Stories
Amoment of Smiles with the rehabilitation process through training sessions
About Shifra
Nyakato Shifra is a 19-year-old female secondary school student from Ruhoko, Ibanda district. She was involved in a road traffic accident (Bodaboda Accident), which resulted in a spinal cord injury and displaced fractures of the thoracic spine. She underwent spine stabilisation surgery with internal fixation at Mulago Hospital and was scheduled to attend rehabilitation for more than a year after surgery. Shifrah lives with only her mother, who provides for all of her medical needs while also caring for her other siblings.
Condition before
Shifra and her family have been staying at Elpis Rehabilitation Services for more than six months, receiving medical care and rehabilitation. On admission, she complained of lower limb pain, as well as back and neck pain. She also had no sensation in her lower limbs and lower trunk, as well as pressure sores on her buttocks and one ankle. She was admitted in a rigid corset that had been placed after surgery.
She couldn't sit, hold her neck up, or roll over in bed. Psychologically, she had given up on herself and had no hope of moving again, and family members, particularly the mother, were concerned about the daughter's ability to move again.
Treatment Received
She received medical care to manage the infections she had contracted, nursing care to treat the pressure sores, psychological care to address the social and psychological issues she was experiencing, and rehabilitation to address her physical and functional limitations.
Rehabilitation treatments included general body strengthening, joint mobilisation, and sensory rehabilitation. Other interventions that were implemented included transfer training, self-care techniques, and wheelchair use.
Condition now
Shifra and her family have made significant progress towards her return to functional ability. She is currently pain-free, has completely healed her pressure sores, and appears to be in good health. Sensation in the lower abdomen and right lower limb has been restored, and the lower limbs can move slightly under control. Functionally, she can sit without support, stand with support, and perform all possible transfers. The family and Shifra are hopeful that she will be able to return to her normal life and perform necessary tasks without assistance.
Quote
Shifra said, “I would really want to stay around to be able to walk and dance again ……. Because you see I came when I couldn't even sit but now at least I can stand and I have hope.”
About Kyobugabe Trinah
Trinah is a one-year-and-three-month-old baby with cerebral palsy, which was discovered at six months when the mother noticed the baby's development was stalled. Trinah is her mother and father's only child, and their first experience with parenting left them disappointed with their child's condition, almost causing a family breakdown. Due to limited knowledge of the condition and societal beliefs, either parent blamed the other for failing to fulfil certain cultural and spiritual obligations. The mother blamed the father for not always attending church, while the father blamed the mother for not taking care of the pregnancy properly.
Condition Before
Trinah's parents brought her to Elpis Rehabilitation Services when she was 6 months old after learning that the organisation provides free rehabilitation services. She reported, that the child was diagnosed with a nagging/weak neck, as well as a failure to perform activities that a 6-month-old baby should be doing, such as rolling, sitting, and head support. The baby was also too floppy and weak to support herself, and the parents were concerned that she was not normal like other children because it was their first child and they had never experienced anything like this before.
Treatments received
As always, management of people with disabilities, including Trinah, began with educating her parents and other community members that her disability was not caused by any spiritual circumstances and was not anyone's fault. We have to show them that they are normal people who, with help, can reach their full potential. We enrolled Trinah in the Paediatric Rehabilitation Programme at Elpis Programme, which provides free rehabilitation to children with disabilities. The program's interventions include strengthening exercises, functional training, and the prescription and provision of orthotics and mobility devices, among others.
The program's unique feature is the involvement of carers and parents in the care and exercise sessions at home, allowing them to continue therapy at home.
Current situation.
Trinah has made tremendous progress since enrolling in the Elpis paediatric rehabilitation programme. She had a four-month milestone delay in development when she was first brought into the programme, but she now only has a two-month delay. She can now move her head and react to stimuli such as sound. She can now sit and roll independently, as well as stand while supported. The parents now have hope that Trinah will be fine and normal, just like any other child.
Quotes
“At least now there is a big improvement. At home, I can put her in a chair and she seats well then I do my other housework……………. She doesn't fall or keep lying down like she used to be.” The mother reported
About Mbabazi Florance
Florance is a 62-year-old female from the Rukiri subcounty in Ibanda District. She had a right cardiovascular accident (a stroke) a year ago due to uncontrolled pressure. Florence was staying with her husband when the incident occurred, and he rushed her to Mbarara Regional Referral Hospital. Florence was stabilised, and after three days of being admitted and regaining consciousness, she was discharged with no functional changes.
Condition Before
I recall the day they brought Florance to Elpis Rehabilitation Centre; she was helplessly carried from the vehicle to the treatment room. She complained of severe left-sided weakness, incontinence, loss of sensation on the left side, joint pains, and facial and mouth deviations at the time.
Treatments received
Florance underwent medical management and vital monitoring after a stroke, including blood pressure, diabetes, and potential stroke complications. The team always ensured that the medications were taken in the proper doses and times. Most importantly, Florence received a comprehensive stroke rehabilitation package that included carer education on handling, strength, sensory rehabilitation, gait training, upper limb functional training, and other topics.
