Report
on Collaboration with Ladakh-Hilfe
Centre
for International Child Health
Ladakh Disability and Rehabilitation
Training Program
June- July 2007
Canadian
Team: 4 Occupational Therapists (Alexis, Deborah, Isabelle, Theresa)
from different areas of specialization (development and behaviour,
neuromotor, positioning & mobility, mental health), 1 Speech and
Language Pathologist (Kate), and 1 OT student (Lea) from University
of British Colombia.
Ladakh-Hilfe
(REWA): Dolker and other local staff. Physiotherapists (Stefanie,
Helena, Nicole, Matthias), Simon (friend of Matthias) also involved
as a helper for equipment adjustments. Email follow-up done by email
with Miriam in Fall 2007.
HEALTH
Inc.: Cynthia Hunt, Stanba, Dadul & Dorje Rafton, other local
staff also assisted during outreach to the villages.
Switzerland
Special Education Organization: Mara
Ladakhi
Partners: Moravian Ability Centre (MAC), CMO and Leh Hospital in Leh,
and Ladakhi communities in the suburban areas of Leh and in remote
villages.
Methods/Approach:
Community Based Rehabilitation was our approach of choice as a community
strategy for sustainable integration of people with disabilities.
This approach was carried out through a variety of strategies, including
utilizing local resources to assist in meeting local needs. We worked
primarily to train the families, local community members and health
workers so that solutions can arise at the grassroots level and integration
of children and adults with disabilities stems from the community.
In this manner, we promoted sustainability and the development of
capacity in the villages. Participatory, action-based teaching strategies
also encouraged full involvement of persons at the community level.
Activities
Completed in Collaboration with Ladakh-Hilfe
First Week (June 17-23, 2007)
" Consultation with Ladakh-Hilfe Physiotherapists, jointly with
Health Inc. staff and local medical staff about current health and
rehab situation in Ladakh.
" Review of rehab files for identified children, requiring follow-up,
in the Domkhar Valley, Skubuchan, Hanu Gongma & Dha Hanu regions,
and review of therapy and equipment needs for these children.
" Provided joint individual and group therapy sessions at MAC.
Collaborated with and provided training to Ladakh-Hilfe staff about
areas of functional rehabilitation, including: development, cognition,
sensory integration, splinting, positioning, speech-language development
and feeding strategies.
" One day outreach to suburban areas of Leh (4 villages) to assess
and follow-up 6 identified children and adults with disabilities (CP,
Spina Bifida, Spinal Cord Injury), with Helena, Dolker, Isabelle,
Theresa and Lea.
" Canadian team provided a wheelchair and created a custom positioning
system for Iqbal, the Head of the Disabled Society.
Second & Third Week (June 24-July 9, 2007)
" Canadian team and Health Inc. did a 2 weeks outreach to the
Domkhar Valley, Skubuchan, Hanu Gongma & Dha Hanu regions to provide
rehab follow-up to the identified children (as reviewed above). Also,
screened, assessed and provided initial support for new children with
a range of disabilities. Equipment was provided and documentation
was completed for each of the children seen.
" Visited Palzes Angmo, who recently experienced an acute leg
fracture. Proceeded to evacuation from Dha-Hanu to Leh Hospital with
the assistance of military staff.
" Provided support for school integration and strategies to promote
learning and communication.
" Conducted a number of community educational workshops on back
and joint care, disability awareness, hearing loss, and on mental
health awareness in the schools.
Fourth-Sixth Week (July 10-25, 2007)
" Follow-up / defriefing between Canadian team, Health Inc.,
Ladakh-Hilfe and consultation with Mara, about children seen during
the 2 weeks outreach in the villages. Recommendations given for follow-up
and documentation transferred.
" Continued to provide joint individual and group therapy sessions
at MAC.
" Collaboration between Canadian Therapists and German Physiotherapists,
with coordination assistance from Dolker, Stanba and Dadul, for follow-up
at the Leh Hospital for medical and rehab care plan of Palzes Angmo.
Several joint visits and rehab sessions were conducted.
" Follow-up for Iqbal, for wheelchair and positioning adjustments,
with the assistance of Simon (friend of Matthias).
" 2-3 days Outreach to two separate areas of Ladakh: Temisgam
with Alexis, Stefanie and Dolker, and Chang-Tang area with Isabelle,
Nicole, Tun-Duk and Yun-Tan. Collaborative rehabilitation follow-up
was done for children and one adult (Tarchin).
" Outreach to suburban areas of Leh (Sabu) with Matthias, Dolker,
Alexis, Isabelle and Kate to visit children with CP and developmental
delay. Follow-up with appropriate equipment (corner chair).
" Mental health workshop provided to a group of doctors in Leh.
" Consultation with Mara at the Hostel for children with hearing
loss, and for family support of a child with autism.
" Participated in the development of educational resources, such
as pamphlets on CP, hearing loss and adolescent depression, and the
initial stages of an educational video on child development.
" Canadian Therapists and Dolker met with the Chief Medical Officer
in Leh to discuss possibilities for future programming to support
children with disabilities.
" Canadian team provided Ladakh-Hilfe with therapy equipment,
such as physio balls, splinting and positioning material (foam), and
sensory-development toys.
" Conducted an "evaluation day" with Canadian team,
Health Inc. and Ladakh-Hilfe to assess disability services in Ladakh,
evaluate this summer's activities and outcomes and plan jointly for
future steps.
Impressions of our Collaboration with Ladakh-Hilfe:
The Ladakh-Hilfe team was very enjoyable to work with. The physiotherapists
gave us a good overview of the situation of children with disability
in Ladakh and supported us in our combined efforts to provide services
to those in need of rehabilitation and adapted equipment. We worked
together as a team, collaborating and sharing our knowledge and areas
of expertise, to enhance the service delivery, locally at MAC, in
the suburban areas and in the remote villages. There was good communication
between the therapists and a desire to further develop our working
relationship in the future.
Areas
of Future Collaboration:
Canadian team's next trip to Ladakh is
planned for mid-June & July 2008.
Continue joint therapy sessions at MAC
Continue follow-up rehabilitation support in suburban areas and remote
villages
Develop educational material together
Combine rehab equipment and material to create an available supply
of resources
Training camps for Community Health Workers on a variety of topics
Advocacy for more services to assist children with disabilities and
their families
