Projects Abroad: Two Week Care Project in Morocco

So here I am, on my flight from Rabat, Morocco to Paris, France, the first of 3 to get back home to Calgary. I thought I’d have time to blog while in Morocco, but the days were just so fully occupied, and Internet connection was haphazard at best, so I knew I’d have to wait until I at least started my return journey!

It’s going to be a challenge to try and blog about my experiences in Morocco. To try and capture what I saw, did, heard, and felt while there proves to be challenging to put into words. It was most likely the best two weeks of my life in so many ways, and as my friends told me (and they were right of course!), Morocco has proven to be life changing. I hope to try and describe what and how as much as I can place into words…but there are also some other things that I’m going to have to wait to tell y’all! ;)

There’s no feasible way I could solely write one blog entry to summarize my two-week experience.  And then I thought I should probably separate my experiences into categories based on what I did while abroad. The first of which is volunteer related, and the second to do with experiencing Moroccan culture.

Volunteering at Ennour Centre

So my placement was to volunteer for 6 hours a day at the Ennour Centre, a day program for children and young adults with mental and physical disabilities. I volunteered there from 9:00am to 12:00pm and again from 3:00pm to 6:00pm, well surpassing my minimum requirement of 18 hours a week! The clients were split into two groups consisting of a younger most child-based group, and another young adult group, up until the age of 30-ish. I naturally gravitated towards the younger group, also because the second group already had another volunteer from Germany working with them.

The morning and afternoon are split into two time frames for different activities, with a snack break in between. The variety in the difficulties the children faced (from Cerebral Palsy, to Autism, to hearing and visually impaired, to cognitive disabilities) did make it challenging to try and work with this group of around 12 children. Having brought half a suitcase full of toys with me, I really did use them a lot while I was there. Some children were provided with puzzles to develop visual perceptual and fine motor skills; others with board games to develop sharing and turn-taking; and a few children needed one on one time for their severe cerebral palsy needs. This included one boy in a wheelchair and another who was ambulatory but never used his right hand during play or daily activities.

I naturally gravitated towards these two boys, Yazdin and Elias. I couldn’t bear seeing Yazdin just sitting in his wheelchair, a huge smile on his face, but unable to participate due to all four of his limbs having severe spasticity. I remember the first afternoon I saw him, and asked him if I could take him to the physio room to work with him. He smiled a huge grin and nodded, so off we were on a 9-day intense journey which included working with him for 3-4 hours a day.

I should probably tell you now that there are mentors (volunteers) at the day centre who run the activities. Two of whom I became close to are Wafaa and Mostapha. Mostapha actually would come with me when I worked with Yazdin, and using French and English and a lot of hands-on demonstrations, I showed Mostapha how to carefully stretch out Yazdin’s limbs, how to look for signs of pain from contractures, to change his position from side-lying to supine; etc. Yazdin was hilarious, he allowed me to stretch and work with him and always would beam smiles at me, but as soon as Mostapha would try to stretch him, Yazdin called him ‘ugly’ in Arabic!! That term was one I picked up on quickly.

After Yazdin was stretched, I thought it would be good to have him use a therapy ball, so we positioned him prone with his arms supporting himself on the ball. We rocked him forward and backwards, side to side, and he loved it!!! He had such a hard time supporting his head up for the first few days, and constantly needed encouragement to look at toys in front of him or at himself in the mirror. By the start of Week 2, he could tolerate over 30 minutes on the ball with his head held up and directing volunteers on how to complete a giant number floor puzzle. He loved it and always asked for the ball, so his sessions kept this routine of stretching and therapy ball.

But then there was the issue of him being unable to sit up alone at home, so he’d always be lying down and unable to do anything.  I was looking at some pictures on the wall and saw one of Yazdin sitting in a specially made wooden chair with high back and table tray, exactly what I wanted to make for him. I asked the centre about the chair, and they still had it, but Yazdin had grown since then and it was too small. I asked Mostapha if there was a carpenter close-by (thanks to Ash for this idea, couldn’t have done this without your idea!!), and lo and behold, there was one right next door to the centre! I went with Yazdin’s mom and had him measured and the chair was made larger and a table to be created for him. He was initially apprehensive about sitting in the chair, but after saying the word ‘shwwiya’ (which means “a little” in Arabic), he agreed, and soon built up endurance to 30 minutes in the chair. We’d play ball games while he sat in the chair, or I’d have him grasp small objects and release it into my hands, all of which placed a beaming smile on his face.

