressed to the palliative state. So we turned our focus to legacy building and adding quality to end of life.  One simple and inexpensive legacy activity that worked well was making a salt dough handprint for each family.

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During my second rotation, I relocated to Toronto to intern in Morgan’s local private practice. She sees a number of teen patients, which was a demographic I knew I needed more experience with. I discovered it’s key to listen carefully to their interests and then go home and study up on these interests to gain common ground for future conversation and show teens that you listen and care about what they have to say. So now I  know  more about the ins and outs of  making slime and the youtube channel, Simply Nailogical, than I ever thought possible. This research paved the way to building rapport and trust with one teen in particular. Showing interest in her interests was a great connector.

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My future work in child life has also be enhanced by working with my mentor on traumatic brain injury cases. I had the opportunity to see treatment plans, do home visits, sit in on team meetings, and understand the billing process through insurance providers. During a recent conference call, a teen’s mother said, “Things started to finally turn around when Morgan was added to the rehab team and started her sessions. She [the teen] found the tools and started to cope, she really improved with Morgan’s help.”

My latest adventure in my internship included a trip to Washington, DC for the One Retinoblastoma World Conference. I had the privilege of assisting Morgan with the child life programming, which included transformative literacy, medical play, and lots of activities with special eyes. It was great to see one child move from fear to familiarization with the sedation mask. Another child displayed new skills of mastery by using the medical doll to practice cleaning and adjusting an ocular prosthesis. Still another young child spoke openly about having a special eye, as he called it, for the first time. One of the teens overheard and said: “Me too, and I like to take mine out with a suction cup.” There is nothing like these spontaneous conversations to bring about that reassurance of ‘sameness” and soothe constant feelings of being different from everyone else.

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Above all, I will finish my internship with ample understanding of what it means to be an advocate for children. Morgan is a tireless champion for her patients, working to be sure they have everything, from a great relationship with their general physician to the correct supports from their school. She moves mountains to make sure the children and teens in her care have everything they need to be happy, healthy children. We need more child life specialists doing this work in the broader community.

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PS: Navigating independent and Canadian internship possibilities has its challenges. I highly recommend the Facebook group for ‘Child Life for Canadian Students’ and http://www.cacll.org/

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