ADAPT continues to watch events as they unfold across the world.
Lesley is well known in the physiotherapy world and amongst the global health and humanitarian community. She spent a significant amount of time and contributed greatly to the ADAPT team. Lesley has lived and worked in the West Bank and Gaza Strip between 1988 and 1999. She headed up the team that developed and ran degree programmes in physiotherapy and occupational therapy at Bethlehem University and a short spell in Gaza at the UNRWA College of Nursing. As a result of these projects and an interest in Biblical sites, she travelled widely in Israel and the Occupied Palestinian Territories.
“Some of the stories in this book are personal, some are about other people I met,” said Lesley, “others are stories I heard and some are more than one story put together. All the stories are based on my time working and living in the Middle East – some are about situations in the Occupied Palestinian Territories and others are based in Israel. I leave the reader to decide which stories are which. Stories represent the complexities of life for all who live there and pose questions but provide no answers. A Chinese proverb says “May you live in interesting times” we certainly did.” – Lesley Dawson
The book includes 76 stories and memories all produced as set pieces of Bourne to Write workshop homework and timed exercises, so the book grew without Lesley noticing it. Now it’s a fascinating and often humorous insight into life and education in a highly complex, sensitive part of the world. The book also features 44 of Lesley’s photographs.
The proceeds are being donated to an organization working with people with disability, Action around Bethlehem Children with Disability (ABCD).
Quoting WHO: The need for rehabilitation is far, far greater than most people assume. More than 2.4 billion people, almost a third of the global population, have health conditions that could benefit from rehabilitation”- Assistant Director-General, Professor Jérôme Salomon opened the meeting with these remarks.
Adding to the spirit of the participants “Foundation, motivation and commitment” were the words chosen by Dr Alarcos Cieza to open the 3rd Global Rehabilitation 2030 meeting.
We would like to express our gratitude for your presence and engagement during the 2-day meeting where WHO has showcased a comprehensive range of new technical products designed to address key challenges in the rehabilitation sector. Your keen interest and thoughtful presentations reaffirmed our belief in the importance of these products. We are confident that they will make a positive impact in strengthening rehabilitation in health systems as stated in the resolution:
- The Package of interventions for rehabilitation (PIR)
- The Guide for rehabilitation workforce evaluation (GROWE)
- The Routine health information systems – rehabilitation toolkit
- Strengthening rehabilitation in health emergency preparedness, response, and resilience: a policy brief
- Rehabilitation in health financing – opportunities on the way to universal health coverage (coming soon…)
The meeting was followed by the World Rehabilitation Alliance (WRA) launch. The launch was celebrated with a video message by Emilia Clarke, actress and rehabilitation advocate, and a musical performance by Ricky Kej, 3x Grammy award winner including the first ever global rehabilitation song! A huge thanks to Ricky and his amazing team for being rehabilitation champions.
If you missed the events you can watch the recordings here:
Interested in joining the team?
Be part of our core team, no global health experience needed, approximately 2-8 hours per month (flexible).
ADAPT is looking for a new member or members in a shared role to join the subcommittee as a Website Content Uploader to help prepare digital content and upload to the ADAPT website. The key responsibility is to accept content from the team and upload to the appropriate locations on the ADAPT website. This will include updating the existing pieces while ensuring proper formatting.
Join us for this free, online event with five eminent speakers on Equality, Diversity and Inclusion in the context of global health inequalities.
The study day is open to all and professionally be represented by ADAPT, Communication Therpay International and OT Frontiers
Having always had a keen interest for humanitarian work, I wanted to involve myself with this area of physiotherapy having recently qualified. Whilst being a member of ADAPT, I was given the opportunity to spend some time working with ‘World Hope International’ in Sierra Leone, through the working relationships I had built. More specifically, I got involved in the ‘Engage the Children (ETC) Programme’ led by physiotherapist Anna Vines. In total, I was living in Freetown for three months, all the while gaining invaluable experience in the field of Global Health, especially as this was my first time working in this area.
