Home Physiotherapy is Possible in Ghana

Mrs Joyce Atta is the mother of a six-year-old girl with Cerebral Palsy, I met Joyce online via facebook on a platform called Cerebral Palsy family network, Joyce’s daughter had been displayed as a hero of the day, the writings accompanying the girl’s picture was what attracted me to engage in an online chat.

Joyce is a Ghanaian living in Kumasi, in the Ashanti region. She was asking on the network how to deal with certain issues relating to her daughter’s condition. It said: “My daughter is a six-year-old with cerebral palsy, she gives the warmest smile but she has convulsed several times, any suggestions on how I deal with that.”

There were several suggestions but many patrons of the network also asked whether she does physiotherapy and can access physiotherapy.

I exchanged contacts with Joyce and we started a chat. Joyce works with a government organization in Kumasi and lives almost at the outskirts of the city. She has three other children; her husband also works with an organization that demands that he travels a lot to other parts of the country to distribute his company’s products.

In a conversation with Joyce, I got a feeling that she is tired of going for physiotherapy every week. “I have to ask for permission one day every week to attend physiotherapy with my daughter. I have been doing this for years and haven’t noticed any improvement in her.

“Besides, it is very stressful accessing the physiotherapy services, I have to carry my daughter on my back; we board about three vehicles to get to the hospital and by the time we get there, my daughter is already tired and does not cooperate with the physiotherapist at all.”

I suggested a home physiotherapy and her question was, “but how?” I then began to explain that there are resources available on line where parents can learn basic physiotherapy and work with their Cerebral Palsy children to achieve some developmental milestones.

Even getting the children to sit for a while takes some effort, I suggested that even if she does not have the equipment, she could improvise. For example, lining a carton box with blanket and placing the child in a sitting position is physiotherapy and with time the child could be sitting on his/her own.

Joyce thanked me after sharing tit bits of basic physiotherapy and encouraging her to be trying it at home instead of just giving up on her daughter. I could feel a glimmer of hope in her voice as we ended the conversation.

Truth is, Ghana lacks adequate physiotherapy systems, and parents are pushed to become frustrated with the system to the extent where they give up. In fact, sometimes having a child with Cerebral Palsy literally means that you just ended your normal life.

Parents, especially mothers, are no longer able to work in the official setting any more. Many mothers out of frustration are forced to abandon their Cerebral Palsy children to their fate – as one mother said, “it is just too difficult.”

That is why I laud the Community-based parents training for children with Cerebral Palsy initiative. Under the programme the Christian Blind Movement (CBM) through their implementing partners, the Presbyterian Church of Ghana, in collaboration with the International Centre for Evidence in Disability of the London School of Hygiene and Tropical Medicine and the University of Ghana (UG), has initiated a research to evaluate the impact of a community-based parent training programme for children with Cerebral Palsy in Ghana.

The project uses a manual titled: “Getting to know Cerebral Palsy” promotes working with groups of parent/caregiver of children with cerebral palsy aims to increase knowledge and skills in caring for a child with cerebral palsy. It promotes a participatory learning approach with an emphasis on the empowerment of parents and caregivers.

Under the project, a group of physiotherapists, speech therapists, nutritionists and other health professionals organize a monthly meeting of one hour with communities and parents with children who have cerebral palsy.

At the meeting basic physiotherapy techniques are taught and parents are encouraged to ask questions. The community together with the parents sets goals of achieving the various developmental milestones for the children.

The Physiotherapist further does a home visit of 45 minutes to look up the children with cerebral palsy and work through their various therapies, encouraging parents to be doing it with the children all the time, even when the physiotherapist is not around.

Mrs Maria Zuurmond, a Research Fellow at the London School of Hygiene, who is part of the team implanting the project, shares how mothers get hearty knowing that even holding their children in the right position does a lot to improve the child’s overall development.

Mrs Sandra Cassermer, a paediatric physiotherapist at the Korle Bu teaching hospital who is part of the team implementing this project, shares her experience of how parents express joy and happiness knowing that they can have physiotherapy at home with their children.

Mrs Hannah Awadzi, Initiator of the Special Mothers Project in Ghana, a project that seeks to encourage mothers of children with Cerebral Palsy while creating awareness on the condition, is advocating for a home physiotherapy service in Ghana.

Mrs Awadzi believes that parents need to be very much involved in physiotherapy and make it part of their lives. She says parents can learn the basic physiotherapy techniques and see the specialist once in a while to assess the progress on the child.

