Without sufficient funding and a more coherent approach, the future of children with special needs is bleak according to Speech-Language Pathologist (SLP) and Audiologist and founder of Ambrose Academy, Kutlwelo Mariri.
She was one of the eighteen young leaders from Botswana who flew out to the US recently to participate in the Mandela Washington Fellowship, the flagship programme of the Young African Leaders Initiative (YALI). Here she discusses her experience and what she has learnt through the programme.
Why did you apply for Mandela Washington Fellowship (MWF) Program 2018?
As a person you need professional and development growth so this was opportunity for me to go and appreciate how far I have contributed with the field of Speech-Language Pathology and Audiology in my country, to learn about the business acumen of making services sustainable and to see what’s next. So since I heard how rich the Business and Entrepreneur track was I believed I should apply and I really got more than what I ever bargained for. It was an experience I wouldn’t trade for anything.
What does it takes to be Mandela Washington Fellow?
It takes a person who has the willingness to change the status quo as well as to care about improving the lives of people. In a nutshell you should be a visionary. I think for last year there was about 37 000 applications and total selection been 700 in Africa as a whole. We were only 18 from Botswana and I was privileged to be part of the Botswana MWF 2018.
What did it mean for you to be selected?
You know Rachel, God’s timing is always the best and we never understand it. I have been meaning to apply but our organisation was not ready for me to go away for 7 weeks so this time I applied and was selected this was perfect timing for me as well as our organisation. For example from the professional side of things we needed to re -evaluate our journey and reposition ourselves to continue being of value to the patients and to special needs children as well as introducing PREVENTION IS BETTER THAN CURE. One of our major concerns is that many children are delayed in speech and language, in fine and gross motor skills simply because of lack of stimulation if we do not attend to this, the number of special needs kids will continue to rise. So as Ambrose Academy we need to address this issue like yesterday otherwise we are sitting on a time bomb.
Where were you placed?
I was placed in a very intensive programme for 7 weeks in University of Austin, Texas under the programme of leadership headed by Professor John Dogget. From the very first day, he told us his intent was not to make us into himself, rather to make sure we graduate from the programme as people who will go and make a difference in our countries and make Africa what it needs to be. He has deep care for Africa and I feel like I owe it to him to make sure whatever I have learnt I better myself and my people. The course covered main areas of leadership, business, critical thinking, self care and this year’s Mandela Theme of Servant Leadership.
So how do the following areas apply in your profession;
Leadership-As you know the profession of Speech-Language Pathology and Audiology is relatively a new profession in our country we still have a long way to go. However what came from the MWF 2018 was that do it in phases, appreciate where you are, where you need to go and keep pivoting until you get at your destiny. Be willing to get advice and be eager to learn so that you keep up with latest trends in your field and NEVER compromising QUALITY.
Also care about humanity and the people you serve as much as acknowledging that some will NEVER be happy with your services no matter how much you try but make peace with that. This really resonated with me very well I always see possibilities with my adult patients and special needs children however one thing that used to hurt me is seeing a parent with buying power not affording their child that opportunity and always complaining about this and that no matter how much I tried.
Business Acumen-Please allow me to generalise in Botswana , there is perception that Health should be FREE even in private sector while its OKAY to pay it in South Africa for example and that has robbed us from having research institutes because research is expensive. In most cases I struggled so much with my patients wanting discount of everything which then makes it impossible to pay monthly expenditure like the rentals and salaries of the personnel. So I heard in all the 7 weeks that passion alone won’t pay bills every day. Prof Doggett made sure we get that. He summarised it like government, private sector even Non Government Organaisations need funds to run. So it doesn’t matter what for, whether for rehabilitation to improve, we need funds to make it first class like in other countries. So sustainability comes in here; if one can’t pay for running cost then they simply face closure.
Self care-Everyone who is in business will attest that as a founder or pioneer of any project you work non-stop with absolutely no time to smell the coffee. This really puts one at risk for cardio vascular diseases and burn out as all they do is work, work and work. However I have learnt to appreciate that one needs to take care of oneself before taking care of other people. All I have been doing is work, work and work. I used to love baking and for the past 7 years I never did it so at least now I have started to learn again, hehehe maybe this festive season I will bake for my family …..