I spent time working in a range of both clinic and community settings treating children with disabilities in Freetown and also occasionally up-country. The work I undertook involved treating children through exercises, distributing handmade equipment to aid positioning, and providing education to both families and communities to try and reduce the stigma surrounding disabilities. During my stay I was lucky enough to be involved in the ETC annual beach outing where we brought all of our families together to celebrate disability in an open and supportive environment.
Personally, this trip was about gaining first-hand experience in the Global Health world to hopefully pursue this area of work in the future. In addition to this, I wanted to be involved in Paediatric Physiotherapy, with it being a keen area of interest for me. Experience is what I desired and experience is what I got! From my first day, I was welcomed into the team and got myself stuck in with the work at hand, which allowed me to not only build my competencies in clinical skills but also my confidence in working in settings with limited health resources and infrastructure.
During my time I definitely encountered some challenges; one of the main ones was learning how to adapt according to the surroundings. For example, on many of our home visits equipment, toys, and resources were all limited, meaning that I had to be adapt in my treatment methods. Another challenge was the language barrier, the main language spoken in Sierra Leone is Krio. One of the biggest highlights for me from my entire stay, was actually becoming more confident in speaking Krio, partially in clinic. Speaking Krio to patients and their families made me feel like I was able to improve on my communication and quality of treatment.
I was able to build meaningful relationships with patients and colleagues which only furthered my passion for this area of work and made me feel genuinely fulfilled in the job I was doing.
My future plan following on from this experience is to gain a job completing Band 5 rotations in the UK for the NHS. I want to build my skills and competencies, to allow me to fully equip myself for more roles in Humanitarian and Global Health work in the future. Of course, I will continue to be a member of ADAPT to ensure I keep up to date with Global Health affairs and learn through frequent webinars and working relationships.
I think if I were to give any advice or take-home points, I would say that if you are interested in this type of work there are opportunities around if you are willing to look and find them. I would urge anyone who is interested to seek more information through ADAPT and to also reach out to other physios who have competed similar work.
In 2002, after retirement as a physiotherapist, I read an article in Frontline about Kumi Hospital, an old leprosy centre in eastern Uganda and now a general hospital, asking for volunteers so I replied and soon arrived into an unknown world. Twenty years later, this has developed into a registered charity with UK Trustees and a local team involved with helping families with children with disabilities and living in extreme poverty in the remote rural areas.
We are partnered with Kumi Hospital, Wheels for the World, Interplast UK and are linked with Dentaid. The local team consists of our team leader who is a social worker, a physiotherapist, a CBR worker, an administrator and a nutrition nurse all of whom are employees of the hospital but are volunteers for KCF. The hospital has an orthopaedic workshop which makes prostheses, simple wooden seating for brain damaged babies and children, standing frames etc.
I stay an average of ten weeks a year and I returned from my last visit in March 2022 when we were joined by our partner Wheels for the World, for a week’s distribution of 119 wheelchairs dispatched from UK and as many again mobility aids. The remaining weeks of our five-week visit were occupied with our rehab programme and fieldwork
The Soroti Care Centre was initiated by our CBR worker to provide support and assessment which we support. Families with children with disabilities or malnourishment can come for assessment and formulation of a treatment plan if appropriate. Home visits follow if necessary. Some of the activities we have include making walking aids such as parallel bars on site with local materials, income generation projects, simple housebuilding, providing wheelchairs, tricycles, mobility aids, rehab, funding for surgeries and hospital nutrition support with the payment of hospital bills with our mission being “Helping Others to Help Themselves”.
We have sponsored youngsters in education all of which have disabilities or a sibling with a disability. We fund school fees from baby class through to university level.
- The latest challenge has been the COVID pandemic where the Trustees have been unable visit in person but our local team has continued as much as the restrictions allowed
- The people’s poverty levels and remoteness limit the access to healthcare and hospital services
- Lack of education in basic health issues and their ability to fund schooling
- Provision of transport
Highlights of Last Visit
- The Wheels for the World Visit and Distribution
- Official Opening Day of the Soroti Care Centre
- The visiting Dutch Orthopaedic Surgeon’s camp
- Our next objective is to arrange the surgical mission of Interplast UK for plastic surgery in October 2022. Our local team is identifying the patients and compiling a list.
