Ica, Peru: Speech therapy

Dr. Berkowitz says:  Now we hear from Lesly, a first year student in the graduate program at Mercy College.  She and Ashley were under the supervision of Lindsay Naylor, Mercy alumna.  The hospital at Ica gives us their pediatric auditorium, which is kind of a utility room.  We turn it into a consult and conference room as needed, often carrying on multiple sessions at once.  All part of the fun.  Note:  although the students did not attend surgery on Monday, they did observe later in the week–always a thrill.

First day:  Today was the first day of speech therapy.
The day started off setting up at 7:30 am at the hospital. This included
getting the handouts with information ready in packets for the
parents. Then the parents started arriving with the children at 8:30am
to the speech therapy room. Their faces were filled with eagerness and they
seemed ready to talk to the speech therapists.
There were many different children of all different ages including
little babies and adults. Speech therapy was given either in groups or
in individual sessions. Lindsay lead the team with her expertise and
was completely wonderful. She started with a group session with
parents who had babies with either a cleft lip or cleft palate. We
gave our information to the parents along with directions on how to
feed their baby after therapy. We also gave them background
information on the compensatory errors the child can produce later on
as they grow up because of the cleft palate. Along with feeding
therapy information, we reassured them that everything was going to be
fine and that surgery was going to be a success. After spending time
with the parents of babies we moved on to older children ranging from
the years of 5-9 years old who were going to get a cleft palate
surgery. We explained to them and showed them examples of the
compensatory errors the children were making and why they were doing
it. We explained to them that because of the cleft palate they did not
have separate nasal and oral cavities therefore leading to
insufficient velopharyngeal closure. We demonstrated on one another
taking turns showing them what techniques the parents can use after
the children receive surgery. We demonstrated blowing air out through
their mouth by blowing on a tissue in front of their face while
producing a plosives such as /p/. The parents practiced with us and
the children were listening carefully. The children seemed excited as
we also gave them toys to entertain themselves. That worked as a
motivation for them to pay attention to us and listen to what we were
saying. The parents were so motivated themselves, we haven’t seen
anything like it. They were beyond eager to learn from us and they
were enormously grateful as shown by they hugs and kisses. Parents
even said they were going to bring in treats for us during the week!
How exciting.
The next group we worked with was an adult who unfortunately was not a
candidate for surgery because of of her age and the lack of tissue she
had in her mouth.  There needs to be a certain amount of free tissue for the reconstruction of the palate. However, she did had a prosthetic device that she used to cover the cleft in
her mouth. We gave her a consultation on trying to receive a new
prosthetic device for her that will be able to help her more. She was
more than happy with the help she received.
Then we saw a group of two children who have already received surgery
for their cleft palate last year and were returning for therapy. We
showed them how to blow air on the tissue, and how to blow a tissue
with their mouth using the plosive /p/ across the table. Along with
that, we also showed them how to produce the /h/ sound before a
syllable or a  word. The children were really motivated
and the parents even more. They promised us they would come back for
therapy through out the week.
After, we have a 3 year old boy who’s mother brought him in for an
evaluation for autism. The mother said that the therapist here in Ica
said the child might have autism and perhaps could have epilepsy later
down the road. Lindsay with her great knowledge and skills reassured
her that he was going to be taken care by us and we would help her as
much as we could with information on how to proceed. We recommended language
therapy for now in order to build his language. Also,Lindsay confirmed
some signs that the child shows that indicate he may be on the autism
spectrum. The mom was very supportive and touched our hearts by saying
she was going to work hard to get her child through it. She said she
was going to come back everyday so she can learn the different
techniques to use in order to motivate her child to talk and how
demonstrate to him certain gestures. The mom left extremely grateful
and hugged all of us.
The day concluded by us visiting outside the OR. We did not have a
chance to observe surgery however, we did see the excitement on
parents faces after their children came out with a brand new cleft lip
repaid or cleft palate repair. Pictures were taken with the doctors
and the nurses along with the Peruvian medical students. They were all
beyond grateful.

