Kanyakumari & Sanguthurai Beach

If you’ve been keeping up with my adventures, we headed to Kanyakumari last weekend. It is the most southern tip of India, and is only 8 degrees north of the equator. To say it was hot is an absurd understatement.

We arrived just in time for the sunset. I have no words to describe sitting on the roof of the hotel, and being so humbled by Mother Nature.

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The sunrise. I managed to scramble out of bed to the roof just in time.Watching the day bloom across the clouds and unfurl beams of light into the sea. I realized how small my problems really are, and how many moments I might miss in a day because I’m so caught up living in my head.

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After the sunrise, we caught a couple extra hours of sleep, and then went to the look out points. We had to take a ferry, and wear the most ridiculous life jackets for the 5 minute jaunt, which really didnt make me very confident in the boat’s ability (or that of the captain..) but irrational concern aside, we spent a couple hours wondering around the rock.

 

On our way back, we stopped by Sanguthurai Beach. Breathing in the ocean and letting the salted wind weave its way through our hair. I never ever wanted to leave.

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More to come soon.

 

xo

B

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Rewind

Alright!

I finally downloaded my camera… so prepare for a photo onslaught. I’ll try and keep it brief!

Last week, we took an afternoon trip to Courtallam Falls, where locals come to bathe and pray. One of the wonderful women I work with in the villages came with us to show us around. P. has the best sense of humor and is so lovely. She carries herself with a sense of determination and dignity; she is truly amazing.

The falls have a few different vantage points, and they were stunning! They’re also home to lots of monkeys; all very adorable and all very capable of running off with your things if you dont keep an eye on them!

 

Near the falls, there was also a temple to check out (they are seemingly everywhere here!) We received blessings from the holy men, which are made of ash. P. anointed us and I left feeling a sense of peace and extreme gratitude for being able to take part in something so remarkable.

 

Lastly, we stopped at a park on our way back to ASSA; it was full of children and their families. There was also a pond, with these very detailed, ornate statues. I loved this one, because the woman looked so fierce. She was my fave by far.

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Fierce.

Hello from the other side.

I suppose I should finally get my act together and update my blog.. I seem to either be super keen to write, or so ambivalent I can’t be bothered.

Since I last wrote, one of my children that I work with has gotten me sick, so Im battling a cold. On the upside, we made it to the southern tip, Kanyakumari, over the weekend.

It was SO nice to leave my “work brain” behind, and properly appreciate the choices and circumstances that brought me to India.

We left ASSA on Saturday afternoon, with a driver who took us the 3 hours to Kanyakumari. We managed to catch the sunset from the roof of our hotel, which happened to be the highest point in the small town. It. Was. Amazing.

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We explored the town a bit, and wondered through a maze of shops. I ended up buying two silk saris for about $50,which is insanely cheap, even for India. The gentleman that sold them to us said his wife and mother hand weave every sari, and it takes them about a day and a half to produce… opening a whole other thought about fair wages all around the world. I picked up a few things for my family at home too, now just to figure out how to get them from Montreal to Calgary without spending a fortune on shipping!

After sari shopping, we went for dinner in an air-conditioned restaraunt. A/C was vital. Between the humidity and the heat, we were all wilting. Everything was amazing, and it was nice to just relax a bit. Deciding we werent quite done, a drink was next on our list. We found a small bar, and it appeared that there were other tourists there, although it was relatively quiet. It felt nice to be doing something I would do at home, catch up with friends over coffee or a drink, and be ‘me’ for a bit, without all the extra labels, sometimes their weight is heavier than I realize.

At this point, we were all pretty beat, so we headed back to the hotel. I ended up having a really good chat with my preceptor on the roof, it was cool and breezy and such a nice break from the heat radiating off all the buildings.

Sunrise was at 6:30, and we managed to race up to the roof again to watch a new day be born. Even though there were clouds lining the sky, the sunrise was beautiful. I took a lot of photos on my actual camera; I’ve just been too drained to upload them off my memory card… Perhaps a weekend project for me.

 

The rest of the day was spent touring the temple on the look out rock; we took a ferry over, although the second look out was closed due to heavy waves and winds.

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Looking back to Kanyakumari

I never wanted to leave. The ocean and salt-filled air is one of my happy places, and it was a struggle to peel myself away back to the ferry.

