the little things

Any Child Life Specialist can tell you what a big difference the little things make. Letting a child sit up for a procedure, giving a patient the choice of which arm to try an IV in, allowing mom or dad to hold the child’s hand, explaining what you’re going to do before you do it, changing a word to be more child friendly: these are all little acts which can result in big differences in a child’s ability to cope and cooperate.

I was helping a little boy finish up with his dressing change today when Lindy was carried in for her dressing. She saw the boy I was working with was tearful and immediately began to cry. Unfortunately there is not the time, nor the space here to keep treatments private. There are often 2 or 3 children having their dressings changed at one time. There aren’t curtains to close, so the kids end up watching the other children and seeing their wounds. It definitely makes the experience scarier for many of them. Lindy’s mom laid her on the table and I stepped in to provide support and ease the transition away from her mom. Lindy recently had one of her legs amputated due to meningitis. Her other leg is severely infected and the doctors are fighting to keep it. Her dressing change today was for the wound on her nonamputated leg. Lindy cried when her mom stepped away, aware of her treatment to come. She laid on the table and looked at me with scared eyes. She only speaks Xhosa, but I spoke to her anyway, trying to put her at ease with the sound of my voice. I walked over to her and helped her sit up. I positioned myself behind her on the bed and allowed her to lean against me with my arm around her in a protective embrace. She calmed immediately. She remained calm throughout the whole procedure, sometimes watching the removal of the old bandages, sometimes blowing bubbles. The simple act of allowing her to sit up made a huge difference in her ability to cope. Often times kids are made to lay down because staff think they are more cooperative or easier to hold or that’s just the way they have always done it. However, if you think about it, the simple act of laying down puts you in a very vulnerable position. Imagine laying down, not being able to see what was going on and being expected to just trust that the painful event being done to you was somehow helping you get better. Pretty scary. The simple act of allowing a child to sit up for a procedure gives them control, comfort, and aids in their cooperation. Lindy was a perfect example of this. I was so proud of her!

I’ve decided one of my favorite moments here is when a child sneaks out his or her first smile. There seems to be a transition period when the kids are too sick or too scared to engage, laugh and smile. But with consistent support they finally reach that moment when they slip out a smile. It’s so much fun to see! Sometimes that one smile opens a flood gate of happiness and laughter and everyone looks on in amazement. Other times it takes a few more days of trust building and support to finally release unrestrained smiles, but eventually all the kids have reached that smiling point. I had a couple "first smile" experiences today and it made me so happy. One little boy who had been so quiet and reserved laughed and played for quite a while today. He even waved goodbye to me when I left. It may seem like a small success, but these are some of my most treasured moments.

The one word that all the kids learn very quickly to say in English is “bubbles.” I don’t know what I ever did at home without bubbles strapped to my neck. These kids can play forever with a tiny bottle of bubbles. They blow them, pop them, spill them, play alone, play in groups, fight over them. Bubbles are seriously my best friends. It has never been easier to build rapport. I just walk up, blow a bubble and am immediately best friends with a patient and his parent. Kids who have been away from the hospital and come back for outpatient clinic come running up to us as soon as they walk through the door. For a brief moment I humor myself enough to think they are excited to see me, but then they plunge for the purple dolphin hanging from my neck and scream “BUBBLES!” instantly bursting my personal bubble. ☺ The lack of bubble mania in the US will definitely be one of my biggest adjustments.

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I’ve decided everyone in Cape Town is in marketing. Whether it’s the guy in the mini bus hollering “Cape Town!” while hanging out the window, or the “stranded visitor” trying to scam you out of your money – everyone has a marketing scheme and a story to sell you at a negotiable price. There is no greater place to witness the world of marketing than the market – I just realized that’s probably where the name came from! ☺ Unfortunately, all the vendors appear to have gotten their degree from the same university and therefore have the same marketing plan. I can’t tell you how many times I have been the “first customer of the day” and therefore entitled to a discount price. Every tent I went to said the same thing. “Take your time. Free to look. I give you good price. Special price for you.” I must be the luckiest girl in the world because I happened upon every special offer there was today! I started to determine whether or not I was going to buy things from people based on the originality of their marketing gig. I can’t tell you how tempted I was to buy the candle from the guy who told me, “Don’t walk in the dark,” just because it was one I hadn’t heard yet. Needless to say, I am definitely not the best market shopper. I feel horrible about haggling and even worse when I don’t buy things. So I bought a couple things I knew I wanted and decided try get up my nerve to try again another day.

People keep asking me what I miss most about the US (other than the obvious friends and family). I have to tell you it’s kind of hard to make that list. Cape Town pretty much has all the amenities of home, but I have come up with a very short list of some of the small items…

1. Being able to walk without having my ninja moves ready and waiting to spring on any unsuspecting mugger. Along with this is the paranoia that sets in every now and then which drives me crazy. Today I freaked out in the market thinking my wallet had been stolen from the purse I had been clutching the whole time. I thought it must have been a pretty amazing pickpocket until I remembered I’d left my wallet at home for that very reason.

2. Being able to tip my waiter based on how well they keep my water glass filled. Asking for tap water makes me feel like I have a horn growing out of my forehead and getting the glass filled up again is relatively unheard of. One waitress actually brought us a pitcher of water the other day – she received a very large tip. ☺

3. Paying for electricity after you use it – not before. The opposite is true for cell phones and internet.

5. Having the right of way when crossing the street. Pedestrians NEVER have the right of way here…even in cross walks. The little green walking man may be beckoning you across the street, but what he isn’t tell you is that car that’s about to turn the corner doesn’t really care that you’re half way across the street. In fact, he finds it necessary to speed up and lay on his horn just to remind you that you do NOT have the right away. You literally take your life in your hands every time you step off the curb.

That’s the top 5 at this point in my day. ☺ Seriously though. I love this place and I have a far greater list of things I will miss from here than things I can complain about. It’s a beautiful city and I have to go now so that I can take advantage of my last few opportunities to experience it.