Servant Leadership-I believe as Africans we have the custom for servant leadership it comes natural to us to care about each other even those in the community however we have diluted this if not lost it.
That is why we have concept such as Kgomo ya Mafisa or every child is yours …… Every child is yours really hit me home when my team and I saw the need to establish a trust that can raise awareness about special needs children or teach the public about rehabilitation it was a way of giving back…..there is so much stigma but the question what do we do about it? Do we advocate for these kids or we turn a blind eye we concluded that we needed to advocate so that whether in government, private sector or NGOs our people can be helped. But our many challenges are that there is no volunteerism anymore, we only care once it hits home and by that time there is nothing much you can do because now when you advocate you fear people will say Oh you are only doing it now because you are going through it even though I personally believe it’s never too late to start.
You touched on the general expectation by most people for free medical/specialist services and you raised valid points. But, what of special needs children coming from underprivileged backgrounds? Are we saying they are doomed because their parents can’t afford specialist services at Ambrose Academy for example?
Oh my God Rachel, this is one area that hurts me the most, it’s just that my hands are tied. You know we are very far from assisting these children. I always say if we the literate ones, with buying power and with so much exposure; we don’t see the value of investing in our children ‘s rehabilitation services or prevention is better than cure programmes what is the possibility of having these services extended to those in deep rural areas? Because once we get it then we will extend it to them and fundraise for them? Until then I don’t know what will happen, we need brave people to stand up and help this situation especially policy makers.
Why can’t you at Ambrose Academy for example extend these services to these children especially that I always hear parents particularly those with autistic children talk about the great improvements they notice in the children once they start at school?
Well we have always asked to be subsidised and the answer we get is that it’s not in the government policy. However NORMAL developing children can be sponsored in private institutions and that’s OKAY BUT FOR CHILDREN WITH SPECIAL NEEDS WE would rather give them P300 MONTHLY. I mean if we don’t do anything now can we ever sponsor them in universities while they are not rehabilitated? No ways. I have asked government since it used to sponsor these children in South Africa, why can’t the sponsorship be extended to services like ours? All the international visitors are saying why government is not assisting your efforts? Who is government Rachel? It’s the people working in government. What they do is to find 100 reasons why they can’t sponsor children in our school even though they can see with their own eyes how we have improved the lives of these children.
The only thing to do I guess is to continue advocating for all these children until Policy Makers hear us, and realise that only talking about how we want to improve special needs children lives it will NEVER happen unless we make it possible for them through enabling policies and implementation not just talk.
Share some of outstanding moments of your time in the US
One of the aha!moments I had was during an assignment I had to write my obituary and read it to the audience. It was so intense and very emotional to a point where Prof John kept saying remember guys you are not dead but we couldn’t help crying because it included how you have empowered your family and how your people will remember you by the sacrifice you made for your country. Did you assist your patients and the children in Ambrose Academy simply because it’s the right thing to do or you sabotaged people you were serving? One thing I really wish for my country is for us to create opportunities for others, I normally say if you go to most organisations for assistance the norm in Botswana is that they will tell you 100 things why it can’t work instead of 100 ways to make it work. However in USA they are willing to solve problems for the benefit of others. Imagine if we had that attitude in Botswana.
The whole experience was eye opening and I will like to encourage all young people to apply for it so that they can go and learn from those who are ahead of us. We need to see the possibilities so that our dream for our country becomes even more brighter and we can indeed tell our African stories instead of others telling them for us.
Is there anything we can learn from the healthcare system of the US?
Health is expensive! I think this is the first step we need to appreciate in Botswana, running away from this breaks my heart. Investing in experts, resources and research is costly; do we have health research units? That’s the only way we can improve our health system. We do not need to re-invent the wheel it’s already invented by those who are ahead of us. All we need to do is work towards that. Nowadays when people are hospitalised I hear them saying I know I am going to die, hospitals should save lives not become places of NO HOPE. We need to change that.
What does the future hold for you personally and Ambrose Academy?