We checked out of our hotel and headed for a nearby beach, and it was worth leaving the look out rocks. The waves and undercurrent were too strong to swim, but we waded into the shallows and collected seashells. Being beside the ocean is so humbling. It reminds me how small and insignificant I am in the context of the world, and to appreciate the amazing wonders of the natural world. Getting back in the car to come home to ASSA was a struggle, I wanted to sit on that beach forever. I need to upload the photos from my camera, so you’ll have to imagine for now 🙂

The last couple days since we’ve been back have been work filled; my kiddos are making some good progress and it’s nice to see that I might actually know what Im talking about in my recommendations. Today was a good day for all of us, so we’re headed into Tenkasi for ice cream (before dinner! the perks of being an adult…) to celebrate. More later!

 

xo

B

 

Lets Talk

Today is Bell Let’s Talk day, a Canadian social media campaign to raise money for mental health initiatives, advocacy and awareness.

It was more applicable to my day than I could have ever imagined.

I went into one village today where my sensory kiddo lives. It was weirdly busy and still, all at once. But not busy with people chatting and catching up with neighbours, or playing with kids. Busy in the sense that people had gathered, but had nowhere to go. Quiet. As we got off the bus, there was a large group of teenage boys, heads gathered closely together. No laughing, rough housing. It was like walking into a post-apocalyptic world.

One of the translators finally turned and in a hushed voice told us a boy in 12th grade died by suicide in his home in the village that morning, and that classes had been cancelled.

Heartbreak.

I looked at the people sitting on their stoops, seemingly searching for some sort of answer in the shattered pieces of their hearts. My supervisor told me that India has one of the highest rates of suicide in the world. More heartbreak.  I couldnt shake thoughts of the boy’s mother, and family, people I had ever met, forever changed by their son’s loss.

I put on my best “holding it together” face, went to see my sensory kiddo (who did AMAZING), bombed another assessment (whole other story) and made it back to the guest house without losing my composure. Barely.

Reading about the suicide rates in India when I got back painted a larger picture as to why teens and others, such as this young man, take their lives at higher rates than elsewhere the world. An article from suicide.org states that “the suicide rate in the 15-19 group living around Vellore in Tamil Nadu, India, was 148 per 100,000 for women, and 58 per 100,000 for men” (http://www.suicide.org/indian-teen-suicide-rates.html). Another article states that for every suicide, there are 20 other attempts (http://timesofindia.indiatimes.com/city/goa/Increasing-youth-suicide-is-Indias-gravest-crisis-Sangath-co-founder/articleshow/52680285.cms).

Suicide in India was recently decriminalized (HUGE step forward; http://timesofindia.indiatimes.com/india/India-takes-a-progressive-step-by-decriminalizing-suicide/articleshow/53667027.cms). Previously, people could spend up to a year in jail, and also be fined.  Jailed for surviving, and in a country where there are huge extremes of economic disparity, someone who is already living in poverty is further disadvantaged by a monetary fine that they probably cant afford. In a country where suicide is illegal, someone who has decided that the pain of living one more moment is greater than the fear of dying, and attempts to die by suicide, they end up in jail. Not in a mental health facility, not receiving treatment or support for their pain and struggles. In jail. Punished further for living.

This is true in countless countries around the world. Factors, often beyond one’s control, including lack of mental health resources, align and people feel like they dont have a way to move forward, and that the darkness is less scary than the place they are in at that moment. And then the institutions that put them in that situation to begin with jail them, jailing their bodies while their minds are jailed by the demons of depression or other mental illnesses.

I have no words to describe the anguish that leaves me with. Where you can’t even cry because its sadder than tears.