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Ica, Peru: Screening Day

Shari Berkowitz says:  Screening Day is always hectic, but the team has it down to a science, and many hands make light work.  Speech Team is always the last stop on the many different check-ups the little patients get on screening day. Here is Ashley’s screening day experience:

Our first day in the hospital was screening day. The moment we stepped into the hospital there were patients sitting and clapping for the whole Healing the Children team. All the families are just so amazing and grateful for the work we’re doing. We saw almost 100 patients. It got crazy! However, we kept a good flow despite two rooms ahead of us sending us patients at the same time! Most patients came for surgeries but there also were some for just speech therapy. There were some returning clients from years past, and they were so happy to see Lindsay. She’s another rockstar here. She knows everyone and is super knowledgeable and friendly. We’re learning so much from her. Just everyone here is so amazing. I’m kind of in awe. I’m even learning about some team members that couldn’t make it this trip that are trail blazers. One doctor stays in a certain country for a couple of months and teaches other surgeons from that country how to do the surgeries and then moves on to other countries and continues to do the same.  Another doctor leaves for countries the day that he finds out there has been some sort of catastrophe to help out. Truly amazing. I’m so happy to have this opportunity and be surrounded by so many smart, genuine and fun people. They truly live by “work hard, party hard.” They are all an inspiration to me and I can’t wait to do more missions in the future!

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Ica, Peru: Travel

Shari Berkowitz says:  Alumna Lindsay Naylor, who is a consummate veteran of these trips, has been joined by Lesly Sanchez and Ashley Rivera, both of whom have just completed their first year at Mercy College’s graduate program in Communication Disorders.  The three of them are in Ica, Peru, providing clinical services to children with cleft palate, cleft lip, and indeed, any other speech and language disorder.  All who come through the door are seen!  Thanks to the surgeons of Healing the Children, Northeast and California chapters, who see the value in what the Speech Team adds to patient care.

Below, the first blog post, from Ashley:

We arrived two days ago (May 7, 2016)  in Peru. The trek out to Ica was a long one but made easier by the wonderful people we’re surrounded by. It’s so inspiring to be with people volunteering their own time and money for such an amazing cause. We met medical students from Lima and they are truly amazing. On top of being in a top rated medical school here, they take 6 months to organize medical documents and they help deal with customs so that all this is possible. Andddd they also come to Ica to help out with surgeries and the patients. I heard last year one student took the 6 hour bus ride here helped for a day, went back to Lima to take a final and then returned back to Ica again the following day. I can no longer rightfully complain about grad school.

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Antigua, Part Three

Shari Berkowitz says:  Not all aspects of trips abroad to offer clinical services are fun and games.  There are cultural differences and disconnects that can knock students off kilter.  Here, Julianna very honestly tells about one of those moments…they usually come in the middle of the night, don’t they!

On the second night of our trip to Antigua, after having spent hours at the Care Project (a facility for children and some adults with severe mental and physical disabilities), I found myself lying in bed, hysterically crying, and texting my mother non-stop. My roommate Lauren was asleep, and though I tried my hardest to contain my emotions, I just could not seem to wrap my mind around the fact that some people in this world are forced to live under such heartbreaking conditions. Cerebral palsy, hydrocephalus, and an incredibly hot pediatric ward were just few of the many things we saw which I had never been exposed to before. I prayed for the health of all the people from the facility, for their safety, and for their happiness. I prayed that a positive difference in their lives would be made soon. But then it hit me: I can make a difference. Especially when I am a certified speech language pathologist. My tears began to stop, and my headache eventually faded. Fortunately, my roommate didn’t wake during my mini-meltdown. Even if I am helping people like those from the Care Project with things like maintaining friendships or expressing their wants and needs, I know that what I can do can be great. Our trip to Antigua made me realize that my fellow Communication Disorders students and I are more powerful than I thought. I am so glad to have “kept my cool” while I was actually in the facility, and that my heart decided to get all emotional once I was back in the hotel. I can be a very sensitive person at times, but when I was in the center with Lauren and Dr. Berkowitz, I surprisingly did not crack. Rather I put a smile on and remained as calm as I could. I think that having Lauren and Dr. B there helped me tremendously, and I am forever thankful to them.


