Will Chan Chea walk again??

Recently, we met 25 year old Chan Chea, out in one of the villages in Kandal Province, not far from Takhmao. Chan Chea become unwell 4 years ago, when she was 21 years old, and since then, has not walked. From the history given, it seems she had encephalitis. It resulted in her muscles changing, becoming very weak and developing some spasticity. When we met Chan Chea, just 3 weeks ago, she was unable to stand on her own. She could hold herself up in parallel bars for a very short period of time, before the pain from standing on deformed feet got too much. Chan Chea showed promise. She had some power in her muscles, and it seemed that if we could help change the position of her feet, and give her a good base to stand on, then with strengthening, could we get her standing and walking again?? So with great casting handywork from physios Sokny and Hoeurn, we started the process of serial casting Chan Chea's feet, aiming to gradually gain a better position. It is highly likely that Chan Chea will also require surgery, which we try to have arranged as soon as possible after her feet are more mobile. Below you can see photos and videos of the procedure over the last couple of weeks. The casting was commenced on Thursday 8th July, with regular casts changes since. Today, July 28th, Chan Chea had her 4th lot of casts applied in the 3 weeks. Chan Chea was also shown strengthening activities to continue at home, and last week was encouraged to practice standing in her casts. Her feet were still not at a neutral position for standing, Sokny's handywork with 'flip flop' shoes to create wedges to place under the heels of the cast meant she could stand in her casts. This was fabulous progress. But today was the day where I really saw that Chan Chea might actually walk again. Today she was so brave. Before changing her casts, assisted by 2 of us, Chan Chea walked about 2 metres in her casts. The look on both Chan Chea's face, and her mother's was of complete joy, and almost shock, that she was actually doing it. Sokny then assisted Chan Chea back to sit down with her Mum, teaching her how to help her to walk safely. Chan Chea's aim is to be able to work and integrate into society. With her disability, she cannot work, and her mother can not work, as she has to look after her. So the family has 2 less incomes, a huge impact on the family. Can we help Chan Chea to achieve this aim? If today is anything to go by, then it's highly possible. She will, however, still require significant foot surgery to further correct the foot, but the casting has provided a great start and enabled her to start strengthening activities and assisted walking in her casts. With discussions underway with surgeons, the procedures will be determined and surgery will occur as soon as possible.




Watching on intently

Visit to do third lot of casts

Just prior to removing second casts,4 days later

http://www.youtube.com/watch?v=S-jymHW0a8I
click to view video introducing Chan Chea


Removing the casts

The third lot

Heel raise being made by Sokny, to allow Chan Chea
to practice standing (need to have a 90 degree angle with the ground)




STANDING!


Below are the pictures taken at the beginning of today's visit, 28th July. Prior to removing Chan Chea's 3rd lot of casts, we practiced walking with her. She required assistance, as her muscles are very weak and the casts are very heavy. Her balance also needs improvement, understandably. She did so well! Her mother has been shown activities to help Chan Chea continue on with at home, to improve her strength.








After the 3rd casts were removed, Sokny assesses her foot

Very helpful chickens out in the community :)

Getting a better position, 4th casts

(28th July)

Meet the Staff

Here at Rose Rehabilitation Cambodia, at Chey Chumneas Hospital, Takhmao, Cambodia, we have a small, but hard-working staff group. A Rose Charities Australia project in collaboration with Operation First Cambodia, the First-Rose Rehabilitation Centre is now well underway thanks to the efforts of all the staff. Dr Sarom is the primary surgeon with the programme, and the other pivotal staff members at present are our physiotherapist, Mr Leang Sokny, and Administrator, Mr Sarin Kanarith. Or Sokny and Rith. Sokny, our physiotherapist, has shown incredible initiative and drive since commencing his employment with us in early July. Sokny has a lot of experience working as a physiotherapist in Cambodia, and in 2008 completed the Advanced Certificate in Physiotherapy, an upskilling programme run by Singapore University, here in Phnom Penh. Sokny is showing all the qualities required to progress to becoming the primary physiotherapy trainer here at Rose Rehabilitation. Having observed him working with patients and children, I am so impressed with his level of clinical skills and almost even more importantly here in Cambodia, his genuine care for the children and patients, and his desire to help and do the best he can. His interaction with families and children is great. He is showing such promise, and I am excited to see how his skills grow and the ultimate benefit this will bring to the community.

Mr Srey Hoeurn, or Hoe, is a physiotherapist employed by Impact Cambodia, and is working with Rose Rehabilitation, and benefiting from Sokny's experience and skills. The aim is to progress the service to train more of the local hospital staff and increase the awareness and understanding of physiotherapy amongst both the community, and local hospital staff.

