Therapy Services for 80 Cambodian Families

by Children In Families Organization
Therapy Services for 80 Cambodian Families
Therapy Services for 80 Cambodian Families
Therapy Services for 80 Cambodian Families
Therapy Services for 80 Cambodian Families
Therapy Services for 80 Cambodian Families
Therapy Services for 80 Cambodian Families
Therapy Services for 80 Cambodian Families
Therapy Services for 80 Cambodian Families
Therapy Services for 80 Cambodian Families
Therapy Services for 80 Cambodian Families
Therapy Services for 80 Cambodian Families
Therapy Services for 80 Cambodian Families

Imagine spending most of your life on your back, staring up at a ceiling of rusting corrugated tin. From time to time a face appears to feed you basic nourishment or give you a bath, but the world passes by you as your head becomes flat from pressing the hard floor most hours of each day. Your siblings run and scream, coming in and out of the house. Yet, you lie there, unable to move your muscles well. Flies and ants assail you, but you do not have to strength to swat them away. You can understand much of what they say but no one speaks directly to you. Because of this, facial expressions and language are delayed.  

This was little Phanna’s life for the first two years. Born with cerebral palsy (CP), his family who lived in desperate poverty had no idea how to care for him. There was no support within their community and since they knew no one else with a child who had CP, they had never seen a better way to care for him. Struggling to survive daily life, his parents would disappear all day to work. Meanwhile, Phanna lay there. Alone.  

Poverty and lack of education mingled with disability, Phanna was in an unsafe situation and at risk of abandonment. In addition, even medical professionals in Cambodia rarely understand what it means to have a disability or care for a child with a disability. Even when examined by a doctor, his parents left discouraged and shamed because they lacked the knowledge needed to care for him well. It further isolated Phanna as his family kept him hidden from the community.  

Thankfully, his story does not end there. Children In Families (CIF) learned of his situation. Soon after, CIF enrolled his family in our Kinship Care and ABLE Programs. After assessments by CIF’s social workers, they determined it was not safe for him to stay with his parents. Instead, a loving Auntie took him in. This was the best living situation for him, giving him the safety and care he deserved.  

The ABLE staff took an active role in training and supporting his Auntie to care for his special needs. He remained in his community and sees his siblings constantly. The Physiotherapy and interaction with his extended family allowed him to significantly develop physically, emotionally, and mentally over these past years.  

At six-years-old, through a partner organization he received a special wheelchair. A whole new world opened for him as - not only Auntie - siblings and cousins can now take him out of the house to play and interact in his neighborhood 

Every day, Phanna is learning his new opportunities and challenges. The community is getting to know his special abilities. We are excited thinking about the opportunities for Phanna, as well as the impact he will make with friends and neighbors. We hope as the community interacts with him more, they will take the opportunity to learn about, embrace and include him. 

Four years later, imagine waking up, being able to lift your head and then sit up with assistance. Your kind Auntie greets you with a smile and speaks directly to you. You eat alongside your family. Then, someone places you in your wheelchair to explore your neighborhood with other children. You laugh and scream and throw a ball. You are safe. You are loved. And you belong.  

The reality is that Phanna’s story is not unique. Many children with disabilities are loved by their families but do not receive proper care and attention due to stigma, lack of understanding, and lack of resources. Usually all it takes is a little support, continued knowledge, and paradigms begin to shift. This is where CIF and the ABLE Program shine.  

 

 

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We are so thankful that, while Covid-19 continues to be a challenge globally, the measures taken by the Cambodian government along with our own modified strategies and procedures for doing things allowed us to resume direct services for all clients. We have been able to take care of some needs that had to wait when the situation was more restricted.

One of those needs was the need for equipment. While the direct therapy services and family training that the ABLE staff provide are critical to enhancing the quality of life for our clients, some children need more than that. A wheelchair or walker for a child with mobility restrictions often means the difference between isolation and impediments on the one hand, and engagement and community participation on the other.

Recently, our staff met with Nala* and her family to bring a long-awaited wheelchair. It is clear from the photo of Nala* that she is thrilled to have access to greater mobility for the first time in her life.

This wheelchair was provided by Wheelchairs for Kids, an Australia-based organization who manufactures and provides adjustable pediatric wheelchairs around the world. Nala is one of the children who had to wait for the resolution of Covid-related travel restrictions to receive this life-changing piece of equipment. We are so thankful that now, at last, she is able to engage so much more easily with other children in her village and really take in the world around her.

