| The world is still not so bad as it looks like sometimes |
| Thanks to some good people we realized few small steps to make the world better. With big help of foundation Jan Pivecka and all friends we collected enough money for the first part of our project. I mean improving physiotherapist methods in rehabilitation centre in Menagesha.
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But you never know what happen in Africa. Every plans what we had made before coming to Ethiopia, completely changed in a minute. My biggest support and help, Michal Spacek, was sent in few days on the other end of this country. So we couldn’t do anything. Just to shared some important contacts and phone numbers and said by-by...
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Welcome… |
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The people in the centre were very nice from the beginning. I was there just few minutes, looked around and the other physiotherapist joined me in a moment. In the afternoon we started to cooperate on one case and the next day I got my own patients. I was very glad that I got the confidence and responsibility of whole personal staff so fast.
Another two volunteers from Great Britain took care about me first few days. Because of that I felt there like at home in two days. : - )
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CHESHIRE - rehabilitation center in Menagesha |
| Welcome to Cheshire Services Ethiopia
Cheshire Services is an independent non-profit making organisation who provide orthopedic and social rehabilitation services for children and young people with disabilities in Ethiopia. The charity was founded in 1962 by British war hero Lord Geoffrey Leonard Cheshire, by invitation from Emperor Haile Selassie's grandchildren, with the intention of rehabilitating children with disabilities.
Over the years Cheshire Services has become afiliated with many international charities and continues to expand its operations treating a wider range of disabilities across the whole of Ethiopia.
Menagesha Rehabilitation Centre
The Menagesha Rehabilitation Centre continues to be the flagship of Cheshire Services Ethiopia. It is the largest rehabilitation centre and is continually adapting to changing needs.
Professionals provide quality orthopedic and social rehabilitation to up to 70 residential children and an increasing number of outpatients. Many of the people that visit the centre are victims of polio paralysis. The centre supplies a comprehensive range of treatments including walking aids, artificial limbs, physiotherapy, counseling and social rehabilitation as well as education facilities and recreational activities for the children.
Cheshire Services Outpatients
The Cheshire Services Outpatients department offers orthopedic treatment to young people and adults as well as a counseling service to help patients overcome social and physical barriers they may face due to their disability.
Customised prosthetic limbs, walking aids and wheelchairs are prescribed to patients on an individual basis. This makes a lasting difference on an individuals life.
Cheshire Services Orthopedic Workshop
All prosthetic limbs, walking aids and customised shoes are made on site by talented craftsmen. With the workshop working so closely with the patients we are able to produce products of the highest quality in minimal time and and with minimal cost.
By training our own staff rather than outsourcing the manufacture of these products we are investing in Ethiopia's future.
Outreach
Due to the size and nature of the Ethiopian landscape it may not be possible for people with disabilities to reach one of the regional centres. The outreach program travels directly to the heart of more than 20 rural and distant communities to provide orthopedic treatment and diagnosis benefiting approximately 4000 children.
The program has two main aims:
Assessment - New cases can be assessed and rehabilitation materials can be issued on the spot. This is also how many children gain access to the residential facilities at Menagesha.
Ongoing Rehabilitation - When children have undergone residential rehabilitation it is vital that they do not regress into their former state of immobility. The Outreach Team visits these children in their own regions every six months to monitor their level of care and to ensure that they are receiving an appropriate level of education.
Community Based Rehabilitation
The Community Based Rehabilitation Program brings together disabled persons, parents and rehabilitation workers to improve the lives of children with developmental, physical and sensory disorders. Skills for essential daily activities such as proper positioning, feeding, bathing and dressing are provided. Other services include mobility orientation for the visually impaired, sign language for hearing impaired and simple exercise therapy.
source: http://cheshireservicesethiopia.org/
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Physiotherapy |
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The physiotherapy is on the high level in Ethiopia in spite of that this country is one of the poorest countries in the world. Education for this job takes three years studying at university in Gondar. It is in the third place in job ladder behind medicine and pharmacy. The program in centre is made according to finance and number of staff.
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Today, there are six physiotherapists in the centre. They take care about out patients (no idea how many) and also in-patients who are children between 3 to 15 years. The number of children is around 70. Out-patients are usually adults after amputees and they are waiting there for a new prosthesis. Then they learn how to walk with it. The children are usually after poliomyelitis. Fortunately for Ethiopia, there have been vaccinating. So the number of the victims of poliomyelitis is still less and less. Of course, there are also other diseases.