Rith has been with us for several months now, and is dedicated and hard-working, and keen to take on challenges. So smiley everyday, his skills are progressing considerably on the job as he tackles the financial and administrative management of a setting up a new local NGO (Rose Rehabilitation Cambodia), the product of Rose Charities Australia and Operation First Cambodia's relationship. Rith has completed a Bachelor of Agricultural Economics and Rural Development in 2009 in Phnom Penh, and is currently studying a Masters of Financial Management. Rith is also showing great promise for the organisation and I look forward to seeing his capabilities extend.


Rith (left), and Hoe

Sokny on the job with patients

Jumpstart June

After more than 3 years of planning and preparation, the month of June 2010 has seen incredibly rapid production and construction of facilities for the First-Rose Physical Rehabilitation Centre. With the full support from the local referral hospital, Chey Chumneas, and Ministry of Health, we have been provided with a vacant space onsite at the hospital on which to build the Centre and therapy 'playground'.

Suitably, this space is located at the back of the hospital's surgical department, which matches in well with the project aims to integrate services with the government hospital and provide a comprehensive service for patients and the community. RoseRehab staff and volunteers will also be involved in training and upskilling of the local hospital staff.

Again today, Dr Kong Chhunly, Director of Chey Chumneas Hospital, expressed his gratitude to Rose Charities Australia for implementing the physiotherapy and rehabilitation project in Takhmao. He reiterated the great need of Cambodians with disability. There are no rehabilitation services such as this in the area, and many members of the community miss out on such services that can change their level of function, and their life. Dr Chhunly identified one of the major barriers as being a lack of awareness in communities about disability and appropriate therapy options. With the Disability Law implemented in Cambodia just last year, it is a sign that awareness of rights for people with disabilities is growing. A significant change.

Below you will see the progression of the construction from the vacant block it was in January 2010, to what it is so far today. Still a long way to go, but well and truly moving along.



















So that's the story of therapy 'playground' development so far. The two pictures above were taken on the 5th July, 2010. Building commenced on the 17th June 2010.

But that's not all.....

Not only has the therapy area been in construction, but at the same time, a staff laundry and bathroom has been renovated. Previously a wet and dirty bathroom and laundry area with inadequate drainage and mosquito breeding ground (Chey Chumneas Hospital has has significant water problems and shortages - another issue currently being addressed), it is now well on the way to a simple, yet hygenic bathroom and laundry area. Renovations began after consultation with the local staff to ensure changes made we're suitable for them to carry out their daily duties. As an example, consideration needed to be made for space in the laundry for the staff to squat to handwash the scrubs. They were extremely happy with the proposed changes, the aspect most happy with - once renos completed, they will be able to lock away their washing soap in the laundry area. Something they have not previously been able to do, and the soap has always gone missing!!! Always interesting seeing the varied perspectives on what is most important for people in these situations.

The pictures below depict the speedy changes that took place last month, and are still continuing.





Plumb lines and bricks!









Many thanks go to all supporters and donors. Without such support and financial contributions, this development could not go ahead. These facilities are what your funds are currently contributing towards building, and are core parts to developing an ultimately sustainable therapy and training Centre for Cambodians.

Thank you so much.

Rose Rehab Cambodia at the 3rd Rose Charities Conference Phnom Penh June2010

Jo Thomson, of Rose Charities Australia presented the current state of her disability rehab project and outlined plans to expand infrastructure and physio program(s). Plans include, a) a development of infrastructure including the construction of a children's therapy playground in the grounds of Chey Chumneas Hospital, Takhmao. b) training of both physio as well as admin staff (Mr Kanarith has recently been employed as an administrator) c) establishing regular clinics d) instigating an outreach program (in conjunction with IMPACT) e) strengthening the physio networks within Cambodia. .
Jo gave a detailed outline of all aspects of the project to date. She also thanked
AYAD for assisting her in her work. Jo is seen in the photo above mid-left, in black

Joanna who normally practices in Western Australia made several assessment visits to Cambodia before gaining an AYAD (Australian Government) sponsorship to help upgrade physiotherapy services in Cambodia.

Rose Charities, and Rose Rehab Cambodia work as closely as possible with Government plans and programs. Sadly some organizations coordinate very weakly in this line. 'This does not help Cambodia in the long run' says Rose founder in Cambodia, Dr William Grut

Planning the RoseRehab Childrens Therapy Playground,

Rose Rehabilitation Cambodia ('RoseRehab') Centre opens

Joanna Thomson, Director of Rose Charities Australia has now opened the Operation Firse / RoseRehab physiotherapy and disability assistance centrer at Chey Chumneas Hosptial, Takhmao. The opening coincided with the 3rd International RoseCharities meeting which was taking place at the same time. In planning and under construction is a childs' therapy playground area....

The therapy 'playground' will consist of equipment and facilities enabling safe, stimulating therapy and play for children with disabilities or injuries requiring rehabilitation. Physiotherapy will be as integrated as much as possible into cultural structures, community groups and, where applicable the whole surgical / medical process