OH, and the best part was when we found a Spiderman mask in the middle of the second week! He asked me to put it on him and it never came off!!! I showed him how to move his head back and forth to pretend to sling webs around and make sound effects, and he was off!!! He also wore a suit on Friday afternoon, my last day at the centre!! I had given him a few Canada and Calgary pins, and he wore a suit proudly displaying the pins on his jacket. It was adorable, and made me want to cry! His mom asked for a therapy ball to use at home, and I was going to purchase one from a medical store in Rabat, but then I saw that the centre had another un-inflated one sitting in the corner collecting dust. So I snuck that onto Yazdin’s wheelchair and told the mom to inflate it with a bicycle pump. It will be used more at home than at the centre, so why not?!

Ok, so now I’m on flight from Paris to Montreal, 3 hours gone and 4 remaining! Anyway, so that was the story of Yazdin. I also worked closely with another boy called Elias, who also has Cerebral Palsy, but is ambulatory yet does not initiate use of his right hand. His smile brightens up the darkest of rooms, his laughs are fits of giggles that he can’t control, and he loves to make sure that activities are set up the way he wants it to be! During my first day at the centre, I saw Elias trying to paint, and even with his dominant left hand, he was having a hard time holding the paint brush and making back and forth strokes. I held his hand and attempted to show him, but his fine motor control was being hindered by the increased tone in his hands. So, I took him off into the physio room and we played a fishing game I had brought with me. The magnetized fish were placed on the floor and Elias and I held the fishing rod and ‘fished’ for the fish, which were then placed in his right hand as he tried to control grasping and releasing the fish. He laughed his head off every time, especially when he was able to turn the reel to pull the fish in. It was the cutest and funniest thing. Over time, using a therapy ball for Elias to lie prone on and for him to use his right hand to retrieve large Lego blocks independently. It was amazing to see the progress within one week with intense 2-hour sessions every day! The final few days, Elias was pretty independent in setting up this activity and using Lego blocks to built using both of his hands. He would also love to play these ball games where I’d throw a bouncy ball to hit the ceiling and bounce off the floor. It really does work for kids to see the adults rebel!! And the most heart warming moment? Elias and his mom one time reached the centre before me and before it opened. He saw me walking from far, got up and walked towards me with arms outstretched, and then gave me a big wet sloppy kiss on my cheek when I picked him up! To see the joy in his face was priceless. And after having spoken with his mom and the centre, I suggested that Elias continue with a rigorous play schedule using as many different sized and shaped manipulatives as he could.

OH that also reminds me of another story! Elias and Yazdin became closer friends since I’d alternate my time with them towards the end. Elias loved to sit on the corner of Yazdin’s wheelchair, wrap his arms around Yazdin, and also give him big wet sloppy kisses. AND there was this one time Yazdin was on the therapy ball when working with me. Elias walked in towards Yazdin, spit out a huge blog of drool on the back of Yazdin and proceeded to wash him as if he was giving him in a shower! Both mothers howled with laughter and I thought, hey, he’s using his right hand to do this, so it’s all good. Yazdin cracked up too.

These two boys were the focus of the second week especially since it was technically school vacation but the centre remained open so I could work with the kids. During the first week, I also spent time with the larger group. We’d use puzzles to have the kids work in small groups, KerPlunk for older kids/teens to play, Memory cards, and this number floor mat puzzle which I am so glad I brought since it was used so much! One time, I ended up reading a book to the kids in French while Wafaa translated. Another time, I encouraged 2 women to get on a couple of exercise bikes that were in the physio room, since they talked about wanting to exercise and lose weight. Then there were two kids with Autism, really tough kids, since they never really had any intervention before! I tried strategies I would use in schools, but really to no avail, and they were at it with each other and everyone else. It made me realize they need a visual system similar to the ones I use at work, and also a set of rules that are summarized and reinforced everyday. Since I didn’t have access to these visuals in Morocco, I told the centre I’d send it once I arrived at home. Including the Give Me 5 strategy we use so much in schools!