Current state
We've seen Florence progress from being carried to sitting unsupported to standing, and now she can walk independently. She can now walk independently and perform the majority of Activities of Daily Living (ADLs). Although she has not fully recovered her upper limb function, we hope that she will be able to use her hand again in the coming months.
Quote
Florance said, “I appreciate the work that these people have done. If I could remember when I came here, they were carrying me, couldn't tell that I had urinated on myself and was hopeless. But look at me now, walking by myself”
About St Ignatius of Loyola
St Ignatius of Loyola is an elderly home operated by the Sisters of Good Counsel that cares for retired nuns. For the past year, the elderly home has worked in collaboration with Elpis Rehabilitation Services to provide elderly care and rehabilitation services to retired elderly nuns. Through this collaboration, fifteen (15) elderly people have received services and are enrolled in the elderly and rehabilitation care programme, which provides physical and psychological care to improve their quality of life.
Conditions before
St Ignatius of Loyola came up with the idea of partnering with Elpis Rehabilitation Services to provide continuous rehabilitation and elderly care to retired nuns after some of the elderly receiving care at Elpis Rehabilitation Services demonstrated significant improvements in health, quality of life, and well-being. At the time of the program's inception, the majority of the elderly reported severe back and joint pain, a poor quality of life, and hopelessness about their own health.
Treatments Received
Elpis Rehabilitation Services offers elderly care and rehabilitation services to the elderly at the St Ignatius of Loyola elderly centre. The management interventions primarily address the negative effects of ageing such as limb oedema, weakness, pain (ranging from back pain to joint pain), and psychological issues such as stress and depression. Specific interventions include physical therapy treatments such as strengthening exercises, joint mobilisation, soft tissue mobilisation, and others. Crutches, compression stockings, joint supports, corsets, and braces are some of the assistive and mobility devices that are frequently prescribed and provided to improve stability and mobility. Psychological care is an important component of the elderly care package because it addresses the worries and stress associated with ageing. These interventions include health education to help them understand their condition and basic counselling to improve their psychological state, resulting in a higher quality of life.
Current state
Elpis Rehabilitation Services began providing elderly care services at St Ignatius of Loyola elderly home one year ago, and the elderly's quality of life and functional activity have improved significantly. The number of bedridden elderly people has decreased from four on average to one. There are fewer hospitalisations and reports of physical illness than in the past. The elderly can perform Activities of Daily Living (ADLs) more effectively and participate in social activities and socialising with others, thereby improving their quality of life and well-being.
Quotes
The Elderly Center Health co-ordinator said, “We really appreciate the work you have done with these people. At least we now take months before we take one for serious hospitalization. They are now okay and aren’t getting too sick quite often like before.”
About Nuwagaba Lilian
Nuwagaba Lilian is a 56-year-old female resident of Ibanda Municipality. Lilian has had bilateral knee osteoarthritis for the past five years, which has caused her a lot of pain, joint swelling, disability, and a lot of money in hospital bills for medications. She is a mother and breadwinner for her family, as well as a farmer, and her condition has limited her ability to participate in farming to support her family.
Condition before
Lilian was referred to Elpis Rehabilitation Services by an orthopaedic officer after all other pain medications failed to alleviate her chronic knee arthritis symptoms, particularly pain. Her main complaint when she came to the clinic was excessive pain and swelling in her knees. Other presenting and assessed cases included severe lower limb weakness, loss of range of motion, joint weakness, and functional failure to perform activities that required bending her knees, such as squatting and toileting.
Treatment received
Helping Lilian at Elpis Rehabilitation Services was a gradual process that took over a month. It included pain management strategies, patient education, joint integrity restoration and support, and joint stabilisation and strengthening. Joint range of motion mobilisation, soft tissue manipulation, and ultrasound therapy were used as pain management strategies. Patient education was one of the most important interventions used to manage Lilian's condition, both psychologically and physically. For someone who had been referred by an orthopaedic officer, her condition seemed so bad that she was almost giving up on her life. Patient education assisted her in understanding her condition and explaining to him that there is hope for her to live again with it. There were knee supports available to provide stability and relieve pain in her knees. Later in the treatment, resistance training and knee stabilisation exercises were introduced to restore joint integrity and functional ability.
Current Condition
Lilian was discharged with home exercises and is fully functional. Her pain level decreased from 9/10 to 2/10 after one month of physiotherapy and rehabilitation. She can now use a squatting latrine and has resumed farming. She only visits the clinic once in a while for reviews of her home exercises, but she is grateful that rehabilitation and physiotherapy saved her from becoming dependent on painkillers, which she was tired of.
Quote
“I wish I knew about this place a long time ago. I wouldn't have suffered this much. People always ask me how I managed to overcome my pain and I give them your number because I know they can also be helped.”, Lillian said
