Working life in St Lucia

This blog is about my new job here on St Lucia. It is for my SALT friends and those of you who are interested in what I do in my working life. I am lucky in my choice of career in so many ways. There is always a need for a SALT, so I have never been out of work! I still find language and human communication fascinating and there is always more than enough to learn; I can safely say I have never been bored with therapy. It is the meetings, politics and corporate nonsense that have squashed the passion out of me at times, including in my recent job, but I never lost the love of working with children and families. It is now a real joy to return to what I love and I find it still rewards and excites me. After almost 18 months without my own caseload it is wonderful to be back.

The CDGC is part funded by the St Lucian Government and part funded by charitable donations. Families pay what they can towards the cost of the therapy they receive. It is a truly inter-disciplinary way of working, the only thing close I have known, is Sure Start, sadly now dismantled by the Conservatives…..but I won’t get political here. This is how early intervention should be delivered in all communities and countries, it would also be an amazing model for Anguilla and St Martin, which I still hope to be involved with in the future. CDGC is staffed by a Pediatrician, a Child Psychologist, a Physiotherapist and a Therapy Assistant with volunteer Occupational Therapists and SALTs. I have just received my Allied Health Council of St Lucia License to practice and it appears that I am actually the first ever SALT registered with them! It is new for SALTs and previous volunteers were not registered. There is one other SALT on the Island who works privately and with adults, but I am currently the only one for young children, and, it seems, the only one registered. Once they go to school, there is no therapy, so I am their one chance of getting help for the next 6 months. I am very proud and my framed license hangs in reception in CDGC with those of my colleagues.

I have had some great orientation which included spending a morning in a local pre-school to listen to typically developing St Lucian children and to learn St Lucian English. There are many dialectal, grammatical and prosodic differences. For example, there is no ‘th’ sound in St Lucian and vowels are, generally shorter, such as ear, being pronounced ‘eh’, like the ‘e’ in egg without the ‘g’. He and she are often used interchangeably, as are in & on, and auxiliary verbs are often not used as in ‘What dat?’ I am having to say ‘bol’ for my very English ‘ball’ (bawl) or the children can’t understand me. The intonation patterns are different too and I am trying to adapt how I say things or I am not understood. I haven’t got to learning any Patois yet but I have heard it a lot, had some of it explained and have read an interesting article on its structure and origins.

Children are assessed initially by an appointment with the Pediatrician, Kim, and either Aritha, Child Psych, or Elaine, Physio. They then agree which therapy interventions are needed and make a plan together with parents, which can also include a group, often interdisciplinary, or integrated interventions with Colletta, Therapy Assistant. There is one case history, one set of notes that everyone writes in, one location for parents to access all support. The approach is very focused on involving parents and developing their skills to support and develop their own children’s skills. The Centre is brilliantly supported by Marla and Leon (Leonorra) admin support and the whole team are caring, intelligent and fun. I have been made very welcome and already have a CDGC polo shirt and get included in all the many treats that get shared, such as sticky fried coconut, star fruit fresh from the tree, bakes (like non sugary donuts) to name a few. The reception and waiting area has a mesmerising wall painting that sets a calming tone.

We each have our own air conditioned and well equipped therapy room with small table and chairs and floor mats and a strict ‘shoes off’ policy.

I have 5 one hour therapy appointments a day, on a Monday just 3 in the morning and each Monday afternoon there is a team meeting to discuss all the cases seen in the previous week so that there can be a clinical discussion and so that everyone knows what is being done with children they are also involved with. It all works brilliantly. On a Thursday, we drive to Vieux Fort, in the south near the airport. There is, very bizarrely, a hospital in an old stadium that was built for the Island Games in the year dot……well at least 30 or even 40 years ago. It looks as if it is falling apart and yet a full hospital is within its structure, the old stadium seats and track still intact on the inside. It is all a little surreal. We hold a clinic in the Eye Department, in a dark couple of rooms with bright fluorescent lights and plastic patio chairs and a curtain between where I work and where Kim and Aritha work……see below. The loos are also antiquated and not in a state fit for a hospital. I am not sure it is entirely coincidental that I have had today off work with an attack of St Lucian belly (my colloquialism), but that’s too much information. It is a good job I don’t suffer from epilepsy or migraines as the light bulb in my bit was flickering all day 😦

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Thursdays start early with an 90 minute drive across the Island to Vieux Fort. It is an interesting and beautiful drive through the heart of the Island, over mountains, past banana plantations, bamboo as big as telegraph poles and enormous tree ferns, through the central rain forest. I now know that the garden of Eden was not in Africa, it was on St Lucia. Everywhere you look, you see more fruit than you can eat in a month, mangoes, guava, papaya, bread fruit, bananas, avocados, tamarind, coconut, plantains, cashews, sugar cane and many I have been told but have never hear of before. Who ever knew cashew nuts grew so bizarrely and beautifully? We had a snack of plantain chips and tamarind balls, a confectionery that is raw tamarind paste rolled in sugar but as sour as 10 lemons in a concentrated mass. Not quite to my taste, which may also not have helped with this morning’s condition. The journey back always includes a stop at a roadside store to buy fresh bread, baked in a wood fired clay oven, delicious….note one slightly nibbled fresh and warm on the way back! I got 3, an akra (local doughy fish cake) and some fresh tamarind juice with ice (much tastier than the balls) for 8 EC about £2.50. I also shared half a guava with Aritha that she picked from the tree we parked under. I am going to enjoy Thursdays, despite the few minor downsides.

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I am going to finish this blog with a few thoughts about friendship and how truly precious my friends are to me, all of you, and I include my family and Anthony’s too. I have been luck to have John and Rachel here for the beginning of my time in St Lucia. It is a sort of coincidence (or are there such things) that they booked their holiday here just when I arrive, but it has been truly special to spend so much time with them, and sassy, beautiful, inside and out, Madeline, and bright, witty and adorable, Guy. John and I have known each other for more than 40 years, yes, we are both old enough!! We have been through a lot, shared a lot as friends and in our separate lives, but have always stayed in touch. I count John as one of my dearest friends and it is so true, that your best friends are the ones that you can go months or even years without seeing and then when you get together, it is so easy and as if you had only been together last week. Well, we have spent more time together in St Lucia than we have in the last 10 years and it has been great. It has also been brilliant to properly spend time with Rachel, to get to know her better, and have fun with her. We have found that in many ways we are quite like minded and she is gem of a human being! We have had many laughs, some dances and some deep discussions which we all enjoy. I am going to miss them, but it has been special. It is wonderful to see them so happy together and as a family, so a few pics of the memories we made.

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