-Julianna Bastone


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Antigua, Part Two

Shari Berkowitz says:  Here is another blog post about the trip, from Julianna Bastone.  She and Lauren were a great team of SLP students and learned a tremendous amount in a sort visit.  Collaborating with the OTA students added a priceless interprofessional opportunity, rarely offered to undergrads.

Trip to Antigua: March 28, 2016 to April 1, 2016

There aren’t enough words to adequately describe my experience in Antigua and how eternally grateful I am, but I will try my best. Growing up, my parents constantly told my siblings and me, “You better always surround yourself with people who are better than you.” When you hang around people who are smarter, kinder, and more optimistic than you, all you can do is better yourself. I feel that during the 5 day trip to Antigua I was around some of the most passionate and skilled people I have ever come across. Dr. Berkowitz, Professor D, Lauren, Clarence, and Tom are full of energy and brains. I was honored to even be grouped with such a crew. They really did bring out the best in me; I was so eager to learn, to make people smile, and to try my best to keep up with them. The first few days of the trip consisted of meeting new people, acquiring knowledge of Antiguan culture and traditions, and developing interdisciplinary skills between speech language pathology and occupational therapy. It was the third day of the trip that meant the most to me.

On day three in Antigua, our entire crew went to the NSA Medical and Surgical Rehab Centre in St. John’s. The setting from the outside appeared run-down and tiny, but as soon as we stepped foot inside we noticed the professionalism of the facility. It was clean, filled with up-to-date medical equipment, and with a friendly staff. Dr. Berkowitz, Lauren, and I had the opportunity to work with two clients who were referred to receive speech therapy services (there are currently no working speech language pathologists on the island, so the staff at NSA seemed very open to the idea of having us there for the day). The first client we speechies saw was a woman with an unknown diagnosis. I don’t want to get into too much detail (because I honestly don’t even know the true details) but basically, she showed signs of having a cerebellar stroke, though there was no evidence to support the claim. Doctors from New York and Antigua did not know what exactly happened to the client, all they knew was that she lost the ability to walk and partake in activities of daily living independently. Her speech was unintelligible to most, and she struggled with every syllable she spoke. Her voice was hoarse, incredibly choppy, and the muscles in her neck were tense. It appeared as if it was physically painful for her as she pushed with all she had to let out every sound and syllable in a word. Dr. Berkowitz brilliantly evaluated and eventually treated the client as best as she could, given we were not equipped with any formal tests or therapy materials (aside from a tongue depressor).

At one point during the session, Dr. Berkowitz asked the client if she liked to sing, and if she had a favorite song. After the client replied with, “Jesus loves me,” (which sounded like /dʒi/ /zʌ/ /lʌ/ /mi/, for those IPA lovers out there like myself) we smiled and asked her if she and her husband would sing it for us. The client soon belted the song as she looked up in her wheelchair at her husband and then at the ceiling. “Jesus loves me, this I know. Jesus loves me, the Bible told me so!” came out of her mouth almost effortlessly, and boy was it loud. I have never in my life been a part of something that powerful and eye-opening. Goosebumps covered my arms, and I sensed the huge lump in my throat that comes moments before a good cry. What I felt in that moment is exactly why I chose to become a speech language pathologist. My heart was so full. Helping people find their voice and communicate effectively is what I want to do for the rest of my life, whether they are singing a song or doing something a bit more functional. I cannot thank Mercy and Dr. Berkowitz enough for giving me that moving moment in the rehab center. At the end of the session, the client thanked Dr. Berkowitz several times, and asked if she could come back to New York with us. That entire day was a true eye-opener and I know for a fact I will never forget it.

The remainder of the day in the rehabilitation center was remarkable too, for I got to see first-hand what it is to be an occupational therapist (OT). If it were not for that day, I feel as if I would never truly understand the meaning of occupational therapy (unless I worked in a setting down the line where physical and occupational therapists work directly with speech pathologists). I have such a deep appreciation for OTs and OTAs after seeing the services they provide for individuals who need assistance in more functional aspects of daily life.

I will use everything I learned from our trip and apply every bit of it in my future, not only clinically, but every day. Stay humble, be grateful, show empathy, and always make an effort to help those who need it….even if all they need to see that day is merely a smile!