While Nala was the one most impacted by isolation and mobility restriction, the benefits of having access to the wheelchair are far reaching. It allows her family members to move about the community more easily with her. She could hardly be left at home alone, while they visited and worked. It also influences her community. Minds are being changed about people with disabilities as neighbors and friends gain more exposure to families and children with disabilities.

Nala is a beautiful child with a smile that melts hearts. Her joy is infectious and needs to be spread, especially in these difficult times. Your generosity allows children to be impacted by the love and care of a family, but it also allows communities to be changed from within. Nala’s mobility is also part of a paradigm shift for her neighbors.

The ABLE Project staff also helped to provide the gift of mobility to two children from a partner organization here in Cambodia. Our physiotherapists were excited to fit them with wheelchairs, also from Wheelchairs for Kids.

We are so appreciative of the support from all of you who have contributed to this project through GlobalGiving. We hope that you are encouraged as you see the impact that your giving has on the lives of these children.

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Working on language skills
Working on language skills

Community-based rehabilitation is a strategy which has been used for decades in lower-resourced countries such as Cambodia. Over that time it has evolved and broadened to include more than medical rehabilitation, though that is still a relevant need. According to the WHO, "Community-based rehabilitation (CBR) is community action to ensure that people with disabilities have the same rights and opportunities as all other community members. This includes, for example, equal access to health care, education, skills training, employment, family life, social mobility and political empowerment." (WHO, 2004). In places like Cambodia, many people do not have access to professional health and rehabilitation services, It was for this reason that the ABLE Project was started. In order for family-based care to be inclusive of children with disabilities, there have to be support services that address the unique needs of those children and their families. Since these services were not present where our families were, we knew we needed to include our own form of CBR. While the ABLE Project has two Cambodian physiotherapists on staff, we also have staff members that we call Community Rehabilitation Team (CRT) members. These staff are trained on the job by our physiotherapists and an expat technical advisor to provide basic rehabilitation support and follow up. While our physiotherapists are based in Phnom Penh, the capitol city, these CRT staff live in the rural communities in which they work. 

This multi-skilled, uncentralized approach had been advantageous since the start of the ABLE Project, but the current Covid situation has made it even more necessary. While the Cambodian government and people work hard to implement strategies to contain the virus and minimize its consequences, travel from one place to another has been limited and we are all doing our best to decrease the spread of the virus. As there is still no end in sight for a return to "normal," however, the risks have to be weighed against the cost of total isolation. While it was possible and necessary during the biggest surge of the virus to limit our contacts to phone check-ins with the children and their families, we have carefully returned to doing direct visits. Research has shown that time is of the essence when working with children who have disabiliites or developmental delays and the earlier a child receives help the better. We don't really have time to "wait it out" if there are ways that we can minimize risk while still providing the support services these children need. Again, this is where our community-based staff are so vital. 

As an example, in the picture you can see Savorn, one of our CRT staff working on language skills with a little girl with speech and language delays. Using good hygiene and masks and trying to maintain a safe distance, she is able to model for the family how to promote this little girl's language development. Consequently, this child has shown significant improvement and the family is really happy. This little girl and her sister also have a chronic health need for which the ABLE Project has been supporting the family to receive treatment. "Before it was difficult to understand Sophea* when she spoke. Now she is speaking more clearly and saying more words. Both of my grandchildren have become healthier thanks to the appropropriate medical treatment and the care and guidance from the CIF staff. I am happy to see them in better condition than I could have imagined," said the girls' grandmother. 

We are so thankful for your continued support which allows us to continue to ensure that, even in the midst of a worldwide pandemic, children like Sophea and her sister are not being left behind. We hope that you are all keeping safe and finding your way to a healthy balance in this crazy time. 

* Name changed to protect the child's identity.

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Community rehabilitation staff ready for action
Community rehabilitation staff ready for action

That's our current take on the phrase "deperate times call for desperate measures." We wouldn't say that things are desperate right now, but they certainly are still quite different from before Covid-19, and the situation can change a lot from day to day. Here in Cambodia the spread of the Covid-19 virus has, unfortunately, become more prevalent. While we had been fortunate to have minimal community spread throughout the first year of the pandemic, things took a dramatic turn in February of this year. We had been using precautions like the rest of the world, even when the virus wasn't doing its worst, but once the virus really started taking off, the Cambodian government took some strong actions to try to reign it in. This took the form of temporary lockdowns where travel was extremely limited within the capital city of Phnom Penh and a few other hot spots, and from one part of the county to another. 