- To continue to consider the families holistically and provide resources within our ability
- To continue with funds raising efforts
Elspeth Robinson MCSP (retired)
Q. When and how did you become involved with Interburns?
I have been involved been with humanitarian works through clinical works and trainings since 2010 when a Charity from United Kingdom Resurge Africa introduced me to ten days outreach program which was designed to be a yearly program which had started about 2009. This was a call for reconstructive surgeons, nurses and rehabilitation specialists needs for the people of Sierra Leone in one of their districts called Make.
Just before this time I had training in burns rehabilitation in Glasgow Royal Infirmary, Scotland. This training was identified as a need for Ghana after a period of time where the visiting surgeons always had to come along with their hand and burn therapist since my country didn’t have any. The outreach program gave me the opportunity to visit Sierra Leone about 4 times and this increase my appetite for advocacy and share my knowledge with others in Africa and beyond.
I was selected to represent Ghana for the first ever Advance Burn Care (ABC) Rehabilitation which took place in Bangladesh in 2015. There I was selected to be a trainer of trainees and that also helped in my zeal to give rehabilitation services to different groups of people using different platforms. The training was by another Charity in United Kingdom Interburns who are into training, education and research in burns to support LMICs. We have had trainings in Ethiopia, Ghana, Tanzania and online trainings for different international bodies and agencies.
Q. Where have you been spending your time recently?
Recently in November 2021 I went to Sierra Leone following the mass Gas Tanker explosion which killed hundreds and injuring over 300 people. I was there for two weeks but had previous engagements with the local rehabilitation team to plan and execute enrolment of emergency acute rehabilitation care.
Q. Can you tell us what the project objectives were?
The objectives of the trip were to give the best rehabilitation and meet the needs of the injured patients.
To introduce the role of rehabilitation in the multidisciplinary burn care team.
To teach the local therapist of the approaches in managing Acute burn patients including those in the ICU.
To robe in the students who were the available workforce with close supervision.
Q. What did you find challenging?
The first challenge was seeking for the approval to enable rehabilitation specialist to be sent on the grounds as soon as possible.
The limited number of physiotherapists in the country and their distribution.
Lack of specialised burns therapist in the country.
Reliable and dedicated system with personnel or staff.
Engaging and using level 300 students who were not prepared for mass casualty management both theoretically and practically.
Q. What were the biggest highlights?
The coordination within few days to get the Physiotherapists to be a part of the initial response team was a good attempt.
The willingness of the students to be taught and practice in an area which was new to them in their program and the support with logistics such as internet facility by the Kings Partnership Sierra Leone helped a great deal with the success of the rehabilitation.
The support by an individual company to help in the Mass Casualty went a long way to assist in the acute, medium and long-term management of the patients.
Q. What plans do you have for the future?
To instil advocacy and teamwork in both the local physiotherapists and the students so as to prepare them for any future disaster management.
To have close feedback with local team to ensure the patients are getting the best of rehabilitation care.
To review the patients for their medium to long term plans by liaising with the local therapists and any other therapist on the grounds.
There are two physical visits to be made before the year ends to ensure the medium to long term management is achieved.
Sustainable seating and standing solutions for children with disabilities using appropriate paper-based technology
Catherine Barton, Rachel Lindoewood, Pauline Samia
The Benefits of Children’s Equipment Donated to Lower and Middle Income Countries : a Case Study from PhysioNet
Heather Angilley, MCSP
Kentaro Mizuya (Ken) is a physiotherapist working in Japan. With a passion for humanitarian work, Ken has joined a few ADAPT events and shared his experience. We were interested to learn more about Ken’s experience, hence we had an informal interview in which Ken shared more about his humanitarian work.
When speaking of what sparked his passion for humanitarian work, Ken talked about an experience during high school: He had an interview with a man from developing country, which inspired him to explore other parts of the world and improve the quality of life of those in need. After becoming a physiotherapist, this experience continued to encourage him to make use of his physiotherapy skills and dedicate himself to humanitarian work.