-Julianna Bastone



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Antigua, Eastern Caribbean

Shari Berkowitz says:  Under the leadership of Cristina Dumitrescu, from the Occupational Therapy Assistant program, we traveled to the beautiful island of Antigua during Spring Break.  The students’ travel was funded by the Mercy College Faculty Senate micro-grant for student engagement.  What follows is a collection of blog posts, written by the two undergraduate students in Communication Disorders.  First, we have student Lauren Kennish:

An Experience of a Lifetime

Experiences and the perception of those experiences, shape who you are, and who you may someday be. Thanks to the Mercy College’s Communication Disorders Program, I have had the most unbelievable month of my life; by far the best educational experiences yet.  I cannot thank God enough for my decision to go back to school. From holding a human heart, in cadaver lab, to watching a 3D heart being printed, and having the opportunity to participate in research abroad, I have gained an abundance of knowledge. I will not bore you with all the mushy details of my personal journey, but I will tell you a little more about one of these educational experiences. Specifically, the opportunity I was given to take part in research on the island of Antigua. This was one of those experiences that stays with a person for the rest of her life.

It was toward the end of February, when I received an email with the subject, “Act fast: Alternative Spring Break to Antigua with Dr. B.” Through the Mercy College Faculty Microgrant, my professor and two undergraduate students would be conducting research on the island of Antigua. As I read the email, I remember thinking, how many students would be applying for this opportunity. I filled out the application questions and emailed it in; I knew my chances of being chosen were probably not too high, but I had to try. As you could imagine, I was beyond overjoyed when I received an email, only days later, that I was chosen. I am not too sure how the selection process worked, but I am still, to this day, thankful! Words cannot truly describe the feelings I had when I read that email. I was flooded with excitement, joy, fear and ever emotion in between; I actually cried. Mid-tear I began researching the internet for everything I could find out about Antigua and its natives.

A few days later my professor, Dr. B, a classmate, and I, met to discuss the importance of this trip. We discussed the facilities we would be visiting and the types of research we would be conducting. The next few weeks were filled with prep-work and research on the facilities. The three of us were in constant communication regarding the trip and the 5th Annual Westchester Undergraduate Conference, which my classmate and I would be presenting our research findings at. Our goals were set, passports were in, and the trip was only one week away. I studied so hard for mid-terms and could not help, but have Antigua on my mind. I could not wait!

The nervousness really set in on Easter Sunday, the day before our departure. I remember saying prayers in church for our safety and the ability to make a difference in the lives of the individuals we would be visiting. Although, I did all my research and knew what was expected of me, I could not help, but worry that I would not be good enough. It was not until I sat at the terminal, and met the group, that I finally started breathing again. The Mercy College group consisted of my professor, a doctor of Speech-Language Pathology (SLP), my classmate, Professor D, who is an Occupational Therapist (OT), and two of her Occupational Therapy students. I could tell right away we were all going to get along great and do amazing things together.

Antigua caught my eye the moment we flew over it, since I was lucky enough to have the window seat, on the plane. The smell of fresh air and a warm breeze welcomed us on the island. Dr. M, of the American University of Antigua (AUA) was there to greet us and make sure our accommodations had been set. It was Mercy College’s affiliation with AUA and Dr. M, that helped establish this trip. The facilities we were to visit included: AUA, the NSA Medical, Surgical and Rehab Center, and The Care Project. We settled in, had some time to get to know each other, and it was time to get to work.

The American University of Antigua was not only beautiful, but well equipped for the field of medicine. Dr. M, an administrator and professor at AUA, gave us a tour of the facility. We were able to see the multipurpose-laboratories, a class/lecture in progress and a simulation skills-lab. AUA had a variety of interesting tool such as: realistic Manikin parts and a patient simulator; Dr. M explained that the patient simulators, could be programmed to having specific conditions, and was life-like in making noises and expressing pain. If ever I wanted to be a doctor it was during the tour of that amazing campus.