The future is exciting MWF2018 has increased my network where I can learn from others and continue to improve myself. I was kind of losing hope with all the efforts that I have tried but now I have been ignited. As Ambrose Academy we will continue to raise the bar and ensure we remain relevant to bring value to Ambrose Academy children, even all other children in this country. We will soldier on and leave no stone unturned until our voice is heard…… GIVE CHILDREN WITH SPECIAL NEEDS AN OPPORTUNITY THEY ALSO DESERVE TO HAVE A BRIGHT FUTURE THEY ARE NOT DOOMED …..
Forgiveness is a virtue
It’s hard to get through life without experiencing some resentment. Executive Director – Phronesis International College (PIC) and Counselling and Psychotherapist, Peacebuilding and Life Skills Education Specialist Dr Thelma Kgakgamatso Tlhaselo-Majela discusses forgiveness and why letting go is good for you.
Forgiveness is a process that positions one on a healing path by choice in an attempt to resolve the psychological stress and trauma one could be experiencing. These pains and emotional injuries may stagnate one into feelings of anger, bitterness and resentment and in worse cases depression, anxiety and post-traumatic stress disorders. If left for long, protracted unresolved psychological distress and or trauma could deepen one more into multiple losses.
It may generate hatred and desire to cause harm on the other and this can throw one into revenge and or vengeance. Forgiveness then starts from the cognitive ability to choose letting go of the emotional and cognitive baggage thus granting the self or inner being power to constructively open portals of intrapersonal empowerment. Moreover, a well-integrated process of forgiveness could shift one into an empathetic and compassionate psychological space filled with virtue and psycho-sociological attributes of restoration that accentuate positive benefits of healing.
In your experience,what are the common issues that need forgiveness?
Life by nature is riddled with so many issues and challenges characterised by diversity and complexity hence appropriate understanding is very important. People are social beings that co-exist through healthy connectedness and this may happen at the physical, personal, socio-cultural, psychological, financial, spiritual; political level to mention a few.
We all need a deepened awareness on how the intra-personal (within self), inter-personal (with others), inter-group (within groups) and international (nation to nation) relational connections play out in life. These healthy relationships deserve to be developed, nurtured and protected lest they become dysfunctional and corrosive.
The common issues for forgiveness are varied and highly individualised. One person may look at what another is struggling with and may consciously or unconsciously belittle it because for them it appears an easy or small matter but people are unique and this deserves respect. The relational betrayals, emotional injuries, corrosive conflicts and intractable may result in residual emotions that can cause people to drift into anger and bitterness. In such accounts, people may find themselves responding through avoidance or seeking revenge which has the potential to cycle one back into deeper pain.
The complexity of forgiveness may originate from the nature and quality of the relationship one had, the nature of the wrong committed with the cognitive interpretations one ascribes to the event. This includes significant others such as spouses (couples), children, family relatives, colleagues, bosses and subordinates in the work place.
Sometimes, it may be people we do not know that have hurt us such as a murderer, rapist or an abuser and may not even acknowledge that they have done anything wrong to us. It may also be about the symbolic losses where the people and or situations to forgive do not physically exist such as a dead person or a geographic disconnection. In such cases, the existential reality of the phenomenon remains true, real and alive in the psyche of the emotionally injured person and requires a healing process.
Is it possible to forgive when one is still angry and can you forgive someone who does not think they have done anything wrong?
Forgiveness is a process that one does by choice for oneself and not for the perpetrator because one understands that the pain and suffering one is experiencing has a direct injurious effect on one’s life. Similarly, revenge and vengeance which for long has been one of the rudimentary human responses can only promote increased pain as it stagnates one into more hurt and pain.
It often cycles one back into psychological trauma hence one needs to perceive value addition in engaging in forgiveness because it can be logically and rationally incomprehensible when one is caught up in this quagmire. A bitter-angry person may grapple with cognitive dissonance which is an internal struggle to understand why they have to release someone who according to them deserves a punishment or better still refuses to acknowledge that they have done anything wrong.