I also had the chance to interact with some of the adults in the program too. Since I arrived early at the centre most mornings, many of the adults arrived at the same time too. Using a little French and broken Arabic, we communicated, and tried to practice counting and saying the alphabet in English. We talked about issues in Morocco and how life is in Canada. They told me information about the younger kids that was really useful. And even when the centre was closed for holidays, some would walk by and say hi. I even played Duck Duck Goose with them once outside on a hot afternoon, and I kept getting chosen to chase them around. I remember stopping and thinking that afternoon that it’s rare to feel such feelings of happiness and contentment without any restrictions, really. I was free to do what I wanted at the centre, with whomever I saw fit, and the staff was really supportive.

The feeling at the Ennour Centre was one of comrodary and support. Anytime a client entered, they’d shake everyone’s hands, ask how they were doing, and the adults were really good about checking in with the children. Oh, and I was pranked one time, thanks to Mostapha! He asked one his friends to come up to me and ask about his arm, which looked like he had CP too. I started to stretch out his hand and found it strange that were no tone, just active resistance from Osama. He then threw his hands into my face and burst out laughing. Mostapha thought it was hilarious and I admit, it was a pretty good trick. He also loved to call other staff members ‘handicapped’. I didn't get the chance to get back at him before I returned, but I do believe long distance pranks are still possible!! J

So after my two weeks ended, I started to think of ways I could continue supporting the centre, which runs mostly on donations. First of all, I will remain in contact with the staff and volunteers to see how the kids are doing and if consultation is needed. Second, the centre is still under-resourced. While they have purchased physio equipment, there’s a real lack in basic therapeutic materials that we take for granted. For example, more therapy balls, Move n’ Sit cushions (also to use for balance), theraband, Theraputty, fine motor supplies (animal tongs, scissors, mini chalkboards and chalk, etc), puzzles and board games, and so much more. I actually just had the idea of creating a Rubric of which games to use with which kids and for certain skills to be addressed. This would also help the staff and volunteers understand the importance of therapeutic use of activities.

So what did I take away from my two weeks with Ennour Centre? So much…It made me realize that the smallest of our actions can have the greatest impacts. I realized that I don’t need a lot of materials, money, time etc to connect with and make somewhat of a difference with children and their families. I realized that families in Morocco who have children with disabilities and illnesses are not supported, and that in many cases, their children are left to their own devices at home and not really integrated into society. I understood the mental toll that children were taking on their parents and families, to a point of desperation for some parents and not knowing what to do with their child. I met two women with Dwarfism whose spunk and life energy I was astounded by, as we sat down and had a conversation about getting married and them wanting to marry a typical person and wanting it so badly.  I met a visually impaired young lady whose smile was contagious, and who would blow me kisses for just sitting beside her and talking. In all honesty, if she were in Canada, she’d be independent with her daily activities and getting around. Morocco just doesn’t have any resources.

Which got me thinking!! And come on, if you know me, you know that I’m very passionate and don’t believe in short-term investments into anything!! I would love to start some sort of organization or clinic that would work with families and their children with disabilities. And I don’t just mean sessions in a clinic, but also home visits and support for their families. It is sad that these children cannot attend school, since they don’t integrate and the notion of specialized schools doesn’t exist in Morocco. So if these children don’t attend centres such as this one, they are basically at home the whole time. And that doesn’t sound right to me.

Then I started thinking about the type of work I do back home, my real job! I love it so much, and am very passionate about it too…but it’s different! I’m working with families who have the chance to receive free support, but then sometimes, refuse it. There are also politics, religious and cultural influences, family dynamics, etc etc etc. In Morocco, there wasn’t any of this. The families were so appreciative of any support they could get, and I really wish I could have done more. I felt fulfilled at the end of the day, and even though Arabic eluded me, I felt like I was still able to connect to the kids. And this opportunity was one where you couldn’t sit back and just help out, you really needed to dive in there!

Ah and this brings me to another point. I was told that I’m the first OT in Morocco to ever work or volunteer! Which is crazy!! Physical Therapy does exist, and I did meet 2 PTs while I was there. But they weren’t really in the same domain as the amazing PTs I work with at Renfrew. These PTs came from a very medical model, and had told the centre to purchase an Ultrasound machine and two other devices, along with a very surgical looking HUGE halogen lamp and vibrating massaging machines, etc etc. And when they were in the clinic, they had no interaction with the kids or adults, but just played around with the toys. I was really confused, since a lot of what I did with the kids, they should have been able to support. 

It was all good though! I was sweaty and grubby at the end of the day and felt awesome covered with kids’ drool and kisses! That’s what I had traveled all the way here for, baby!!!


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