Mental health is everyone’s concern. You. Your sister. Your friend. Your neighbour. Your boss. Canada is starting to have the conversation within our own boarders, but we have a lot of work to do. Suicide is the second largest cause of death in teens aged 10-24. Almost a quarter of people 15-24 die by suicide. That is too many young amazing brilliant souls we’re losing every day, every month, every year. Not to mention the the rate of death by suicide among Indigenous youth is an injustice we should be enraged by. Every single one of us. Its not “someone else’s problem”, its Canada’s problem and that means every person that calls themselves a Canadian. First Nation youth are 5-6 more times likely to die by suicide than non-aboriginal youth in Canada. 5-6 times. Numbers from 2000 estimate that First Nations male youth die from suicide at a rate of approximately 126 per 100,000 people, (http://www.ctvnews.ca/health/suicide-among-canada-s-first-nations-key-numbers-1.2854899) and that rate has only increased over the last two decades. There are a whole host of reasons as to why that is, and I encourage you to read more about the conditions on First Nations reserves, and the governmental policies that created those conditions. I am not in a position to speak for the diverse people that make up our First Nations populations, so seek out their narratives and perspectives online, in the news, on Twitter, anywhere you can educate yourself without having to take away from the call and more importantly, action for change. I am happy to talk about some of the ways I know of to do that, and explore other ways with you too. We can learn and grow together. Listen, read, reflect.

So today, and every day. Talk. “Fine” doesnt always mean fine. Ask. Listen.

Someone I hold very dearly shared an article with me, and others today, on social media. And I feel like Michael Landsberg puts it more eloquently than I could ever, when writing about his friend Wade Belak.

“If you were saddened by Wade’s death then here’s what you owe him; you owe him the belief in his pain. ” 

Believe someone when they share.

To read the rest of Michael Landsberg’s article, check out http://www.tsn.ca/depression-and-my-friend-wade-belak-from-sept-13-2011-1.340782

To support Bell Let’s Talk please check out: http://letstalk.bell.ca/en/#EXT=CORP_OFF_URL_letstalk_en

 

Keep talking. Keep loving each other.

xo

B

Playing catchup

I’ve been slacking off on writing the last couple days; by the time we’re finished work (anywhere from 5:30 to 8pm and onwards) my brain just doesnt have the energy. Not to mention I want to enjoy some time with the other students and try to be present. Not thinking about what to write, or when, or why, or how Im going to figure out the next client Im going to see, or how much I have to do.

Today was a bit of a hectic day; I saw my two kiddos at the EI centre this morning. The one with the short attention span (because of his needs for sensory input, specifically having the fan on) had a near melt down. Crying, kicking, screaming, hitting, the whole works came out. He specifically lashes out at his mom, but seeks her out for comfort as well, as do most kids. I was challenging him for sure, hence the behavioural outburst. He has an autism diagnosis, and his obsession with the fan interferes with his functional abilities. So after making him do  a round of a small obstacle course, I would let him turn the fan on, but only if he started to make a meaningful sound (“Po” is the start of the Tamil word for “on”, so that worked or “Oh” for “on”). No obstacle course, no fan. No sound, no fan. Pretty tough for a 3 year old, but having him learn that he needs to ask, or attempt to ask, and do the work required will help his behaviour in the long run. There’s a lot more clinical judgement that goes into this, so it’s not that Im trying to trigger a temper tantrum, but its a result of him doing things he finds tricky.

After that, I was supposed to see another child who lives at ASSA for a splint, but she didnt show. So my supervisor and I pulled an audible and headed into Tenkasi (the closest town) to pick up a few items for one of the children I will be treating in the villages. His family is very very poor, they appear under nourished so supplies or toys are not overly feasible for them. I picked up a washing brush (similar to a surgical brush but a bit softer) to help reduce his sensory defensiveness (dislike of sensory input, from touch, sounds or sight) because he’s been quite deprived thus far. He spends almost the whole day laying on a thin blanket over a concrete floor, with a single bulb providing all the light in the room (which is basically the whole house). This family’s situation is heartbreaking, and I know they are doing the best they can, to support this child and his siblings. There are so many unfair systemic issues that place people in poverty like this, and its a challenge to not become enraged. Rage might be an appropriate reaction to the family’s circumstances, but I dont feel like it will be helpful to treating this child and offering realistic, feasible solutions to his parents. I am instead choosing to be grateful that they have access to some home services, even if it’s late in the game (he’s 6, and looks 3), and that they are at least connected to OT and other health care providers. I am choosing to make the most of my time with this family, and provide low-cost or free interventions, so that they (hopefully) feel empowered moving forward. It’s challenging me personally, and my heart breaks for this family. But I have to trust that they, and myself, are doing the best we can under the circumstances we have. And it makes me very grateful for the circumstances I have, and the other privileges and opportunities afforded to me.

We watched the most incredible sunset tonight, and booked a trip to the most southern tip of India, Kanyakumari, for this weekend. This is an area where 3 oceans meet (he Bay of Bengal, the Arabian Sea and the Indian Ocean), and it will be great to go explore a different area of India. We will leave Saturday afternoon, once we’re done with patient rounds and then take a car the 2 and half hours to the coast, returning Sunday night.

In the mean time, this was the sunset we were treated to tonight. The picture really doesnt do it justice, but it will have to do! The two other students and myself, went to the top of the guest house up and then up another ladder to catch this. Well worth it in my opinion.

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xo

B

Day 9

Ouf. Today.

I spent the morning in the EI centre, working with my two kids there. It was the first time I had met one of my clients, and the translation portion was a lot harder than anticipated. My other client’s mother ended up translating, which was helpful. Next time I will definitely be calling on ASSA’s dedicated translators for everyone’s benefit. Having other clients translate is nice for relationship building but not necessarily privacy.

One of my children/clients has a REALLY short attention span.. doesnt respond to his name unless paired with a command, and will sit still for literally 3 seconds, doesnt speak etc. My challenge is to increase his attention span so he can dress himself and teach him how to jump. Its going to be interesting, and push my skills as an OT.

The EI centre is really hot, and I left there feeling absolutely wiped with a raging headache. The children’s challenges put my skills to the test, not to mention the language barrier, and I really have been doubting if I will make any sort of impact or am even cut out for this career path.  After some substantial self-doubt and a bit of internal moping, I realized that the hard days are going to be hard, and the good days will be good, and that the only thing that stands in the way of the days being good or bad (and anything in between) is me. The more I dwell on the things I dont know or continue to doubt myself, I lose out on being present in the moment. That has always been a challenge for me, because my mind tends to run away on wild adventures, and I’ve thought of every outcome (usually ones that dont involve me succeeding unfortunately) before I’ve had a chance to breathe.

On the upside today, it rained!!!! FINALLY. The area needs it so desperately, its so dry and arid here. We went into Tenkasi before dinner and did a bit of shopping; I bought yellow pants (Hi Im Britt and Im an impulse shopper).Yellow is my favourite colour, so it kind of just had to happen. I’ll post a photo if I ever become brave enough to wear them!

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View looking into the fields

We also booked a weekend trip to Varkala beach; we’re headed the first weekend of February. Its a few hours away from ASSA, so we will most likely leave Friday morning and come back Sunday night. The beach is apparently amazing, and the hotel we’re staying at is a close walk.The other perk is that it is a “Western friendly” area, so we can wear our swimsuits and not cause a scandal.  Im definitely looking forward to working on my tan (aka laying under a large umbrella wearing SPF 70) and seeing the ocean. Stay tuned!

 

xo

B

Day 7

I’ve been a bit MIA the last couple days from writing, and for what I think is a good reason!

Tuesday I was back shadowing in the Early Childhood (EI) centre, and was able to find out a little bit more about the child I met on Monday. It will be a small adjustment to treat a child daily, but also a great opportunity to see (hopefully) steady improvements in his abilities, and build a positive relationship with him and his mother. I will hopefully pick up one more client in the EI centre, so I have two there, and then two in my next project!

As part of the funding provided for ASSA, one of the donors is asking that the Canadian Occupational Performance Measure (COPM) be administered to parents of children receiving home therapy (this is really cool and I will explain about home therapy shortly. Hang tight!). The COPM is traditionally an OT measure, and looks not only at the child’s performance of a task (e.g. how well they dress themselves, do they need assistance for the entire task? some? just buttons?) on a scale of 1-10 but also the parental satisfaction about the child’s performance. The satisfaction is the key component; by measuring the changes in the parents response we can see if the parents feel the therapy is working and worth while. I travelled 2 days this week into rural villages along with my supervisor and other health care professionals (HCPs) (special educators, speech teachers, community resource workers, which I dont entirely understand their role yet but Im sure I will become more familiar with) to meet families and trial the COPM with them. Wednesday we met with 4 families; I was able to complete 2 of those interviews and then coached the other  HCPs that afternoon and today about what types of questions to ask, how to explain the tool and the scoring system. Its a challenge to coach, especially as not all of the words or phrases translate well into Tamil, so its forcing me to be precise and specific in my words, and not to overcomplicate things by talking too much (which, clearly, I like to talk). Part of my learning objectives here will be to improve my coaching skills, and to learn more about adult learning styles so I can be the most effective coach and enable the people Im collaborating with to problem solve through the assessment and truly understand its purpose.