Home physiotherapy is possible!

 

Daycare Centre Staff schooled on Cerebral Palsy

Staff of the Darkuah Daycare Centre were on Friday schooled on Cerebral Palsy and the basics in handling a child with Cerebral Palsy

The staff, received the training as part of a project called: Special Mothers Project that seeks to create awareness about Cerebral Palsy while encouraging and sharing experiences with mothers (Parents) whose children have Cerebral Palsy.

Cerebral Palsy is a neurological disorder that affects movement.

Mrs Hannah Awadzi, Initiator of  Special Mothers Project, said, the Daycare centres are usually the first contact point for babies and sometimes the staff get to know more about the children than the parents

“In this era where many parents are beginning to lose confidence in the house-helps, and most parents tend to be very busy with their work, the daycare centres are very important in terms of child development,” she said.

Mrs Awadzi said nowadays many daycare centre are taking babies as young as three months old and there is the need for education on handling “Special children” in a way that would not complicate their development.

Ms Akosua Darkuah Asante, Head of the Daycare Centre, expressed appreciation for the education and urged her staff to endeavor to look out for any things they found abnormal on any child and report to parent for urgent attention

Train Health Staff to Identify Cerebral Palsy Early – Nutritionist

Ms Esi Foriwaa Amoaful, Deputy Director, Nutrition at the Family Health Division of the Ghana Health Service on Thursday advocated for a nationwide training of health staff to enable them identify children with Cerebral Palsy at the very early stage

“It seems that many parents with children who are cerebral palsy do not know what is happening to their children, they are forced to believe that  their children are suffering from spiritual attacks  and therefore do not do much to help their children.”

Ms Amoaful said this when the International Centre for Evidence in Disability in collaboration with cbm, a Christian Development Organization organized a meeting to share findings of a base-line study to determine the quality of life of care takers of children with Cerebral Palsy

The study is being undertaking by CBM, in collaboration with the International Centre for Evidence in Disability of the London School of Hygiene and Tropical Medicine and the University of Ghana (UG) to evaluate the impact of a community –based parent training programme for children with Cerebral Palsy in Ghana.

As part of the programme, Specialists, including, Physiotherapists, Pediatricians, Nutritionists, Speech therapists, and a team of researchers visited selected parts of the country to educated and train parents of children with Cerebral palsy on basic physiotherapy skills

The Specialists also organizes a three hour community meeting once a month and a 45 minutes home visit to such parents to see how their children are progress and work together to achieve basic development milestones of the children

Mrs Maria Zuurmond, Research Fellow at the International Centre for Evidence in Disability, sharing some findings with stakeholders, said about 70 percent of the children with Cerebral Palsy they are using in their study are malnourished

She explained that most of the parents do not make the needed time to feed these children and some do not feed them with the right food.

“We noticed that some of the parents or care givers feed the children in a lying position, because the children are not able to sit, they choke on the food and are not able to feed properly, within a short time of our study we have already lost six of such children,” she said, pointing out that it could be due to malnutrition or maltreatment of the children

As part of our programme, we are teaching parents and care givers how to handle the children and we have already have evidence of mothers who are now holding their children with Cerebral Palsy well and seeing an improvement in their health.

Mrs Zuurmond said 84 percent of the parents of children with Cerebral Palsy have no knowledge what is happening with their children.

The study is using 76 children in total across the country. The team uses a parents training manual titled: “Getting to Know Cerebral Palsy” to teach the parents. The project is a 24 month project which started in January 2015 and ends December 2016.

Dr Isabella Sagoe-Moses, National Child Health Coordinator at the Ghana Health Service, reiterated the need for more education and awareness on Cerebral palsy.

She said: “If more people know about Cerebral Palsy, then more people will be supportive of these children instead of maltreating them.”

Mrs Hannah Awadzi, Initiator of the Special Mothers Project in Ghana, who commended the project, said there was an urgent need to train mothers of children with Cerebral Palsy with the basic skills in physiotherapy and speech therapy to enhance the quality of life of these children.

“I believe that the parents, especially the mothers are the best people to understand and handle their children well, if the mothers are empowered they can also create awareness about the condition and increase acceptance of these children in our society.”

Mrs Sandra Carsamer Asante, senior physiotherapist at the Korle Bu Teaching Hospital, who is part of the team implementing the project said, she had seen evidence of improvement and enhanced living with the families that are being piloted for the project already.