El paramilitarismo en el contexto Latinoamericano

“These were real people with real problems.”

Lynn was a novice SLT, and an English-speaking coloured female. She worked in an urban public hospital. At the time of this research, she was still enjoying her work there.

The red blood splatters directed my path on my way into the hospital that blistering summer morning. The gore ends at the entrance of the trauma unit. Other colleagues casually walked past and through this mess. It had only been a year and 2 months that I had been out in the real working world. Perhaps over a length of time one can become immune to this sight. As I entered the hospital I heard a group of nurses speaking in isiZulu and from my limited knowledge of the language, I could only gather just a bit that it was about the blood splatters outside. My headband kept my curly hair away from my face as perspiration ran down. The waiting room of the speech therapy department was full of tired parents and fussy children waiting for their turn to see me. I tried to muster a genuine smile. After all, I was glad that so many of them had kept to their appointments. The windows did not open and there were no fans or air conditioning in the department. I was sure to hear during the course of the day, the clients’ and their families’ stories of how dependent on public transport they were, and also how many could not afford the rising costs of transport. I was also sure to hear their silent complaints about the systems here at the hospital: they dread the long queues simply to collect the hospital files. I was aware that coming for therapy either for themselves or for their loved ones meant getting time off work or arranging for care for the other children at home, which may have its own financial implications. It seemed like much sacrifice for a 45-minute session once or twice a month. These were real people with real problems but I was glad that they were there to see me.

Restless in his bed in the paediatric ward staring out the window at the ocean, Dre acknowledged me approaching but looked away when I greeted him. His mum was with him. “Hi mum, do you remember me? I am the speech therapist. I met with you the other day.” Half acknowledging my presence, she greeted and continued typing out something on her mobile phone. When I had met her previously she had quite a negative description of her son. She said that he doesn’t listen and is badly behaved. However, my initial observations gave me a sense that he was much better than what his mother made him out to be. I had a vague idea of the little boy that I was going to meet. All the nurses said, was that he doesn’t speak too well. He was willing to follow me into the therapy room and engage in light conversation. However, the session quickly turned. Beads of perspiration settled on my upper lip and on my brow as I watch Dre quietly slip in and out of lucidity. My heart racing, I waited to see for any more signs. I had never seen anyone having a seizure before. I only knew of the textbook version of epilepsy and what was unfolding in front of me was different because there was no shaking or frothing at the mouth. The

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nurses mentioned that he had seizures but I didn’t think that it would happen in my session. He then became quiet and dropped his head. These few minutes felt like hours until he finally came around. I could see that he didn’t understand me when I asked him a few questions. He slowly regained his composure. I communicated with him in simple sentences; I had to repeat myself frequently. I contorted and twisted my face to see if he would react. Would a smile work? Something eventually caught his attention. It was one of the toys that I brought along. As the session progressed, I could tell that this little boy wanted to communicate with me. I felt that he appreciated me trying my best to communicate with him at his level. I think he was enjoying the attention that I gave him in this 45 minutes that I have been sitting with him. It was the little things, like helping him to tie his shorts tighter or that I let him sit on my lap.

The session turned again. He clenched his fists and slamming them onto the table he then lunged forward toward me. He muttered something under this breath and screamed “No, no!” I just glossed over this and did not give a reaction although I was deeply concerned. He kept fidgeting with the ties of his shorts, twisting and rolling it up. He then repeatedly tapped the table with his hands. He could not seem to sit still. But why was I expecting him, a young lad, to do so? If somebody is not well behaved or if they are hyperactive, there is that great possibility that they do not take in what they hear the first time. I repeated most of what I said because of the look of confusion that he gave me in those moments of silence. It was in those moments that I think he had the seizures. After a while, he got up again and ran around the room. This happened at least three times in the session. I felt uneasy and afraid. Whenever I thought a seizure came about, I wrapped my arms around him thinking that he may fall over. I think I needed to discuss this with the nurses or the doctor and I needed to do my own research. I was reluctant because of what I might to find out.

I returned to the speech therapy department to find one of my clients, Kito, waiting there with his dad. Kito and his family spoke Swahili as their home language. However, his dad was able to understand a little bit of English. I previously asked his dad to write down important Swahili words or phrases for me. He was kind enough to teach me pronunciations of words that I could use in the session. This was not always very successful because I did not have background information on the language itself, so the accent, specific sounds in a language and other linguistic features were not things I was familiar with. The school-going clients, like Kito have not been so problematic because most of them go to English-medium schools so they know some English. The foreigners with their little ones or the elderly clients posed the greatest challenge because of the lack of interpreters for the languages that they speak. There were many foreigners in the area because it was a business hub to find jobs and start shops. These clients were Swahili, Amharic, Shona and Lingala speakers. There are some local clients who also speak Afrikaans, which isn’t very common here. Thankfully, most of them do have the broken

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English and we are able to communicate. However, I am not sure about 100% effective service delivery then. Sometimes I think it would be easier if I could speak and understand multiple languages.

Practice in the real world is much more difficult from the time when I was a student at university. Back at university, we had our supervisors there to offer advice or problem solve with and for us. I think that I needed to be thrown in the deep end back then. They needed to task me with everything that I would have been expected to do in the world of work like setting the appointments and advocating for services. I needed to learn how to adapt my communication for these different tasks. Building a good rapport with parents and the clients was something that was drummed into my head by my clinical supervisors. I suppose that building a relationship of trust would help in the long term.

I realised this when I did an initial assessment on a bilingual client, Thuli. Her mum was concerned about her child. Sensing her increased anxiety as the seconds went by, I decided to reassure her by speaking with Thuli’s mum. I explained Thuli’s condition, suggesting behaviours that she might have noticed at home. She was quite astonished by how much I knew, and how I was able to communicate this to her using every day experiences. I think she was particularly grateful because I could relate to the situation with my knowledge. I felt satisfaction too that my communication was successful in this case.

There have been a few instances where I felt that I was not a successful communicator. One of my biggest problems in my workplace is the language barrier between me and my clients and the lack of interpreters. The PRO [public relations officer] at the hospital sometimes assists in sourcing an interpreter from the PRO but this requires forward planning in notifying his office, finding someone who is available and waiting for his reply. Many of my clients are walk-ins and it is not fair to make them wait for an indefinite amount of time because of a language barrier. This is when I use a colleague or other staff members like the nursing sisters, depending on availability. However colleagues are not willing to help a lot of the time. It can become so difficult. Sometimes I don’t want to go and ask. I rather try and to communicate with clients. I try and learn the main words in a language and it could possibly help me in a session. It involves lots of visual input. There are those cases when the interpreters that are available may not be suitable for the clients because of the language difference. Most of the interpreters can help with the Zulu–English language barrier. Even then I am not always able to guarantee that I am providing a 100% service delivery. But then what do I do in situations where clients and their families speak Swahili, Amharic, French or Lingala?

I wanted to stay here at this hospital for a while longer. I felt that there is a lot more that I needed to learn and will learn. I will probably die never knowing all the strategies of how to communicate with clients. I think at some point I will be equipped with the skills and will communicate successfully at most if not all sessions with my clients and will learn to adapt

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and problem solve more … more … allowing it to flow and be more easily done. While I was in the middle of my thought my phone rang. It was the nurse from the male medical ward. There was a patient referred for speech therapy. He sustained a traumatic brain injury and was brought in this morning. The blood splatters at the entrance of the hospital were his.

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