Rehabilitation for 50 Children with Disabilities

Welcome again! Thank you very much for your continuous support to Patan CBR Organization which ultimately helped in serving the needy community of Nepal. Till dte you gave us US $ 18,441 and received 190 donations.We praise you for supporting Patan CBR in the mission of rehabilitating Children with Disabilities. A small act of kindness from you has changed the lives of these children.

This time I am going to report about the training program conducted by Patan CBR.The "7 days basic physiotherapy training for parents and caregivers of Children with multiple Disabilities" was organized by Patan CBR with financial assistance of Lalitpur Metropolitan City and Interpedia from April 5 to April 11, 2018.The total number of participants were 25 who were parents and caregivers of Children with Disabilities (CWD), both physical and intellectual.

The content for the first day of training was basic human anatomy and physiology.On the second day, discussion was on common musculoskeletal problems, importance of good posture and home remedies for managing  musculoskeletal problems. Same day, next session was on introduction of cerebral palsy, types of cerebral palsy and its management.

The content delivered on third day was introduction to different types of disability as categorized by Government of Nepal. Also their management was discussed in short. Next sessions was on different types of assistive aids like orthosis, prosthesis, mobility aids. They were also introduced to bones, muscles and joints of human body.

The session for the fourth day was on different activities done in occupational therapy and physiotherapy; different types of therapeutic exercises used in physiotherapy.

The fifth day of the training was on the ways to help parents and caregivers of children with cerebral palsy in daily taking care of their children.The practice session was on how to give physiotherapy to children with disabilities at home.

The sixth day session was on caring of children with intellectual disabilities. Next session was on speech impairment and its management; psycho-social counselling.

The last day of the training was on community based rehabilitation of children with multiple disabilities.

The trainers were mostly physiotherapists and others were working as special education teachers for children with disabilities as well as social mobilisers for many years. One of the participant said "The classes were conducted in simple local language and we got opportunity to have hands on experience through practical classes. So it was effective learning".

Another participant said "Although the training was of short duration we got to learn very important things. This knowledge will help parents and caregivers like me in daily caregiving of children as well as giving basic physiotherapy". One other participant said "After taking this training I am confident that now I can identify the type of disability  and refer to appropriate health centre. Now I can also counsel other parents and guide them in giving basic physiotherapy”.

Sharmila Shrestha, the course coordinator for the training said "We have lots of children with Down's syndrome, Cerebral palsy and Autism, Intellectual disability at the centre for whom we provide different services along with physiotherapy. But, providing professional care i.e. through expert to each child in the community is nearly impossible. By organizing trainings like these, we can impart the professional knowledge to the parents and caregivers of children. This will ultimately lead to better care for CWD and parents/ caregivers become more responsible. We have plans to organize similar trainings to more people in community in coming days".

Speaking on the closing program,  the director of Patan CBR said "We have been able to continue this type of program at Patan CBR due to support from Global giving. As the part of this program, we are doing many activities. One activity is this training which was done in coordination with local government of Nepal and Finland".

Greetings from Nepal! We raised US $ 17,847 till now. Thank you so much for your donations and good wishes. We have been able to continue our services only because of you. Thank you for bringing positive changes in the lives of children with disabilities in Nepal. 

This time I am reporting about a child, Mahesh (name changed). Mahesh lives with his parents, a sister and a brother. His mother does tailoring work and his father is a sculpture. Mahesh has been visiting Patan CBR since 16 years but it is very difficult for him to come regularly without an escort.

Mahesh is getting physiotherapy services along with education at Patan CBR. He speaks basic English, Nepali and Newari languages. He has dysarthria (difficult or unclear articulation of speech that is otherwise linguistically normal).He is independent with toileting and eating; can get dressed by himself basically except  buttoning and tying shoe laces.

History of the child

The mother suffered from typhoid at 2nd month of pregnancy. He was born full term by forceps delivery. Doctors had indicated possible abnormality at the time of birth. He had stiff muscles and was slow to start sitting and standing. As an infant he was unable to speak and dependent for activities of daily living. He has ataxic cerebral palsy (Ataxia is a lack of muscle coordination which may affect speech, eye movements, the ability to swallow, walking, picking up objects and other voluntary movements. A person with persistent ataxia may have damage in the part of the brain that controls muscle coordination - the cerebellum). He also has intellectual disability and speech impairment.

Effects after intervention

After regular physiotherapy for so many years, he has improved significantly.

Mobility:  Mobility is independent but at times very unsteady. Before he used to have lot of falls when he started to walk. Now he is able to walk longer distances. But still he needs to be escorted to prevent any accident. There is hyper tonicity (fluctuating type) in left side more than the right side.

Balance:  As in ataxic C.P the children mostly have problem with balance and co-ordination. He had problems in static and dynamic balance before. After regular physiotherapy, balance in standing has improved a lot. Now, he is able to stand on one foot, feet together and maintain balance in dynamic settings.

Upper limb function: Hand eye coordination has improved a lot. He can do his activities of daily living and can help the mother in domestic chores by doing simple tasks. He is able to write with right hand.

Speech: Because of dysarthria, he had difficulty in speaking and he tend to use gesture more than verbal communication. Now he is able to speak more clearly.

Education: Now he is able to read and write simple words and can do basic calculations. Patan CBR tried a lot to admit him in normal school but the school denied admission due to his physical and intellectual disability. He participates in drawing competition and indoor sports like boaccia.

Mahesh's mother says, "There has been a lot of improvement in my son after attending Patan CBR regularly. My son is nearly independent in his activities of daily living and also tries to help me with simple house chores like making tea, giving water to plants, sweeping etc. He is very eager to learn and regularly does homework given by his siblings. Without the physiotherapy and education provided by Patan CBR, I can't imagine my child being what he is today. "

The Physiotherapist at Patan CBR says," He is a very motivated and active child. He is very serious about doing regular exercises. He daily exercises in home for 1 hour on self. When children are motivated and active, they improve surely."

Mahesh's father says," He had delayed development and did not walk till 6 years of age. After receiving daily physiotherapy at center and practicing it at home, now he is able to walk and do his Activities of Daily Living. It would not have been easy to raise him if we did not have all the support from Patan CBR."