Week 6: Phu My Medical Clinic

July 29th, 2014

Tyler Thorne ’15, Keeler International Fellow in Cross-Cultural Psychology

This was my final week at the Clinic and it feels so strange to be finished with my Fellowship.  I tremendously enjoyed going to the Clinic everyday and working with the children.  I did not realize how attached to the children I would become and truthfully, I am very sad to leave them.

The week started off slow as many of the children were still sick, yet once they returned we were very busy.  Many of the children had regressed in the behaviors that we were reinforcing, thus we had to dedicate more time reviewing behaviors, and working on approximations of behaviors that the children had already learned.   For example the speech therapist had the children do a review sheet, where they practiced sounds, and previously learned words to get them warmed up for the session.  For physical therapy we spent more time stretching out the children with Cerebral Palsy as their parents often do not have the children do anything physical and they returned extremely stiff.  From this I learned that as a psychologist I must be flexible, and be willing to change the therapy schedule in order to meet the needs of the patient.

After a few days of therapy though a majority of the children have made up for what they lost when they were sick except for self sufficient eating habits.  The children have really struggled to relearn how to self feed again.  The two children I work with mostly have regressed to the point where they do not grab the spoon and wait for me to feed them.  This is incredibly frustrating as it took literally 5 to 6 weeks to develop these behaviors and they where extinguished after only a week or two off.  I believe this is due to them not feeding themselves or having to practice self sufficient eating habits while they were sick at home.  It is also related to Vietnamese culture as I have found that it is not uncommon for a parent to spoon feed a child, even if that child is completely capable of feeding on their own.

The physical therapy is the area that I have seen the most improvement.  In the 6 short weeks that I was here several of the children have taken great strides in being able to walk without assistance. The children with Autism made small improvements but I feel that they needed much more one on one time and really a better system.  I think it is really tough as many of the staff do not understand Autism and the children are then not treated normally or with proper social cues, which interferes with properly learning those skills.  The therapists understand and provide a nurturing environment for the children, yet once therapy is done the nurses take them to the play room where the Autistic children basically play by themselves and not expected to display proper social interactions which is counterproductive to the therapy.  Yet this is due more so to the culture than anything else, in Vietnamese Culture those with disabilities are seen as lesser and almost sub-human, hence many born with disabilities are abandoned and placed in orphanages.  Thus as the nurses have not had any education on what is going on with these children, they believe that the children will never be able to grow or develop and the nurses act differently toward these children providing a less nurturing environment.  As sad as this is it is not specific to Vietnam as in many cultures mental illness has been misunderstood and been seen as demon possession or punishment for sins in a previous life rather than a situation that can be improved.

This week we also did Art Therapy and Dance Therapy with the children.  During these activities I actually drew a lot from what I learned in my Basic Acting course, such as activities and games, so thank goodness for a liberal art education or I would have been at a loss for things to do during this time.  These activities are usually done in the afternoon after the children have finished their other therapies. Art, dance and music are all great for the children as you can physically see how it calms all the children, as many of them become understandably frustrated during their structured therapy.  Also this therapy type is great as it works on their coordination, creative thinking and it helps the children learn to cope with new tasks as many of them have a hard time adjusting to new situations.  The children also love these sorts of activities, so its great to see them happy and having fun.  I also continued teaching some of the children English, which is actually really fun and I am just amazed at how clever the children are.  Many of them had picked up phrases from working with western volunteers or doctors but with some structure they have quickly learned more than just basic conversation.  It is also important for their future to have a skill such as being able to speak English, as these children are disabled (the ones who are learning only have physical disabilities) they are not allowed into the school system.  Given this, they have a lack of opportunities for jobs or a means to support themselves, yet if they learn English this opens up a whole new set of opportunities.

It was incredibly sad when the children found out it was my last day as all of them started to cry.  We had cake as a going away party for me but some of the kids did not even eat because they were too busy crying about me leaving.  Overall this was an amazing experience, and from it I have learned a great deal.  It has also really directed my goals for the future, I really enjoyed working with children and I feel that I would like to work with children in the future.  I am now sure that I would like to work in a Clinical or patient orientated setting rather than solely doing research.  I am also extremely grateful to the staff for working with me and teaching me a great deal about therapy and the Vietnamese Culture.   While there were some situations we did not see eye to eye on I have made life time friends and professional contacts.

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