We were lucky enough to get to spend a day at the NSA Medical, Surgical and Rehab Center. The OT group spent most of their time in Antigua, at this facility. Once I walked into the building a clean smell filled my nose, and I immediately noticed the lobby was full of inviting colors. I could not help but notice and comment about the paintings throughout the hallways. The atmosphere was so friendly and the staff full of energy. I loved this facility; there were surgical rooms, offices for patient counseling/therapy and a large rehab section, filled with gym and therapy equipment. There was jazz music playing in the background throughout the workday. The facility serviced stroke patients who needed multiple forms of care; the patient’s symptoms and severity of symptoms ranged from physical to communicative disabilities. The work administered by Professor D, the OT was so informative. As she applied physical care to her patients, my classmate and I were able to observe and document her teachings. We were also able to witness her students work with patients. Dr. B, the SLP, gave insight on how OT and specific therapies conducted on an individual, we had been working with, benefited the patients use of speech-associated body parts. Dr. B was exceptional in her assessments, evaluations and treatments. I had personally never had experience with stroke patients prior to this trip. Dr. B’s work with two specific patients was not only educational and informative, but enlightening. I had always had my heart set on working with children, but this day was the first time I felt a pull toward working with adults. Since this trip I have set out to observe and expose myself to more adult therapies. This day was one of my favorites in Antigua because of the exposure to both professions working together with patients. I would definitely love to work in multidisciplinary settings, in the future; team work is crucial!

The Care Project was our first and last destination; what a place. It was a single story building located on the grounds of what once was the island’s main hospital. Besides the Hospice, which was available to all elderly natives, The Care Project, was the only other occupied building on the abandoned grounds. The building had been a pediatric ward, and was still structured as such. This was a place for individuals with disabilities. The facility was geared toward children, since most of its occupants were young. The staff serviced both residential and day-patients, whose disabilities and impairments ranged in type and severity. Some of the types of disabilities included: Hydrocephalus, Autism Spectrum Disorder, and Cerebral Palsy. Communications impairments ranged from completely non-verbal to limited verbal intelligibility. There is funding provided to The Care Project through an organization known as, “Friend of the Care Project.” Money is raised in multiple ways to provide the children of The Care Project with functional toys, books, therapy enhancing tools, as well as activities; such as: painting, sensory play materials, and more. There is a room within the ward-structured building for “class-time.” Although the entire building is clean and full of beds and patients, it felt like a hospital; whereas this room did not. Once I stepped into the classroom, it was like a different world. It was full of colors, educational material, children’s artwork from previous class sessions, and a circle-time area, with mats and pillows. Child centered facilities are second nature for me and I would consider returning. To see the volunteers and staff work together to make the lives of these disabled children better and more enjoyable, was something I will never forget. To witness the smiling faces and take part in daily activities with these children, was beneficial to my studies and my life.

Throughout our time in Antigua, extensive observations, individual needs assessments, and semi-structures interviews were conducted, for qualitative data collection. The staff and volunteers were welcoming, kind and grateful for our presence, in both facilities. More collaboration is definitely needed in the area of Speech-Language Pathology, Occupational Therapy, and other therapeutic fields; especially at The Care Project. Hopefully Mercy College is given future opportunities to make a difference at this facility. If so I would definitely love and appreciate being a part of that work. This was truly an experience of a lifetime!


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It is my duty and pleasure, Madam.

As a group, we have worked in many hospitals, in many countries.  We always receive a warm welcome, but sometimes there are underlying struggles to deal with the minutia of the locale.  A hospital administrator might insist on last minute hoops to jump through, or local staff might be promised to be available but they actually are not…lots of hurdles to face, problems to address, knock ’em down one by one and go forward.

Not at Sancheti Hospital.  From the elevator operator to Drs. Sancheti (senior and junior), everyone was ready, willing and able to make it work for the sake of the children.  The residents, the nurses, the guy who brings the tea…we were treated with the utmost care.  I could get used to that!  I think we all could!

When saying goodbye to a volunteer from the BJS, I thanked him for all his hard work.  He replied, “It is my duty and pleasure to serve you, Madam.” Well!  Who can argue with that!  The BJS is doing wonderful work, especially with orphans of farmer suicides and empowerment of girls.  I’m honored that they were on board for this mission and hope to work with them going forward.  Some of the orphans need speech therapy…we will see where life takes us…”Shari Doctor” and “Helen Doctor” have a lot to think about.

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