But irrespective of the reason, holding on to anger, bitterness and resentfulness within the inner self can only grant one false gratification that they are holding the perpetrator to ransom. Needless to say, we have no control on how the other person thinks and feels and we may actually be subjecting ourselves to increased injury and punishment from the very issue we are contending with.
Seeking professional help will assist one to work through the psychological defence mechanisms such as denial, repression, rationalisation, reaction formation, regression to mention a few that may promote dysfunctional tendencies in un/forgiveness processes. Notwithstanding, people need to be assisted with respect for human dignity within them and never be forced and or coerced into forgiveness when they are not ready to do so. Given that anger will consume the person already holding the pain and hurt whether it is perceived or real, working on forgiveness can be a desirable option to open the healing process.
Can you discuss the rewards or benefits of forgiveness?
As can be seen, it often pays to work through forgiveness hence the concept of working it out because people respond to pain and trauma differently. The rewards and benefits shared in this context are not by any means exhaustive because there are several psycho-social models for assisting people to process forgiveness issues and this requires well trained service providers.
*People who are angry and bitter are often not desirable in social contexts because they may consciously or unconsciously spill this negative energy on other people and this tends to repel instead of attract social connections. At intra-personal level, we are likely not to find our inner life peaceful and enjoyable if we are ever stuck psychosocially on anger and bitterness because it may promote self-hate, poor self-concept and negative self-esteem. So it pays to be gentle to love yourself enough to desire good emotions about and towards other people for that will rub corrosively on your personal well-being. The benefits of forgiveness include enabling one to circumvent these psychological pains and trauma that can affect quality of life with self and others which may compound stress levels.
In extreme cases people may sink into depression and anxiety which could ripple into other areas of life such as sexual dysfunction, eating disorders, substance use and abuse, relational conflicts and psychosomatic illness. Forgiveness builds a healthy mindset and that attracts a healthy personality which consequently leads to healthy social and physical well-being. Forgiveness fills the inner space with good attributes and this is shared with others. We then by addressing forgiveness issues reduce on maladaptive tendencies and lift on psychosocial protection thus leading to safeguarding the intra-personal, familial, corporate and societal communities from effects such as divorce and relational stressors.
At corporate and industrial level, a socio-psychological space that is riddled with un/forgiveness is a breeding ground for visible and invisible costs. For instance, a huge cost can emanate from a collective environment that is unproductive because of collective stress and restlessness. A workplace where people are transparent and honest and regard others with respect to deserve forgiveness often tends to promote healing communities where others feel safe and do not fear hence they can work to the optimum level of their potential.
We also benefit as a nation when we are characterised by forgiveness because we have a strategic desire to promote a knowledge-based community as the foundation for transformational change. Botswana considers people as a reservoir for knowledge and wisdom to lead as change agents and if we are a community that is unable to work through issues of forgiveness, we may create or nurture a psycho-sociological space that disempowers collective construct for healing communities.
A Motswana who is able to forgive is likely to live with people from other backgrounds and has a healthy and broader capacity of dealing with diversity and differences with virtue and competencies for the 21st century to advance the nation at local, regional and international level.
Rabiya Mahomed-McGeoff: Talking Marriage and Family Therapy
Increased mental health awareness is leading to demand for therapists to serve couples and families. Licensed Marriage and Family Therapist, Lead Clinician, Rabiya Mahomed-McGeoff talks to SunHealth about being one of the most important confidants a person or family can have.
What is a Marriage and family Therapist?
A Marriage and Family Therapist is a mental health professional trained in psychotherapy and family system, and licensed to diagnose and treat mental and emotional disorders within the context of marriage, couple and family system. A Marriage and Family Therapist treats a wide range of serious clinical problems including adult schizophrenia, depression, marital problems, anxiety, individual psychological problems and child parent problems.
How did you become a couple and family therapist?
When I did my undergraduate studies in Psychology, one of my professors was a Marriage and Family Therapist.
He introduced systems theories and they made sense to me. So I decided to pursue marriage and family therapy.I did my Bachelors in Psychology with a minor in Women Studies at University of Massachusetts. I did my Masters in Marriage and Family Therapy at Alliant International University in the US. After completing my Masters, I did clinical experience for two years, completing 3000 hours of direct client contact (which is a requirement in the State of California before one can seat for the licensing exams.)