Today we saw 6 families; after the first child’s visit, the mother toured us to the nearby Kundar Dam.It was about a 1.5-2 km walk, and it was so peaceful. The water level was quite low; there hasnt been rain in over a year (Im sure I’ve mentioned that before, sorry, the heat is melting my brain and memory).

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Hardly any traffic, the birds were chirping, the sun was shining… I was very grateful for the opportunity to be there, and for the choices that I had made to bring me to that moment.

On the way back to where we needed to catch the auto to go to the next client’s house, we stopped at a playground. Im pretty sure the HCPs had more fun than the client who was with us! It was really cute to see everyone having a nice time. This statue was in the middle of the playground, not sure what the symbolism was but definitely a sight to see! There was also dinosaurs, which for some reason surprised me… They seemed a little out of place? But kind of reminded me of being at the Calgary Zoo. Regardless of how scrambled my brain was/is, the park was a good time!

 

After that, we visited a couple more families and had lunch. This was the view out of the one family’s home.. So. Amazing.

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We visited more families in the villages; one family had two children with special needs and did not wish to receive therapy as they were afraid it would make their children worse and that they would one day be suddenly “cured”. This happens in Canada too, and its so hard to walk away from the situation, knowing that therapy could make a difference for that child and family, but that they have a different lived experience than myself (or other HCP) and it is just as valid as anyone else’s.

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The air in the villages is fairly clean, and it is nice to enjoy a breeze; it can be over 30 degrees (32-35) during the day. It can be a lot to take while walking through the maze like streets and between villages.

We also came across many goats and cows; this lady seemed to enjoy having her photo being taken and posed for me in the middle of her meal! If you look closely, you can see the gaps between buildings; there are small narrow lanes and often many homes tucked away along the lanes.

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The kids I will be working with on a weekly basis are both low vision with some other conditions (epilepsy, CP etc); one is very complicated and has very low muscle tone, along with a lot of sensory processing/stimulation difficulties. He will be the most challenging of my kids I think, but also one that I believe will really benefit from OT, and that I am able to be effective in my treatments and family education for carry over and continuation of therapy. It will be especially challenging as these families live in quite drastic poverty, so any therapy interventions I recommend should be sustainable and easily accessed in the local community, with minimal (ideally no) cost. We shall see, fingers crossed!

Work work work work work work

Day 4!

Today was a bit of a rollercoaster. After toast and peanut butter for breakfast (seriously such a treat), and a slowish start, we met with Ram, the head PT and were assigned our clients. E & S will be working in the spinal cord/stroke units and I will be in the early intervention (EI) unit.

The OT who works in EI wasnt there today, so I met my first kiddo with the special educator who performs the treatments while the OT is away. His mom speaks fairly good English (insert hallelujah hands here) and I was able to gleam some information from her about her son’s strengths and weaknesses. He’s only 3 and a half, but I think he’ll be a lot of fun to work with. Many of the children who come to for EI have developmental delays, autism, cerebral palsy (CP) or other conditions that affect their overall development (socially, neurologically, motor-wise, sensory etc.) and are seen by OT and PT daily. This can make a marked difference in the children’s gains and overall function in their daily lives.

My second child did not attend today, as it is the last day of Pongal. I shadowed the PT in the EI unit and observed him working with a child who had weak pelvic muscles and poor postural control due to sensory issues stemming from his autism diagnosis and other co-diagnoses.

The afternoon was spent trying to track down information on my children that I would see (Mega fail. Tomorrow is another day…) and then meeting with Ram and another PT about going into more remote villages to do EI work. It was all a bit chaotic, but tentatively, I will be going into villages ~30 minutes away 2 days a week to evaluate and treat children who could have a variety of conditions and issues, ranging from spina bifida, autism, CP, sensory processing/integration problems, etc. We will travel with a community resource worker who is trained in OT, PT, SLP (speech language pathology) and is able to carry out the treatments that the other professionals have recommended. I’m feeling pretty overwhelmed about that, but feel like it could be a really good opportunity to challenge myself and see OT on a very grassroots kind of level. I’ll chat with my supervisor more about what exactly she thinks it will entail, although it’s really tough to say until we’re in it. Cue my anxiety here.

