26 September, 2010

Careers Day at ANDC

What a fabulous day! Friday 24th September was Careers Day for 'A New Day Cambodia', an alternative care centre for children who were scavengers in the Stung Meanchey rubbish dump. The centre provides a safe, healthy environment for the children to live, and learn.
Our staff from Rose Rehabilitation Cambodia excited to be invited along to speak to the children for Careers Day. The children listened with all ears as Rith he spoke about his role as an administration and finance manager at Rose Rehabilitation, provoking questions from many of the kids. He outlined the path he took to get to where he is today, and the hardwork and study he has done, and continues to do. Quite a few hands were raised and smiles shone when he asked who was good at mathematics!

Sokny and Hoe then talked to the kids about physiotherapy, stimulating the minds of everyone. There were a small number of children who had heard of physiotherapy before, but mostly, no one knew what it was. Some brilliant questions were asked, including what should be done if someone sees a moto accident and someone has broken their leg? The kids were really interested in First Aid and would really like to know what to do in these type of accident situation, which happen so often.

The kids did an amazing job at listening, and giving their undivided attention to the speakers. They earned themselves a well-deserved break where they could bust out into the yard and play football - which, might I add, they are very talented at!

Sokny, Hoe and Rith really enjoyed the experience of talking to the children about their respective careers and were really happy to be able to participate in broadening the kids' knowledge on what they can do when they finish school. They actually commented that they would have really liked something like this when they were at school, and that often people did certain courses simply because the opportunity happened to be there, not because they actually wanted to do it. This itself impacts society in Cambodia hugely, as there are commonly people doing jobs they have no desire or passion for, and as a result the job is not done well. By educating the children about options, and encouraging them to think about what they like doing and want to do, they have a much greater chance at living a fulfilling, productive life. They can reach for the stars!

* Sokny, Hoe and Rith, very happy after their presentations
* The team from Rose Rehabilitation picture with ANDC staff, Annette and Lisa.
Friday was also the last day for Jillian Thomsen (far right), a volunteer we have had with us at Rose Rehabiliation for 9 weeks. We thank her very much for all her efforts and time she dedicated to Rose Rehabilitation. We enjoyed having her in the office and on the road with us, and will miss having her around. We hope she goes home with some wonderful memories of her time in Cambodia with us. Thank you Jill, safe travels home.

20 September, 2010

Srey Tung - she wants to read and write

And why shouldn't she? She's 29 years old, and has had a disability almost her entire life. She was never given the opportunity to go to school, or to learn, or to work, or to do anything fulfilling in her life. Might I add - disability can actually be seen as the result of attitudes and practices that prevent people from enjoying economic participation, social inclusion and equality, rather than the result of an individual’s impairment. Srey Tung's situation depicts this very much - her role in life so far - simply to exist. Lying on the bed in the corner. You know what? She wants this to change. Her family also want this now. Below you can see Srey Tung lying where she has spent so many years lying.

The two pictures below were taken last week, at our first village visit to Srey Tung. Wow, did she pull a crowd! These pics show just a few of the many onlookers. Not a lot of privacy in the villages, everyone wanted to see what was happening. And they were intrigued. Srey Tung was out from the bed in the corner, and doing things they'd never seen her do before. From this session, Srey Tung decided she wanted to be able to sit independently. Such a functional position for socialising, eating, drinking, and generally seeing the world as it happens. Not to mention the other health benefits that come from positional changes and sitting up. All of her bodily systems will improve.

Coming back today, she draws even more of a crowd. Srey Tung is not nervous today, either. She is happy, talkative, and expressive. Something we were yet to see.

Srey Tung's strength and endurance today was impressive. Previously, she could not hold any position of anti-gravity on her own for more than a second. Today, she was able to almost independently arrange herself and push up onto her forearms when lying on her tummy. And she could stay there for a minute. A huge improvement. And she was far less uncomfortable. Whilst still working very hard, she was happy and smiling through out. And extremely grateful when given the opportunity to rest!

In particular, a woman, who turns out to be Srey Tung's neighbour, was there today and was so involved with the treatment session. She was encouraging, and assisted where she could. She listened, and wanted to learn ideas. She had discussions with Srey Tung's father, passing on ideas. This lovely lady was astounded, completely surprised at what she was seeing Srey Tung do. She had no idea she would be able to do any of the things she was doing today. She really wants to see Srey Tung progress even further.
With all the chatting going on today, the topic of reading and writing was raised. Srey Tung revealed she cannot read, and she cannot write. But she would like to. Do something everyday. Learn. Be counted.
That's the next aim - to find a way to get some education for Srey Tung. She is able to hold a pen, and even though not formally tested, I'm sure she has the cognitive ability to learn to read.

This story really highlights the lack of awareness amongst Cambodian communities regarding disability. Very, very slowly attitudes are changing, and this is helped by the implementation of the National Law on Disability in 2009. There is a long way to go, but slowly as the country recognises the rights of people with disabilities, and health awareness progresses, opportunities will hopefully arise for all people to lead productive and fulfilling lives.

Chan Chea - walking is in her sights!

So we're still plugging away with Chan Chea, who is desperate to walk! She talks about how she feels everything has improved - her ability to eat, drink, reach for things, sit up, move around - but what she wants even more, is to walk. And you see, this is a reasonable and realistic goal for Chan Chea. I believe she will get there. She believes she will get there. She practices every morning, and has the support from her entire family. The photo above was taken last week, where she was significantly improved. But today, she had improved yet again. Below you can see Sokny and Chan Chea's brother helping her to walk, slowly reducing the support required, and walking a lot further with less rests.

The video below was taken when we first arrived this morning - no warm up, no preparation. Chan Chea just stood up, and started stepping out from the bed on her own. Brilliant.

What an Amazing Man!

Tuesday 14th September saw the team head across to Prey Veng to meet with Veterans International staff. VI have significant experience in the area of healthcare and rehabilitation for people with disabilities, and are keen to develop a relationship with Rose Rehabilitation. In particular, Manager of Prey Veng VI Mr Ull Meng Hour has expressed interest in joining with Rose Rehab to assist with funding and support for a separate independent project he has insitgated. Mr Hour is an incredibly amazing, interesting man. An amputee himself, he speaks opening about the discrimination he has endured in Cambodia, and how he has overcome this to be now be working in a stable, productive job and living fulfilling life. Astutely aware of discrimination and crushed self-confidence of those with disabilities, it is Mr Hour's intent to see that all people with disabilities, particularly the most vulnerable - women, receive education, vocational training, and a fair go to prove they are capable and worthwhile.

Mr Hour sustained his landmine injury in 1984 when working with the Cambodian military on the Thai border, rescuing refugees from the border camps. Mr Hour continued to battle discrimination for years, but persisted with proving his capabilities and contribution to society. Eventually, he managed to get a job with VI, and from there has progressed to where he is today - Manager at Prey Veng.

Mr Hour does amazing things for the Prey Veng and Svay Rieng communities. He has an independent project that supports women with disabilities to live together in Prey Veng and receive education and vocational training. Mr Hour's dream is to see the project expand so that it becomes a women's federation, where the women with disabilities support other women with disabilities in obtaining education and work. It is with this part of the project that Rose Rehab have linked in and have applied for grants to support this project. We very much look forward to this relationship developing and seeing this extremely worthwhile project get off the ground. Mr Hour continues to stress that it is not him who is to run this ultimately, but the women themselves. He is not after recognition. A most noble man who plain and simply wants to help others.

The women are pictured below with Mr Hour and staff members of Rose Rehabilitation, and then Mr Hour with Rose Rehab staff.

Each one of these women has a disability, and each woman studies either at high school or university. Without this work that Mr Hour has done, these women would be with no opportunity to develop independence or gain an education. One woman came from begging on the streets of Phnom Penh, and is now studying at university and really enjoying it.

