Rehabilitate 1000 Persons W. Disabilities in Nepal

At the moment, we have a success story of Dal Bahadur Singh (name changed), a 4.5-year-old boy and the son of Punikala Kami. He is a permanent resident of Soru Rural Municipality, Ward Number 6, Purumuru, Mugu. Dal Singh has been diagnosed with both physical and speech disabilities. He comes from a family with a poor socioeconomic background, consisting of eight members, including his mother, father, and five siblings.

During a screening conducted by PHASE Nepal to identify people with disabilities, a physiotherapist observed that Dal Bahadur Singh has multiple disabilities requiring physiotherapeutic treatment to develop motor control. When PHASE Nepal staff met Dal Singh in the community, he was being carried on his mother's back. Upon requesting his mother to lay him down on the floor, PHASE Nepal staff noticed that he was able to maintain a side-sitting position, with one hip in abduction and external rotation, while the other hip was in adduction and internal rotation. He exhibited a lack of control over his pelvis, and drooling of saliva was also observed. During the examination, we observed that he was responsive to the therapist's gestures and partially followed commands (albeit with some confusion). Additionally, there was a slight increase in tone in his bilateral ankle plantar flexors. The physiotherapist concluded that Dal Singh had delayed motor development and speech disability, with a possibility of hypoxic ischemic encephalopathy.

The physiotherapist believes that there is a good prognosis for Dal Singh if he receives proper physiotherapy and other healthcare services, such as speech therapy, in a timely manner. A comprehensive intervention plan was devised by the physiotherapist team, which includes neurodevelopmental treatment, gait training with manual support, supported standing, stretching exercises for bilateral ankle plantar flexors, hip flexors, hamstrings, hip adductors, piriformis, and targeted strengthening exercises focusing on individual muscle recruitment. Play therapy, such as horse riding with the aid of a log or pillow, and proprioceptive neuromuscular facilitation (PNF) techniques, were also incorporated.

After six weeks of physiotherapeutic interventions, Dal Singh has begun crawling using reciprocal movements of his upper and lower extremities. His parents have been provided with instructions for daily home-based exercises, including stretching exercises with a 25-30 second hold, 30-40 minutes of gait training, supported standing, range of motion exercises, and limb positioning. PHASE Nepal staff planned to further improve his gait by introducing parallel walking bars, and he was also recommended a nutritional diet appropriate for his age.

Dal Bahadur Singh's mother expresses her gratitude to the entire team at PHASE Nepal and remains hopeful for her child's positive prognosis. Thank you for your support and kind donation!

With gratitude,

The PHASE Nepal Team