I sat for the two exams and passed. I got licensed as Marriage and Family Therapist in California, USA.
What do you most enjoy about your work?
Giving clients hope, a voice, walking them through transitions and seasons in their lives and seeing them gain insight on their issues.
What is the most challenging thing about marriage and family counseling work?
The most challenging thing is when I work with teenagers where parents don’t want to get involved.
They just drop their children and expect me to fix their children. In most situations you find that parents are the ones with problems and are the ones who need therapy not the children.
What is the biggest myth about therapy?
That you only go to therapy when you have problems. That is not the case; therapy empowers and helps to facilitate personal growth in one’s life. For couples, therapy helps with tune in and awareness of issues before there is a problem.
It strengthens the family and the marriage bond. And also the assumption that therapy is free. I still get amazed by my educated friends who get shocked that therapy is a paid profession.
In general, what do specialists in this practice offer?
We offer couples therapy, individual therapy, child therapy, and group therapy on different issues; grieve therapy, premarital counseling, divorce mediation and recovery.
We consult for organisations on different issues including restructuring, retrenchment and workplace communication.
How do you stay detached from your counselling work? Is it even possible?
I have been practicing for more that 10 years now, throughout the years I have created some rituals that help me to transition from work to family life.
I have learned to set clear boundaries. At the end of my work day I put my phone on a silent mode for 30 minutes. I write down things that I have accomplished on that day and one thing that I am thankful for. I do basic breathing exercises. When I close my office door that’s the end of work – when I get in the car I listen to music until I get home.
What experiences are most useful for people becoming counsellors?
You need to be passionate, enjoy working with people and be willing to learn from your clients.
What seems to be the biggest obstacle for clients in therapy?
Not taking responsibility for the choices one has made over the years.
Mental health problems seem to be skyrocketing in our society lately? What are the reasons for this and what can be done about it?
I don’t think mental health issues are skyrocketing. Mental health issues have always been there. It is only that in our culture when we don’t understand something we find a way to label it. Mental health was often labeled as “botsenwa, mopakwane or boloi.”
There was a stigma for a person suffering mental health problem and their family. Often times they were ridiculed and treated as outcasts and shame to their families. Now people are beginning to be open about mental illness and it seems like it is skyrocketing because of the increased awareness.
We need to educate people more about mental health so that they can be aware and be sensitised on mental health issues.
That is a step to destigmatising mental health and learning the importance of early intervention, which can make a difference in one’s life.
If there is one thing you wished your clients or patients knew about treatment or mental illness, what would it be?
Mental health is a real illness. It’s not a character defect and it is okay to live with mental illness.
I have heard that after a couple has a child, which is notably one of the happiest times in anyone’s life that the satisfaction and overall happiness in the marriage can dramatically decrease. Is this true, and why is this? What can couples do to sustain their marital happiness after children?
Having a child is a transitional time in a couple’s life. The reason why it feels like a couple’s happiness has decreased is that the couple did not prepare for the transitional period and therefore they don’t know how to behave, or support each other with the introduction of this new person in their lives.
It is important for the couple to prepare for this period. This is another time in a couple’s life where couple’s therapy is necessary to help process and explore different ways of preparing for the anticipated additional member of the family.
The challenging thing in this transitional stage is that one partner takes a back seat while the other one is the driver of all things baby.
It is a normal transitional challenge and with preparation and awareness it can be handled better to ensure that the fire keeps burning.
What do you do to personally cope with stress in your life?
I pray, read, exercise, spend time with the people I love, balance family life and work life.
If you had your schooling and career choice to do all over again, would you choose the same professional path? If not, what would you do differently and why?
I will do it all over again. I feel honoured and humbled when people come to my office and choose to trust me with their inner fears. It often gives me joy to see them walking away with a smile.
As a therapist I make a difference in people’s lives.
What is the best advice you can offer to readers on leading a meaningful life?
Be true to who you are as a person.
FROM GRASS TO GRACE
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