This was a problem for us in several ways. For one thing, there are children in the ABLE Project who live in the provinces but travel into Phnom Penh periodically for reassessment of their conditions and to have their medicines refilled. Children with epilepsy are one of the primary groups to whom this applies. It is essential that those children receive their medications and the lockdowns came without much notice, so we had to do some quick coordination to ensure that they were covered. Fortunately, we were able to work out a plan with the hospital where they receive their assessments and medications. The children received virtual assessments facilitated by our province staff where the doctors at the hospital were able to interview the families and view the children via video calls from our staff. Then we were able to find a transport service which was authorized to travel through the checkpoints so that the medicines could be sent from the hospital to where the children lived. Yay! Problem solved. 

Another challenge was supporting our province staff in using a new assessment tool. We had just transitioned to using this tool prior to the pandemic and, under normal circumstances, our physiotherapists from Phnom Penh would have been doing in person training and coaching to help our provincial community rehabilitation staff become more familiar and proficient with the tool. Since we've been able to do very little traveling between the provinces and Phnom Penh, we adopted the same strategy as we used for our children who needed virtual visits with the hospital. We've begun to use video calls to coach our staff through the assessments. It is not the same as being there in person, but we are making it work and it's helping us to stay on top of things despite the current limitations. In the provinces, where there has not been as much transmission, our staff are still able to make face-to-face visits with appropriate protective gear. For our clients in Phnom Penh we still have to do visits virtually until the number of new Covid-19 cases flattens out. 

Thank you so much for hanging with us through the challenges of Covid-19. We know that the pandemic has been hard on many people, including financially, and we really appreciate those who have continued to financially support this work. Understandably, some donors have not been able to continue their support, so, if you have not given recently and are able to help make up the difference, we would be so very grateful!

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Some Good News

We’re so happy about the progress that has been made in the worldwide Covid-19 situation. Though, we realize that we are “not out of the woods yet” and that the virus is still making life very difficult for many, the development of vaccines and the decreased strain on the health care systems that many are reporting offer a glimmer of hope. We hope that the availability of effective vaccines to all people in all parts of the world happens as efficiently as possible so that you all can begin to have some relief, wherever this finds you. As for us here in Cambodia, the situation has remained pretty stable with regard to virus transmission. Though the economic impacts have been severe, the projections are not quite as dire as they had been previously. It appears that recovery is happening, though there is still a long way to go. Even before Covid-19 hit, many Cambodian families lived only one crisis away from being able to sustain their livelihood, creating great vulnerability for their children. So, whether or not Covid-19 remains a threat, Children In Families will continue our work in strengthening families and improving their resilience.

Another bit of good news – last report we mentioned that we had a challenge in finding a stable source of medication for a child with cystic fibrosis. We are happy to report that we are now able to get it on a regular basis from a local pharmacy once again!

 

Continuing in the “New Normal”

Despite the stability of the Covid-19 situation in Cambodia, efforts remain strong to keep it that way with many people continuing to wear masks and practice social distancing as much as possible. The ABLE staff members are conscientious in their observance of these protective measures. Of course, frequent hand washing is also a must, but ABLE Project staff strive to do that at all times when providing therapy services. The ABLE team has resumed pretty much a pre-Covid schedule while making these necessary accommodations. Over the past three months they have provided over 400 face-to-face visits, most of them at the families’ homes, but also providing some visits in hospitals, health clinics, or schools, depending on the needs of the children and their families. While providing therapy is one of our primary activities, advocacy is also important, whether it involves helping a child with disabilities to be included in public school or ensuring that children with disabilities get the medical care they need and that their families understand clearly about their health status and medical care. Through CIF’s advocacy and support, one child with partial paralysis in her legs has just started school this year and she couldn’t be more excited!

Once again, we want to thank all of you for your support of the work of the ABLE Project. Your giving allows essential services to continue for these vulnerable children and their families.

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Organization Information

Children In Families Organization

Location: Phnom Penh - Cambodia
Website:
Facebook: Facebook Page
Twitter: @Children_in_Fam/
Project Leader:
Lynny Sor
Phnom Penh, Cambodia
$10,262 raised of $50,000 goal
 
162 donations
$39,738 to go
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