Teaching a young girl about surgery

This past month I had the incredible privilege of spending time with the Child Life Department at the Shoe4Africa children’s hospital at Moi Teaching and Referral Hospital in Eldoret, Kenya, which is currently the only Child Life program on the continent of Africa and in most of the developing world. My singular objective going into this portion of my practicum was to observe and learn as much as I could about the ways Kenyan Child Life Specialists operate and provide services to patients and families in a government national referral hospital. Although I spent 6 years working as a Certified Child Life Specialist in different children’s hospitals in the U.S. and also worked on various healthcare projects while living in Uganda for a year prior to starting my MPH program, until this summer I’ve never really had an opportunity to explore what Child Life services actually and practically look like in a low-resource setting in a developing nation.

Regardless of the setting, the main objective of all Child Life Specialists around the world is to minimize the anxiety, stress, and trauma experienced by children and their families during challenging medical events and hospitalizations. However, during my time in Eldoret last month, I quickly discovered that while the main objective and core functions of Child Life Specialists might appear to look the same across various settings throughout the world, numerous cultural, financial, and environmental factors significantly influence and alter the daily responsibilities and activities of Child Life Specialists working in low-resource settings in developing countries.

During the course of my 5 weeks in Eldoret, I was privileged to spend multiple days simply observing each of the 6 Child Life Specialists employed at the hospital as they attended to their normal duties on their respective patient units. I was extremely impressed with their deep level of understanding of children’s psychosocial needs during hospitalizations and adverse medical events, despite living in a culture that rarely acknowledges or focuses on any type of psychological or emotional issues. I was also amazed by the strong relationships they’ve built with different members of the medical team and could clearly tell that each Child Life Specialist is very highly valued on their respective units. Finally, I was incredibly impressed by the resiliency they demonstrated in the face of constant adversity and their ability to effortlessly adapt their skills to meet the needs of patients and families even under the most challenging circumstances.

Engaging in medical play with a  young boyFor instance, I watched as a Child Life Specialist working on the burns ward successfully utilized distraction techniques to reduce the fear and anxiety of a 6 year-old boy with severe burns on 50% of his body during a painful dressing change when he wasn’t given any pain medication or sedated due to medication stock-outs at the hospital. On another day, I watched as a different Child Life Specialist working on a general medicine ward used therapeutic medical play techniques to interact wordlessly with a child who could only speak a rare tribal dialect and who almost died from a rare parasitic disease because the only known treatment for the condition was located in just one area of the country over 6 hours away from her rural village. In another instance, I watched the Child Life Specialist assigned to the oncology ward psychologically prepare a child to undergo a surgical biopsy of a massive facial tumor that had been growing out of control for several months because his parents and other villagers believed he had been cursed and had taken him to several local witchdoctors for “treatment” prior to bringing him to the hospital. I also observed as a Child Life Specialist working on the surgical ward prepared a young girl for a life-changing surgery that had been delayed countless
times during her prolonged hospitalization because the hospital did not have the resources to purchase a specific piece of equipment necessary for the surgery.

Bearing witness to these types of situations during my time in Eldoret definitely increased my awareness and appreciation of the complex cultural, financial, and environmental factors that Child Life Specialists in developing countries like Kenya have to routinely deal with when working with patients and families. It was both a privilege and an honor to learn from such dedicated, skilled, and resilient global Child Life professionals!