Therapy Services for 80 Cambodian Families

Thank you so much for your support of the ABLE Project. Here is what has been happening lately.

Goodbyes

Since our last report we have had to say goodbye to two valuable teammates. Courtney, an occupational therapist from the U.S. who has helped to support us over the last three years, has returned to the States, and Bridget, who has spent a good part of the last year with us humbly sharing her wisdom in the field of educational psychology, has returned to New Zealand. We're so thankful to have had the benefit of their expertise informing the way we care for and empower children with disabilities and their families in the ABLE Project. 

Skill Building

While Bridget and Courtney were with us they also helped to share their expertise with partner organizations. The ABLE Project was able to arrange a learning exchange with OIC, an organization dedicated to developing the speech therapy profession here in Cambodia. In exchange for training that Bridget provided to their staff on behavior strategies and working with Autism, our staff received training last month on helping children develop communication skills. The training was provided by one of their licensed expat speech therapists and a Cambodian assistant and offered a good framework for our staff in understanding the components of language, how to know where a child is having trouble, and how to help. Also in January, our Project Manager, Srey Ny, provided training to eight families in Kandal, one of our provincial locations, about protecting the rights of children with disabilities.

Welcome Vanda

While we miss having Courtney and Bridget with us, we are delighted to have welcomed aboard a new staff member. Vanda, our newest Community Rehabilitation Team member, just joined our team this month. So, over the last few weeks, our Project Manager, staff Physiotherapist, and Physical Therapy Technical Adviser have all been spending significant time training her and having her accompany them on client visits. The role of the Community Rehabilitation Team member is really important as it allows children and families to receive much more frequent and consistent support. There are very few university trained physiotherapists relative to the population of Cambodia. The ABLE Project is currently serving 66 children in five provinces in addition to Phnom Penh, which requires our two Cambodian physiotherapists to do a lot of traveling. The amount of time available for them to visit cases directly would not be adequate if our Community Rehabilitation Team members were not available in the local communities to provide follow up in between visits from the physiotherapists. In the places where many of the children in the ABLE Project live there are few or no other rehabilitation services available. Having our physiotherapists travel to the local communities and having support staff living and working in these communities provides access to services that many children would not have otherwise. Vanda will be the only ABLE staff member living in Kampong Chhnang (Children In Families does have two social work staff members there) so it is essential for her to be well grounded and confident. So far, she has proved to be a quick learner and able to develop good rapport with the children and their families, both of which are essential.

So, thank you again for your support of the work of the ABLE Project. Your giving helps give children the opportunity to experience and achieve their potential within their communities. 

Links:

• Read more about the ABLE Project here

In our last report we shared that the ABLE Project had received five new cases within a two-month period. That trend has continued, as we have received an additional seven cases in the last three months. This highlights the tremendous need for services to support families in caring for children with disabilities and chronic health needs here in Cambodia. The lack of services available to families means that many families have a difficult choice to make – relinquish their child to institutional care, or try to care for their child the best they can without access to any interventions to improve their child’s situation. Families who are caring for a child with disabilities or a chronic health condition face tremendous pressure with regard to resources of time and money and, in many cases, experience a decline in their child’s and family’s situation. But, the good news is that, with the right supports, these children and families can thrive. This is why it is so vital that these supports be provided. Without them, children with disabilities do not have the same opportunity to have their right to appropriate care within a loving family protected.

The ABLE Project team is not only working on building our own capacity to meet these needs, we have been offering up assistance to other organizations so their staff are equipped with skills to make their services more inclusive of children with disabilities and responsive to their needs as well. Through trainings and consultation we are building stronger collaborative relationships with partners to work with them in making quality care available to more children with disabilities. As we look to the future we recognize that we need to continue to keep building on both of these fronts: building our own capacity through hiring and training additional staff, and continuing to develop a more structured approach to helping other organizations build their capacity. Many organizations working together in close collaboration will have a widespread impact in making family based care inclusive throughout Cambodia. The ABLE Project is committed to having a strong role in this effort.

Recently, Family Care First produced a video to highlight the work of the ABLE Project and the difference that inclusive family based care can mean for a child. Srey Oun* had been abandoned at a local hospital and her family could not be located. She was born with significant congenital anomalies which made it difficult for her to eat. She was also blind and in need of surgery. Children In Families received her into emergency foster care and the ABLE staff began working with her and her emergency caregiver, while also working with CIF’s social work staff to find a long term foster family for her. Please click on the link below to watch the video and see the beautiful difference inclusive support for family based care has made in the life of this little girl.

* Child's name has been changed

Links:

• https://www.facebook.com/FCFREACT/videos/2354907911415697/UzpfSTE2ODg0ODQ2OTE5MToxMDE1NzM3NzEyOTYzOTE5Mg/

ABLE has been busy with an increase in partner referrals, cases accepted and frequency of family visits. We are happy to see that more children with disabilities are remaining in their families and that those already in care are receiving an increase in therapeutic in home services.

5 New Cases in 2 Months

Providing holistic services for children with disabilities in family based care can be a slow process, however ABLE has found that slow and steady wins the race when working with families and children in crisis. Families often require weekly support in the beginning phases and ABLE is happy to see that this investment often results in stable families who have increased confidence to care for their children who may have complex needs.

Through ongoing advocacy with the wider disability community in Cambodia, ABLE has seen an increase in referrals from partner organizations over the past 3 months. These referrals result in an assessment with ABLE team and kinship care staff, where a plan is made with the family to provide support to ensure that families stay together whenever possible or find other solutions that result in children staying with extended families or other safe families in the community. This month, ABLE has accepted 5 new cases resulting in 4 out of the 5 referral cases remaining in their families. We are overjoyed to see children with disabilities realize their right to grow up in loving safe families.

