I am Hispanic, born in Puerto Rico.  My family were farmers originally from the Canary Islands (San Miguel de Abona in Tenerife, Spain). In this regard I enjoy visiting Hispanic countries, sightseeing,and going to local restaurants.  I recently had the opportunity to visit Cali, Colombia and participate in a congress whose theme was health related disabilities primarily as they affect children. I received an invitation to attend from my friend Dr. Hernan Pimienta who is the chairperson of the Department of Physiology and past Vice Dean of the School of Health. The congress took effect over two days but had some pre- and post-celebrations. Contrary to other congresses that I have attended the one in Cali had a large number of activities performed by children with, what I could judge to be, cerebral palsy, Down syndrome, autism and other neurological problems.

Figure: Hernan Pimienta in his office. Dr. Pimienta recently received a lifetime achievement award for his contributions to teaching and research in the neurosciences.

Colombia is a very large country with three mountain chains dividing the land into different sectors. Travel over long distances is curtailed by the mountainous terrain. Getting assistance at tertiary hospitals may be problematic given the topography. Also, there is very little governmental support for treating children with disabilities.  As a matter of fact some of the laws of the country make you doubt whether there is a sincere effort by the government to help the needy children.  In one case, for example, the government will provide a translator to a school if the same has ten deaf children. Given the fact that these deaf children will be distributed across different grade levels, the individual support a single translator can provide to each student is limited or nonexistent. Many parents thus complain that the health services in Colombia have not changed for the past 3 decades. To compound problems, public knowledge and education in regards to health disabilities in children is limited.

Some of my Colombian friends that were educated in the US offer a somber comparison of resources among the two countries.  In the Unites States educational resources are not optimal, but at least they are present. In Colombia they are non-existent. Many of the efforts to improve the quality of life of children with disabilities therefore stems from parents themselves rather than the government.

Before going to Colombia I remember having a meeting with other members of the faculty at the University of Louisville where someone cited the low incidence of gainful among our adult autistic individuals. This is striking. Despite a major difference in government resources among countries (Colombia and the United States) the number of of both adults and children employed in Cali, Colombia was very high. Several programs that were presented at the congress I attended, employ children from early ages to perform in musical activities. One of them had over 200 children involved in performing arts with its main troupe having traveled all over the world giving exhibitions. I was amazed by one of these children who although exhibiting the contortions of severe cerebral palsy was playing the bongos and never skipped a beat. Another young lady with Down syndrome took center stage and amazed the audience with her charm and grace while performing typical dances from Colombia. All of the participating children were smiling, enjoying themselves during the presentation, and deeply proud of their achievements. Least to say that everybody in the audience was deeply touched.

A number of people explained their music methods for teaching handicapped children. Even when primitive (meaning using friendly pictures to illustrate musical notes on a sheet of paper) they all seemed to work. As long as you have patience, employ age and severity dependent methods, and deeply care about the children your efforts at teaching them seem to always be rewarded An added bonus is that benefits obtained by children participating in the musical recitals translated into education gains at their schools.

I remember a few years back Dr. Geraldine Dawson was explaining an early intervention model for autistic individuals (The Early Start Denver Model).  The educational program was  set in a fairly thick book format.  While Dr. Dawson explained the model, I waited to learn something innovative, something that would change the approach to teaching. This never happened.  Instead, I only heard guidelines that could have been supplanted with common sense and the use of tender loving care.  I soon recognized that without any exposition to the system my own daughter was using the same principles in raising our autistic grandson.

I do not believe that people, especially children, change with geographical boundaries. The examples of parent organizations for children with disabilities from Cali, should certainly promote similar efforts around the world.  Most of the approaches need only to be applied with common sense. Having specialized team members like occupational therapists or speech pathologist is certainly a bonus but their absence is not a hindrance towards establishing useful interventions for children in need.

Addendum 10/31/13: Some photographs of the events: