‘Disability is Not Inability’.

Posted by Francesca Rutherford on Tuesday 12th December 2017

I have recently returned from Ethiopia after an amazing trip visiting some of the projects funded by Ethiopiaid and running in the Great Ethiopian Run with other donors (read about that trip here). I was then fortunate in being able to stay on for four days at the Cheshire Services Menagesha Rehabilitation Centre to learn about the day to day therapy that goes on there.

I work as a Paediatric Physiotherapist in the Children’s Unit of a District Hospital where we see new born babies with club feet but never older children, as if we cannot correct the deformity with exercises we refer to a specialist orthopaedic consultant within weeks of birth. At Menagesha the majority of patients have ‘neglected’ club feet, and because they have been walking or crawling in an abnormal way many have also developed contractures at their hips and knees. 

They have surgery in a hospital in central Addis Ababa and can then spend up to a year at Menagesha as they typically need between 9 and 11 serial plasters to continue to stretch their feet into a better position. It was interesting to swop ideas about different ways of stretching tight limbs and I was able to carry out some treatments despite my extremely limited Amharic, which is hard to learn due to the unusual script. I often found myself wishing I had spent as long mastering a few more words as I had on training for the 10km run that had featured earlier in the trip!

I had exchanged emails with the Menagesha physios, and also a UK physio who had visited two years ago, before I left and so had been able to bring out some equipment that is hard to find locally. This included some swimming costumes and hydrotherapy equipment which I was able to demonstrate and teach the physios how to use. 

One of the things that really impressed me was the standard of equipment that was being made in the workshops in Menagesha, particularly the wheelchairs that are custom made for disabled people who live in remote parts of the country. They are measured by outreach teams who also note the terrain that the chair will be used on and any particular requirements like the ability to carry goods to market. Then next time the team visits they take the wheelchair out to the individual, along with crutches and supportive boots to hand out to others who are having difficulty getting around.

Most of the children have come from far flung regions of Ethiopia and can be as young as 6 years old so it is a long time to be without their families but there is a lovely feeling of community with the older ones helping the younger ones. I happened to be there on International Disability Day and there was a lovely celebration with the children joining in dancing competitions and running races as well as enjoying watching the staff doing a sack race! I liked the slogan that is prominently displayed around the centre:  ‘Disability is Not Inability’.

I was also able to spend a day at Reed House, a new outpatient rehabilitation centre run by Cheshire Services in the middle of Addis Ababa. Here children with neurological conditions such as cerebral palsy, spina bifida and head injuries receive free treatment in an environment that wouldn’t look out of place in the UK. They normally attend for a weekly session where they are given treatment and ideas that their parents can carry out at home. For most of them this includes standing in a frame that in the UK would be provided for daily use at home, but has to be funded by the family in Ethiopia. Richer families are able to have a frame made at the workshop in Menagesha, but the majority just stand at their treatment session. Once the parents are confident about therapy to do at home the frequency of visits decreases, much as it would in the UK, thus allowing more patients to benefit from the service.

First I watched the initial assessment of an 18 month old girl who had been referred from a local hospital, as this sort of treatment is not provided by the government. The assessment tools were very detailed and gave a good baseline by which to measure progress. I then spent the rest of the day joining in treatments and had a valuable exchange of ideas with the physios who were all very dedicated and keen to learn. Although there was generally plenty of equipment they didn’t have many specialist therapy toys for the youngest children so I hope to be able to send some of these soon.

I feel really privileged to have had the opportunity to spend time learning more about the work of Ethiopiaid and have come back even more convinced of the value of their work. All the projects I saw were providing a high quality of care tailored to what is required by using local partners who are working tirelessly to improve the lives of disadvantaged Ethiopians. I have also seen how over the years the UK team has been proactive in finding new partners and continuing to expand the projects it supports, but by remaining focused within one country are able to keep monitoring that money is well spent.

So in conclusion please do consider making a donation - I know regular direct debits are particularly useful as it helps the charity to plan the most effective use of funds.

Vivien Patel
Paediatric Physiotherapist

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