09 September, 2010

Just another day at Rose Rehab

Below you can see a couple of treatment sessions we had today in our therapy room, which has recently been transformed from a dingy, windowless, unfunctional room. It's been painted, windows, lighting and a fan installed, and had the attached bathroom cleaned up. So while still without equipment, we have now started treating in this area with the use of a mat on the floor.
So this is what occurred in there today:
Sokny and I met and assessed 29 year old Srey Tung. She has never visited a doctor or any medical professionals until now. When she was just 7 days old, she developed a fever. Her family took her to see a Khmer traditional healer, and after 3 days, her fever settled and she was better. However, they recall she had poor neck control as she developed, and had no power in her arms and legs. So for 29 years, Srey Tung has been lying down. She doesn't leave the house, and has no form of assistive seating. All day, she stays at home on the floor. She is able to roll to her left side, and her right side independently. She would like a wheelchair so she can get out and about in the village.

After assessing Srey Tung, we can see that she has significant leg muscle contractures that prevent her from being able to sit up on the floor, as well as poor strength. She does, however, show signs of power, and it does seem we will be able to work on her strength and function. When we talked about this with her, she said she is very happy to learn exercises to help get her stronger, and stretch out her muscles. Whilst it was probably quite a scary day for her, coming to see us, at the end of the session she stated that her body felt very comfortable! It would have been the first time her body has ever been in some of the positions it went into today, and provided a great stretch for her.

Here we tried supported sitting on a stool - because of her tightness in her legs, it is too hard to do on the floor. She has very weak trunk muscles and is unable to hold herself up, but it is something we can work on.

Lying on her stomach next - something she has never done before, and we got quite a laugh out of her as she rolled the whole way over!
With a bit of assistance, and re-positioning, we were able to get her into a reasonably comfortable position, but remember, this is stretching her out into positions she's never stretched before, so was quite uncomfortable initially. It is also a position that enables her to use her back, arm, and neck strength to prop up on her forearms and look out infront, and to the side.

It was a big session for Srey Tung, but she'd like to see us again, which is great to hear. She says she's going to practice these activities at home with her parents. Next time, we will visit her at home at see what the setup is there, and how we can incorporate activities into her homelife.

Next we saw 15 year old Srey Mien, who has nasty back pain after working in the rice fields with her family. The back pain is so much that it stops her doing activities around the house. She left school many years ago, and has been working at home since.

After a treatment session today, Srey Mien reported she felt better than before she came in, though she was still obviously in significant pain with certain movements. With exercises to continue at home, we will see how she is next week.
Cambodian farm life involves incredibly hard physical labour, with prolonged periods with the body in full flexion, or bent over. It really doesn't surprise me to find a 15 year old farmer in severe pain from such work. Many many people here report back pain, but not many seek help, or do not know that they can. They do not see anyway they can change their habits, as the work and the farming has to be done in order to make a living.

08 September, 2010

Splints on... and almost walking!

Presenting... Chan Chea standing proudly in her new splints!!! Last Wednesday 1st September, Chan Chea was fitted with her new Ankle-Foot orthoses (AFOs) at Cambodia Trust(CT) in Phnom Penh. We did a follow up visit to her home on Monday 6th. Chan Chea loves the splints, much more than the casts. As you can see from the photos, however, the splints don't hold her in quite the same rigid position, but have the added benefit of being able to take them off, and being lighter, and cooler. Her fore foot was significantly riding up at the front of the splints, and so we decided to take her back to CT today to have an extra strap added to control the foot better.

So today.... what a day!
With support, Chan Chea walked the length of CT's parallel bars, approximately 10 metres! What a feat for this girl, she's been working so hard at getting stronger, and so wants to be able to walk out in her village and visit people.

Time for a quick rest, very tiring work!

And back to it again

Whoops! 'Chor trong', Chan Chea, 'stand straight'!

Compared with the beginning of the walking session, the support required to assist her reduced significantly. She still lacks confidence, but it is improving all the time.
Given the negative attitude so commonly associated with disability here, it's been amazing to see the support Chan Chea has from so many different family members, each one doing all that they can for her. Today, we met her uncle for the first time. It's great when we observed Mum and her Uncle each providing instructions and learning techniques from Sokny (physio). In the early days, Mum was just continually, and understandably, holding Chan Chea close, reluctant to push her. Now, she's helping to teach her to walk.