For a child with multiple disabilities, postural management improves quality of life. Reflective standing throughout the day in upright and sitting postures benefits the child’s function and participation, skeletal alignment and strength, energy levels, bowel and bladder function, and respiratory capacity. Postural management interventions rely on the use of external supports to functionally and appropriately position a child who would not otherwise be able to stand, sit, or walk independently. As a pediatric physiotherapist doing some voluntary work for a charity in Kenya, which involves training local therapists in postural management and making seats and standers from recycled paper and cardboard, I would like to share the beauty and success of this postural management initiative.
Children with disabilities in Kenya
An estimated 114,500 children are born with cerebral palsy in Kenya each year, and 70% of those children live in poverty. Almost half of them will not be able to sit or stand without support and will spend their time lying on the floor or on a mattress. For poorer parents, having equipment that can help position their child or even get therapy for their child is just a dream. Without money to travel to clinics or hospitals, they feel alone and overwhelmed by their situation. Few parents have had the diagnosis explained to them and therefore do not know what is the best way to care for their child, which means that children remain lying all day in the same asymmetrical position, on the floor or in a bed, without stimulation and without being able to move. Without good postural management, children often develop fixed and painful contractures, such as hip dislocations, limb contractures and spinal deformities. They are stuck in their homes and unable to participate in family or community activities. Ignored by those around them, overlooked or forgotten, they have an isolated and often painful existence.
The APT KENYA project
He APT KENYA Project began in February 2022 in Njoro, Nakuru County, in response to the needs of these children. APT, or appropriate paper-based technology, is a sustainable solution that uses readily available, cheap and recyclable waste cardboard, newspapers and flour-based pulp to make chairs and supports to support posture. In the workshop run by Potters House CBO, layers of cardboard are glued together using a paste of flour and water and covered with multiple layers of paper before being painted and decorated. All materials are locally sourced and Potter’s House CBO employs parents from the families the charity works with, providing them with income to help feed their families and pay school fees.
This equipment allows children to sit or stand up and participate in family life for the first time. Families and neighbors begin to see the potential in children and other children bring toys and play with them on their trays. Some children have begun to communicate, making sounds after years of silence. Others have been able to hold a cup for the first time, feed themselves, and even draw pictures. Still others can now attend school thanks to proper classroom chairs. The project is changing lives and helping to break down the barriers and stigma faced by people living with disabilities in Kenya.
Since specialized pediatric training for therapists in Kenya is limited, I also provide training to local therapists as part of the project. This serves to strengthen the skills of local therapists in diagnosis, treatment, and prescribing adaptive equipment for children. These therapists then work alongside APT workshop staff who make custom chairs and frames to produce affordable assistive devices for children with disabilities in their communities.
The project also benefits the local community financially and employs three full-time staff from the local APT workshop to manufacture the equipment, and therapists to measure and prescribe devices and adaptations. A tailor is hired to make the cushions, straps and harnesses, and the less skilled work of wallpapering and painting is offered to parents of families living in poverty, allowing them to earn enough income to support their families. while they search for alternative long-term employment. . In its first year, the project built and delivered more than 100 items to Kenyan children with severe disabilities, directly improving their quality of life. From qualitative interviews in a study we carried out Regarding the effectiveness of these seats and standers, we found that APT improved the functional ability of children, improved their participation in daily life, and reduced the family’s caregiving burden (Barton, 2022).
But perhaps the children’s families say it best:
CAREGIVERS APPOINTMENTS
“Many thought he couldn’t go to school, but with the help of the device he is now in school. “It has changed the mentality of some people.”
“When kids come up to her while they’re on the device and playing together, I can tell she’s trying to say some words.”
“I’m glad to see that my son can spend time with other family members and not be in the same position all day.”
“The fact that he is sitting has changed some people’s perception that he will never do anything.”
“Because he can see the people around him and even follow them with his eyes, he tries to make noises as a way of communicating.”
“The lying position seemed definitive, now when people find him sitting it is a way of telling them that this child is like any other human being.”
“It’s helped him play with others.”
APT Support KENYA
To find out more about the project and ways you can help APT KENYA continue to transform children’s lives, visit our website: https://www.thepottershousecbo.com/apt and follow us on Facebook: https://www.facebook.com/APTinKenya.