Ken has had various experiences of humanitarian work as a physiotherapist:
- He volunteered in Dominican Republic in 2011-2013. He was mainly involved in the rehabilitation of patients and education of clinicians on mobilisation techniques.
- Ken’s first humanitarian experience was as part of the response to the Earthquake in Kumamoto in 2016, when he mainly worked on providing shelters and support to victims.
- His most recent humanitarian work was in Mozambique in 2019. Here he was mainly rehabilitating patients and supporting the medical team.
Fig1. Picture of Ken teaching manipulation skills at Dominican Republic
Fig2. Picture of Ken repairing a wheelchair in Kumamoto
In 2017, Ken registered with the Japanese Governmental Emergency Medical Team as one of the first few physiotherapists. The Japanese Governmental Emergency Medical Team is part of the Japan Disaster Relief (JDR) team and is classified by WHO as Type 2 Emergency Medical Team. JDR is run by Japan International Cooperation Agency (JICA). JDR has existed since 1979, but their response to the Nepal earthquake in 2015 was the first mission that included a physio as a part of JDR medical team. Ken participated in the second one, which was the Mozambique cyclone response in 2019.
Ken shared the details of the response to Mozambique. In March 15th 2019 Cyclone IDAI hit Mozambique, leading to more than 1,000 deaths. The JICA organised JDR for the response: The first medical team was dispatched on March 28th, and second team on April 5th. Ken was part of the second dispatched medical team.
Fig3. Picture of destructed buildings in Mozambique
There were a few roles as a physiotherapist in the team. Apart from attending to patients with rehabilitation needs, another major part of the volunteer work is assisting the normal function of the medical team. This includes interviewing patients in the reception area, maintaining equipment such as tents, toilets and generators, burning waste, preparing meals, and other non-clinical work.
Fig4. Picture of field clinic and accommodation area in Mozambique
Including follow-ups, 794 patients attended the clinic. The most common diseases were acute respiratory infections, acute watery diarrhoea, malaria and cholera. Among these patients, around 5 had rehabilitation needs.
When speaking of the differences between work in Mozambique and that in Japan, Ken said that due to the nature of the response, they had to be creative and flexible with the resources around them. This included making walking aids with wooden sticks from local trees. At the same time, they also had to be aware of the effective use of resources. For instance, due to a shortage of plastic chairs, they made use of card board boxes and issued them to patients instead. This was because it would be unfair if only some patients have received them.
Fig5. Picture of Ken issuing crafted stick to patient
Apart from lack of resources, there were a few more challenges faced by the medical team. The weather at Mozambique is extremely hot, with temperatures of up to 52 degrees. This can easily cause dehydration and general discomfort of the patients and staffs. In addition, the area of major traumas was far away from city centre, leading to bad access and delayed arrival of equipment. In terms of medical perspective, data collection was difficult as there was inconsistency on the type of instruments being used. Also, there were no exercise handouts that could be issued to patients after therapy sessions. Despite these challenges, the medical team was welcomed by the locals and blended in well with them.
Fig6. Picture of the medical team and the locals
The field clinical was open for 12 days, and Ken and his medical team left on April 17th. When asked about other thoughts on this volunteer work, Ken said that humanitarian work connects people, and that even under the worst circumstances, there are no people who don’t smile. Ken plans to continue with the humanitarian work and get involved in JDR. He hopes to work abroad when he has fewer social commitments.
Reflection on the interview
In this interview, what motivated me the most is the passion and dedication Ken had on humanitarian work. As there was no overseas physiotherapy overseas network in Japan, Ken joined other virtual events organised by other international physiotherapy networks in order to learn more about physiotherapy humanitarian work. That was quite similar to that in Hong Kong where I’m from: The role of physiotherapists in humanitarian work is not as significantly recognised as that of Doctors. Also, as a student with no real-life experience with humanitarian work, I was quite surprised that the major part of the volunteer work is non-clinical.