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Children don’t have a therapy from the beginning. First time, they are assessed. Then the physiotherapist decide, if it is necessary to do the surgery of ligaments or not. The surgery is made in Russian hospital in Addis Ababa. The doctors can do only two surgeries of Cheshire patients in a week. So sometimes it happen, young patients wait for surgery quite a long time. The next step is plastering of pares (POP). The patients are placed in recovery room (usually are plastered both legs). They start slowly to rehabilitate approximately after 4 weeks. Till that time, they are almost immobile. They move little the in the bed or sit outside just to get some sunshine. They use the wheel chair to look around. The happier one are walking around in spite of plasters on their legs and scolding staff. :-)
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| Approximately 15 -25 children have daily rehabilitation. There is no time to do more. First time, you need to collect your patients and the younger one exactly to pick up. If you are successful, you can start the therapy. The therapy is not only rehabilitation but also psychological. It is hard to explain 5 years old child, that the therapy is sometimes painful. In addition he or she speaks another language. Sometimes you can see them crying. But later, when you see the effect, then you know it was worth to do it... |
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| How to do POP ( plaster of pares )... |
| POP is shortly plaster of pares. Or we can say correction of the paralytic limbs with the help of plaster. The doctors, chiropodist and pediatricians concerned by this problem in Europe.
In Ethiopia, the decision is up to physiotherapists. They are responsible for decision about individual therapy of each patient. Also they decide in which case to do the surgery or not….The surgery is made in Russian hospital and the price is symbolic 300 Birr.
The most often diagnosis in Menagesha Cheshier centre are Club feet (it is congenital defect – the feet are in inner rotation and gait is on the lateral sides of the feet). You can see there also lot of very bad contractures of knees and hips. It is caused as consequence of poliomyelitis. After this disease the limbs suffers by pares and part of muscles are weak or atrophied. So it means the limbs are immobile.Contractures made discomfort and the correction is more and more painful. Hand in hand with these the consequences are growing.
The most important for the therapy is to steam off the contractures. It means to release the ligaments around joints. It is necessary to do the surgery, in cases with big contractures.
The rest is made only by plasters of pares ( POP ). When the plastering is finished, the patient get the individual orthosis and the exercise training and gait training can start.
You can think that the method is quite long, painful and maybe a little bit obsolete. But then, you get 14- years old patient who never walked before. Both knees are dislocated and feet are rotated backwards. The whole legs are in so big contracture…And then you see him going home after few month, walking with crutches or without. That time you’ll understand. You can do a lot for a small price…even the small beautiful miracle...
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| correction of extremities by plastering |
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| another correction - putting the small nogs in the small gaps... |
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| and plastering again... |
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| Award after big effort - before and after therapy... |
| Before the step to the unknown, there is a big fear. You know, it wouldn’t be easy all the time. You have no idea what will happen. You still ask yourself if you are really so strong and if you really know what you are doing…
But if you don’t lose your mind even courage and in bed time you don’t break down and still continue to realize your intention, award is coming soon.
All the time I went again and again to recovery room and took care about young patients who couldn’t move because of heavy plasters. I pushed them to do the sport and tried to motivate them. Whether in English or basic Amharic I still tried to explain how important the exercises were for them. After few weeks they left recovery room and started to train walking. That time my colleagues and I more and more pushed them to the harder work.
After few months of hard work in rehabilitation center I was also awarded. One of them was Agenchesh. 13 years old girl, who after few month therapy and effort of the whole team in center and above all effort of herself , started to walk.
Can you see that pride? Don’t be afraid of your dreams…
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| Cofee ceremony |
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| with the children from the recovery room |
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Babylon Tower |
| It is quite difficult to work in foreigner country, where nobody understands you. So if you really want, you need to work as hard as possible. You start to learn their language. But what to do, if there are another 80 different languages? Then you need to use sign language. ”Show me, give me,” and also use mimic. So finally you don’t need to be afraid. You’ll understand everywhere even you don’t know any word.
