Community Based Rehabilitation

The rain gods were in our favor today. The sun was bright. The paths into the villages not washed away. Together with the community based rehabilitation worker from the Creative Self Help Centre and physiotherapy students from Divine Word University, we headed into the villages.

The first client we visited was a 5 year old boy with cerebral palsy. While the physiotherapists completed their evaluation measuring his range of motion, elasticity, etc, I observed his social skills, interactions between himself and his family, and some simple cognition skills. He was able to make eye contact, reach out for the balloon, and follow simple commands. He was smiling and responsive. His parents want to work toward the goal of him sitting independently. We took measurements to make him a chair and I urged the parents to continue to talk and play with him.

This compound was filled with children. No shirts or shoes. No school. No toys. Skin rashes and diseases. Extended stomachs. Thin and frail arms and legs, like toothpicks. Inclusive education targets not only the disabled, but the disadvantaged too. Its heartbreaking, but we can't save them all.


Our second client presented more challenges. When completing village assessments, the most valuable information is gained through observations. This picture is worth a thousand words.

This 10 year old boy was adopted by his aunt. His parents did not want a child with a disability. Just like his wheelchair, this child has been left out. Due to lack of stimulation and other treatments and therapies, this child has multiple disabilities. In addition to his inability to hold his head up, make eye contact, or interact in any way other than crying, he has limited range of motion when assisted and presents with an inverted sternum.

This family lives near a lagoon and the CBR worker plans to provide water therapy in an effort to increase independent body movements. I modeled social interactions for the family and encouraged them to talk, sing, and play with their adopted son.

Friday, the CBR officers are conducting a workshop on making cardboard chairs. The physiotherapy students and I will make chairs for these two boys which will allow them to sit up and be a part of the daily interactions of their families.

In addition to providing therapy services to these children, another goal of outreach visits is to increase the awareness of disability rights. Helping them to understand their child and assuring them that their child's disability wasn't punishment from their wrong-doings or from the gods. Showing these families that their child can smile, laugh and play like their other children is the most important component of our visits.

Community based rehabilitation and inclusive education are the future in PNG!