Increase in Family Visits

A core service of ABLE is family visits: opportunities to meet with families in their homes and support them in a variety of ways such as psychical or occupational therapy services, special education, medication management, and family training. Many of the families who need these services live rurally in Cambodia, requiring ABLE staff to travel nearly a day in some cases to visit one family. The value of providing services in the natural environment has led to safer, more stable, and more confident caregivers. It’s also expensive and time intensive. We are excited to say that with increased funding and staffing we will now be able to see every family at least once a month. For many cases we see them weekly, especially families new to services or families experiences are particularly stressful time, but we are happy to say moving forward we will be able to meet our goal of increased frequency of services for all of our families. Thank you to all donors and supporters for being a huge part of making this happen!

Accessing Training and Improving Services

Through the support of our Global Giving partners we are happy to announce that we have hired new key staff members which was outlined in pervious updates. However, with ongoing support our staff have been able to access ongoing training in key areas of disability. These past few months our staff have trained in Autism and sensory integration and one staff has returned back to school to pursue a bachelors in physical therapy. These trainings have increased the quality of our care especially in the area of supporting children and their families with Autism.

The past few months have been busy and in reflection a fruitful time in seeing 5 children supported to remain in their families, an increased frequency of services provided to nearly every family, and an increase in quality of services for children with autism in family based care.

The ABLE team would like to take a moment to say a special thanks for your continued support and update you on the progress of our team and families over these last few months.

An Expanding Team

To expand on our previous report, our team has welcomed an additional physiotherapist, Chet, and she has been a perfect addition to the team. She is busy already supporting families with medical appointments, in home therapy sessions, and providing additional coaching to our provincial staff around physical therapy interventions.

We are also happy to welcome Bridget to the team! She is an educational psychologist who will spend the rest of the  year volunteering with our team to research, prepare and provide training regarding behavior management skills to our staff and families. Her experience in autism is especially valuable to our team as we seek to provide comprehensive supports to children with autism at school, home, and in the community.

Expanding Services

As the ABLE team expands in both expertise and staffing we look to increase the frequency and quality of our services. Previously our project manager, SreyNy Sorn, was wearing many hats as project coordinator and lead physiotherapist. As the team expands we are excited to free up time to increase staff training, home visits, and program development. We look to expand services not only to the families supported by ABLE but also to partner organizations.  As staff numbers have increased, we have been able to provide consultation and training to two partner organizations around feeding, nutrition, adaptive education, and community inclusiveness. We look forward to expanding these partnerships so that many more children and families can receive the support they need to grow and thrive.

Expanding Confidence and Independence

For one young boy a supportive home environment has made all the difference in his confidence and independence at home and in the community. Before entering the project, he struggled to walk short distances without having breathing difficulties due to his chronic health issues. ABLE is happy to report that with family support, continued training, medical management, and home adaptation he is now running and playing with his sister around the family home. He loves to walk around the community with his family and welcome his sister home from school.

ABLE is happy to see that as our team expands, our expertise increases. It effects real life change in the families that we serve. ABLE has become convinced that children belong in families, and with the right support they can grow and thrive as valuable members of their communities.

People with disabilities often face barriers which prevent them from participating in the life of their communities. The ABLE project works to remove the barriers that prevent children with disabilities from entering into family-based alternative care and making these systems more inclusive.  

Community attitudes can often be one of the biggest barriers to inclusion of people with disabilities. Fear or stigma attached to disability can make a community less inclusive and keep people with disabilities isolated. In such an environment it may seem impossible to recruit a family willing to foster a child with disabilities who is not related to them, and even the sustainability of kinship care can be threatened by negative community sentiment.

What we have learned from our experience is that we don't need to look for inclusive communities, we just need to look for inclusive families who can pave the way for making their community more inclusive. Within any community there are people who think differently, who have had different experiences which make them more willing to take on the challenges that come with caring for a child with disabilities. By identifying the kind of families who are willing to take on the role of being a foster family, and then equipping them for that role, we help them to become community advocates. The experience of watching a family care for a child with disabilities breaks down barriers for others in the communities and begins to make the communities more inclusive. It leads to other families expressing a willingness to care for a child with a disability.

Since our last report...

In December, we reported that we were looking to recruit another physiotherapist and that they were in short supply. We can announce that we have hired a physiotherapist, named Chet Aom, who has recently graduated from the country's only physiotherapy training program. She will start mid-March. We have also enrolled two new children into the ABLE Project, both of whom are in Children In Families' Kinship Care project, bringing the total number of children in the project up to 49. 

During January and February the Better Care Network filmed an interview with Srey Ny Sorn, ABLE's project manager, and Lisa Yunker, one of ABLE's technical advisers to share their learning. This video will be completed soon and will be available via the Better Care Network's website to allow other family-based alternative care organizations to benefit from the experiences of the Children In Families' ABLE team. 

Srey Ny is speaking this week at a UNHRC side event on preventing unnecessary separation and institutionalisation of children with disabilities. We are grateful to share the lessons we have learnt about how to create inclusive communities that support children with disabilities and the families that care for them. We look forward to learning from the other organisations represented at this event and together, see children with disabilities thriving in loving families and communities. To find out more, follow our facebook page.

Thank you for your continued support. We cannot do this work without the generosity of partners like you.

With Much Thanks,

Lisa Yunker (ABLE Technical Advisor at Children in Families)

Links:

• https://www.facebook.com/ChildrenInFamilies/