Humanitarian effort provides early intervention

By Jason Mosheim

Nestled between Romania and Ukraine lies the world's other boot-shaped country, Moldova. Independent since the fall of the Soviet Union in 1991, the country has a 99.1 percent literacy rate and a sizable agricultural industry, yet it remains the poorest nation in Europe.¹

The health care system in the republic of Moldova is considered a Health Care System in Transition (HiT) by the European Observatory on Health Care Systems. The observancy collects and analyzes data to compose profiles of HiTs to "support policy-makers and analysts in the development of health care systems in Europe."²

The health care in this country of 4 million is "not as structured as it is here," said Lauren Zimet, MS, CCC-SLP, who recently traveled to its capital, Chisüinaùu, on a humanitarian mission to help children with speech, language, feeding and swallowing problems. The mission was funded by the not-for-profit Jewish Healthcare International (JHI).

The U.S. health care team that took part in the week-long program included Zimet, founder of Early Insights LLC, and Susan Orloff, OTR/L, director of Children's Special Services LLC, both of Atlanta, GA, and physical therapist Miri Ratson and psychologist Inbar Kremer, both of Israel. The team had three translators, two medical doctors and one who also served as the JHI coordinator.

The team members met with Michael Kirby, U.S. ambassador to Moldova, and visited Pro Familia, one of the two early intervention centers in the country. Kirby expressed his desire to improve health care in the country. Hopefully, other health care missions will come to fruition with his assistance, Zimet told ADVANCE.

The team performed collaborative consultations at Pro Familia.

"I was impressed," said Zimet, who is certified in neurodevelopmental treatment (NDT). "It was a cohesive effort of international professionals coming together to share their knowledge. As the number of world health care missions increases, there will be more messengers to deliver updated information and protocols."

Through the early intervention centers, some children are being identified early and getting the help they need from clinicians.

"It appears that health care in Moldova is taking a turn for the better," she said. "JHI is there several times a year, so they're definitely getting inservices and information."

Another important member of the U.S. mission team was Zimet's 7-year-old daughter Brooke, who served as a peermentor and assisted in presentations given by her mother. Zimet demonstrated oral-motor exercises and positioning techniques to attending medical doctors, nurses, social workers and psychologists.

Brooke also assisted the other therapists during one-on-one consultations.

"She demonstrated sign language, which was easy for her since she's been signing from infancy," said Zimet.

The mission was based on a week-long camp for children with special needs and their siblings. The team members provided individual consultations for the children. While the diversity of their needs was quite vast, one thing that was consistent was the families' attitudes toward getting help for their children.

"[They] were so caring and patient waiting for their consultation," Zimet recalled. "I found the complete nuclear family so interested and appreciative of information."

Children, parents and grandparents all attended the sessions. Like their U.S. counterparts, Moldovan caregivers "share the same strong desire to help their children," she said.

For many of the children, the therapy services they received at the camp were the first they ever received.

"There were a few breakthrough moments, which were very touching," Zimet said.

A few stood out from the others, including a child who was blind and deaf. The child drank from a straw for the first time.

Zimet did not know what to expect when she gave a PowerPoint™ presentation to Moldovan health care professionals. It's one thing to present in front of your colleagues in the states, she observed; presenting a demonstration with a translator in another country is a different story altogether.

"I definitely went in with uncertainties on how it would go, but as it turned out we received audience feedback even across language barriers," she said. "It was a positive sign when, in a very hot, small crowded room one afternoon, the clinicians chose to stay and continue the rest of the program even when they were given the option to leave."

One group gave the U.S. mission team a standing ovation, and several of the presentations went beyond their time slots because there were so many questions.

And just like in America, one of the most popular topics was autism. "We discussed treatment protocols and briefly touched on alternative therapies," said Zimet.

Though thousands of miles away from Moldova now, she hopes to continue helping.

"They have a need for information, therapy tools, materials and supplies," she said. "The U.S. mission team will meet soon to determine how we can best continue our support of this important cause."

Would she go on another mission? It's a possibility, she said.

"I asked my daughter, and she said 'maybe,'" Zimet recalled. "As we landed in Atlanta, I felt a deep sense of patriotism. To put everything in perspective, our health care system in the United States is not perfect, but the freedom of choice that we have is priceless."

References

1. Central Intelligence Agency. (2007). The World Factbook. Accessed via www.cia.gov.

2. MacLehose, L. (2002). Health care systems in transition: Republic of Moldova, 4 (5). Copenhagen: European Observatory on Health Care Systems. Accessed via www.euro.who.int/document/e81265.pdf.

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