Im trying to remember that its only been 1 day, and there is so much to learn and grow from. Deep breaths.

xo

B

 

 

Day 3…late

We havent had internet for the last 24+ hours, so here’s yesterday before I debrief our first working day!

Today was a deliciously lazy day; after breakfast we went to the chai shop on the campus grounds and waited for what we had been told would be cow races. Cows are very sacred in India, and so none of us had any ideas about what to expect. The races were to start at 10am, and in true Indian form, nothing started until around 11:30 (India time is definitely a thing). Cows from ASSA’s pastures were brought in and tied to a fence outside one of the main reception buildings; they had been adorned with flowers and various colored spices or chalks. In my efforts to take photos, I moved off to the side of the cows, and one of the older gentlemen watching ushered me into a spot near the staircase so I was able to get a few shots. This seemingly simple gesture is reflective of the general atmosphere at ASSA, and the places we have visited thus far; everyone is so genuinely kind and wants to ensure we are having a good experience in every way.

The cows were fed what I assume was Pongal, and bananas (!!), and showered with flowers. The people who look after the cows were also given gifts for their work. After that the cows were untied and turned loose to wonder the grounds.

After lunch, we enjoyed some downtime and then took an auto to a nearby temple, Mahalingam Mountain temple. The ride was about 40 minutes, and there were lots of people out and about. The main form of transportation here is walking, or motorcycles. Many people don’t wear helmets, and suffer head injuries or spinal cord injuries (SCI) in accidents; the majority of the people at ASSA with SCIs have been in motor vehicle accidents. We passed through smaller villages, and the relative poverty is something I’m still having a hard time comprehending. Everyone is dressed very well to celebrate Pongal, and the colors of the women’s saris are amazing. I didn’t take photos of the villagers; it felt rude to snap photos of them as we whisked passed, without their permission or any inkling of who they are as people and their stories.

Many of the temples are built at the top of steep or long stair cases; the devout will go up on their knees or crawl. The temple we went was at the top of some very steep stone stairs; you also must go barefoot. The auto driver agreed to wait, so after tossing our shoes into the auto we climbed the sun-warmed stone stairs. The stones were just hot enough to encourage your tired legs to keep moving, and not remain idle too long, lest you feel like you were burning the soles of your feet.

The views were ABSOLUTELY worth the climb. The temple itself was stunning, intricately carved stone and passages. The surrounding hill sides were full of palm trees and fields. Many people were at the temple celebrating Pongal, and we had many people approach us to take photos or inquire where we were from; many children are very curious, but when we waved they would often become suddenly shy and hide. We met some very nice families, and after a long walk down the stone, we found some cold drinks. 3 soft drinks cost 14 rupees (less than 50 cents CDN), which is wild to think about. The price difference in every area is absolutely incredible; for a 40 minute auto ride to and from the temple, and for the driver wait for us, was 400 rupees, or about $8. Definitely a change from a $20 cab ride in Calgary to downtown, or a $50 cab ride from the airport in Montreal!!

Tomorrow is our first official day of work; we will meet with Ram and be assigned patients for the upcoming weeks. I will be working in early childhood intervention, so with children under the age of 6 I believe, with sensory impairments, on the autism spectrum or developmental challenges. This is the understanding I have at this point, but I’m sure I will learn a lot more this first week! I am able to draw on an offsite Canadian OT who specializes in pediatrics, as my supervisor here specializes in adult/neuro (stroke, SCI etc.).  We most likely will be working from 9:30-5:30 every day; seeing clients in the morning with time for documentation and research in the afternoon. I’m pretty nervous about the language barrier but hope I am able to draw on some mime/act things out and depending on the special education teachers’ schedules, have them interpret; a few of them speak (some) English. We will also be continuing games night for the SCI clients on Wednesday evenings, and adding in a games night for both the Boys and Girls dormitories in the coming weeks. People from the ages of 16-30 live in these dorms, and we’re hoping to run the games nights on the same evening for both groups.  I’m not entirely sure what to expect, or feel very confident in my skills… I’m having some doubts about how much I really know and how effective I can be; I’m hoping I will pleasantly surprise myself but also preparing to crash and burn… Fingers crossed!