At the beginning I neither understood English. The speed of talking was quite high :-). After two days I got use to. But the fight with reality just started. Young patients didn’t speak English. They only knew how to count till five :-). So I had no choice and slowly started to learn Amharic words. After two weeks I understood a little bit to my children. I had no idea what were they talking about, but I got the point. To do the group training in Amharic was not problem for me after few weeks. I could also do some assessment and I could instruct my patient how to do exercises. Lately, when we accepted new patients I proudly asked: “Amharic?” The child just stared on me, shrugged its shoulders and answered : “Oromo!”……..
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| group training |
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| ELEPHANT - at the end of the training we did animals just for fun |
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EPILOGUE |
| I spent almost 4 months in Menagesha rehabilitation center. In spite of the beginning was not easy, I got used to be there and came in quite fast. Not even language barrier or the different methods broke me down. I also tried to share my experiences and knowledge. I worked in team of physiotherapists and my boss gave me responsibility to create the group training. I did this training with children in recovery rooms who couldn’t move a lot because of heavy plasters. I didn’t see the results immediately. But after few days and weeks I saw small improvement. Children were stronger and the exercises were easier for them. Their coordination was much better. The balls didn’t fall down and therabands broke up under the big effort and power of my patients. The weak children could finish the whole therapy without shouting: “Oli, Oli ene dekameni !” (Oli, Oli I am so tired).
These exercises should have been the base for next therapy. And at the moment when the children left the recovery room and started to rehabilitated, they were in better condition. Now when I turn back, I can say, I did a good work. I am bound to You for this experience. Due to You, who donated this small help It was possible to realize this project.
The day I was leaving I said hallo to my colleagues and my friends. I was so sad. More difficult was to say hallo to my young patients. Few of them were crying and me also inside of my heart. They were my children and my friends and that time when I had to leave I appreciated how much they liked me. In the center I left peace of my heart. And not only there. The whole Ethiopia, the whole Africa is the place , what will exactly get you.
Oli (aneb Olie, Oliga, Ori, Kone, "ferendji", "Sweet heart", Olga,...) Tichackova
oli@a-artdesign.com
31.3.2010
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+420 608 170 490
email: oli@a-artdesign.com |
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Mgr Olga Tichackova
physiotherapist
In my life I wanted to be whatever: cleaning women, doctor, Pank girl, Hippie…Deep in my mind I wanted to travel from babyhood. In my five years I was convinced that when I grew up, I would visit Koala bear in Australia. At the age of puberty I wanted to continue my first love to the Russian countryside and finally in my twenty I really did my first trip to Africa by hick-hiking.
I studied Charles University in Prague, the specialization of physiotherapy. Nowadays I work in hospital in my home town Jicin and in my free time I travel by finger around the map of the world. I met Ali just in time and traveled with her to Ethiopia. So I began slowly to realize my dream. Thanks to this adventure I started to think how to help in Africa. One year later, after big effort and big help of my close friends finally I went to rehabilitation center in Menagesha.
You can love everything on traveling. Somebody collects souvenirs, somebody hunts pictures and somebody hunts adventure. From these tinny joys we can be happy all our life.
So why shouldn’t go right now? :-)
Oli
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Cheshire Services |
| Rehabilitation Center Menagesha (more) |
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| in the gym |
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| we are also children!! |
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| Masserati - 4 months in the recovery room |
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| children from the recovery room on the sun |
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| children, children, children...... |
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| Yabsra, our sweet heart |
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| strenghtening of upper trunk and upper limbs |
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| training of coordination with the ball |
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| waiting for individual therapy |
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| "Cheshire disability day" |
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| "Cheshire disability day" - enjoy for everybody... |
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| "Cheshire disability day" - pulling rope race |
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| "Cheshire disability day" - who will sit the last? |
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| "Cheshire disability day" - and Oli lost........... |
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"Cheshire disability day" sport for healthy
even handicaped people |
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| "Cheshire disability day" - crutches running |
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| living room |
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| Menagesha surrounding |
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| Menagesha surrounding |
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| result - first steps!!!! |
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| I have new, orthopaedic shoes! |
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| handicraft |
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| I look forward for sliding down! |
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| even we want to play! |
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| Yassu, guy from somalian borderline, 5 years old |
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| NOMA patients - young and adults |
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| NOMA patients |
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| disability is not inability!! |
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| Kokobe and Salamauid, how to remember!!? :-) |
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| my dear children |
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| Theraband training (pružná guma) |
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| sometimes also big effort |
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| at the end the BIG aplaus for everybody |
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