UPDATE 2015 SO FAR…
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As I write this I am not sure if I am awake or asleep but being this tired is understandable considering the past 2 months that my TU team and I have had in Puerto Vallarta (PV), Mexico. It has been the most hectic but also the most incredible and productive 8 weeks for Therapies Unite.
POSTURAL MANAGEMENT PROJECT This is our major project for 2015. We have been focusing on postural management since the start but this year we really want to make an impact in PV. With the help of many organisations we have been able to really develop this project and I am very excited about how much we have progressed already this year. I want to say a special thanks to Sarah Davies and MeDiCT, International Aid Trust, Specialised Orthotics Services, Rotary International (Cannock, Burntwood, Brewood, Walsall, Marina Puerto Vallarta Rotary Clubs), Instituto Nuevo Amanacer and ADAPT.
Postural management is the one of the most important things to consider for children and adults who have little or no control over their posture. A good postural management program is individually designed considering the child’s posture for 24 hours of the day and includes exercises, orthotics and the provision of specialist equipment such as wheelchairs, standing frames and night time supports. It has an endless list of benefits with the most important being to reduce the risk of the development and extent of deformities, promote comfort, improve eating, drinking and communication and enable the child to be as independent as possible. Little or no attention is paid to postural management in Mexico due to a lack of education about it and also a lack of specialist equipment. For this reason many of the children we work with have very severe deformities and poor quality of life.
We started our project in January with the delivery of 10 tonnes of specialist equipment. This had been sent from the UK and included lots of wheelchairs, specialist seating systems and therapy equipment. We had some marvellous helpers on the day from my local neighbourhood as well as the Club Rotario Marina Puerto Vallarta and my Mum and Dad who I managed to convince to take a day out of their holiday to help!
On the 19th of January Marcelle Field, a Postural Management Specialist arrived from the UK to spend 3 weeks helping us to set up the project. We started by doing a tour of all the specialist childrens centres and schools across PV. We delivered 2 training sessions at two of the centres who cater for approximately 200 children with varying disabilities. These sessions included working with the parents, therapists, carers and centre directors to teach them about the important of postural management and also to give some advice and ideas about positioning at home. Alongside the sessions we also are in the process of developing postural management booklets which will be used by professionals and also parents to give them more information about how best to manage their child’s posture.
Following these courses we ran two clinics for children and adults with complex seating needs and we managed to assess and provide new wheelchairs and activity chairs to 10 children. The children were seen in clinic and assessed by our therapy team which was lead by Marcelle and included myself, Laura and Tiffany, our TU volunteers from the UK. We also had Oscar and his wife Laura helping us who are Mexican and make an incredible team as he is our technician and she is a therapist! Oscar has started to work closely with us and has been absolutely amazing. He is able to fix and adapt all of our wheelchairs with very basic tools and very little instruction and as a wheelchair user himself he has a great insight into what is best for the people we work with.
In addition to these clinics we also spent time in two of the centres working with their staff and therapists to help assess and provide new wheelchairs/activity chairs for the children. We have been able to provide new wheelchairs, activity chairs as well as develop individualised seating plans and provide on the job training for the staff, therapists and family members.
Another major part of this project is the moulded wheelchairs. A moulded wheelchair is most suitable for a child or adult who cannot sit in a normal wheelchair due to the extent of their deformities. It is especially moulded to fit their body shape and then mounted onto a wheelchair base. We selected 5 children to have moulded wheelchairs and completed their initial casts in PV. The casting bag is huge and I brought this all the way from England. It was very kindly donated by Specialist Orthotic Services as well as the compressor. They had a good chuckle at me when I turned up to pick it up and asked if it would fit in a suitcase! It was squashed between me and my Mum in the car all the way to Heathrow and we had some very funny looks in the airport. The bag is basically made up of tiny polystyrene balls and during the moulding process the bag is softened and hardened using the compressor, which removes or inserts air as needed. The bag is placed on a specially made wheelchair (thank you Oscar!!) and the child is placed in their maximal seating position whilst the therapists shape the bag to their body using their hands and the compressor. Once the team are happy with the position of the child, the bag is hardened off and the child is removed and then a layer of Plaster of Paris is applied to make the preliminary mould. This process takes around 2 hours (or much longer when you have wriggly children and a very slow compressor!). Once our moulds were completed Marcelle and I flew them to Monterrey (packed very carefully!) to be delivered to Instituto Nuevo Amanacer (INA). The INA is a specialist centre that has a postural management clinic where they assess and make different types of wheelchairs. It is the only postural management centre in the country that can provide this specialist service and thanks to MeDiCT we have wonderful links with them. We waited with baited breath as we opened the boxes and were very relieved to find that the moulds were all in one piece. They have been left at Monterrey and will be made into fibre glass ready for collection in March. The whole process is costly (around £600 per chair) but the results are incredible. We are working hard to get more sponsorship from the UK and Mexico to try and fund more of these chairs to be made. There is such a need for them and so many people who would benefit. It is incredible to see the difference, even during the moulding process, you can tell that for the first time many of the children are actually comfortable and supported. All of them were so relaxed once the moulds were finished and you can see from the photos how different their postures are in the moulded chair as opposed to their normal wheelchairs.
We are planning on returning to Monterrey on in March with Oscar and Nadia (our local physiotherapist) so they can spend a week with the postural management team learning more about the assessment and manufacturing process. This is all part of our long term Postural Management Plan. We are aiming to open a centre in Puerto Vallarta, employing and training locals to manage the services. The centre will be named in memory of our first ever volunteer, Catrin Pickles. The aims of this centre will be to assess and where possible provide wheelchairs and postural equipment to local families. We have the option of using the equipment that is donated from the UK which can be modified here but also we have the option of ordering more specialist seats from the clinic in Monterrey. We are also able to start making moulds in PV and send them to Monterrey. As well as completing assessments and providing equipment we also plan on using the centre as an information hub where parents and professionals can come and learn more about postural management as well as other therapy interventions. We are starting small but hopefully with the continued support of our sponsors and new sponsors we will be able to develop and expand our services further in the future.
GENERAL CLINICS Aside from our postural management clinics we are also running general clinics within the community. We have been helping many people with all kinds of musculoskeletal and neurological problems. It is always such an incredible feeling to see the difference a simple piece of equipment can make. We had the honour of meeting a man called Salvador in January. My family and I spotted him on the main boardwalk in the centre of town selling sweets and cigarettes from his little makeshift wheelchair table. I asked him if there was anything he needed and he told me he would love to have a cushion on his wheelchair to make it more comfortable. The next day we took him a special pressure reliving cushion and he was completely shocked that we had actually kept our word and that we were giving him this gift. I invited him to come to one of our clinics so we could check his wheelchair. It turned out his wheelchair had been rubbing his back so much he had a large open wound. He had not even thought to mention this to me. We managed to fix his chair and make it more comfortable for him and then gave him a special commode for his home and a shower chair. This kind of basic equipment makes such a difference to people’s lives and we are so grateful that we are able to meet people like Salvador and help them to have a more independent life.
CATRIN’S PENGUINS Our swimming group just keeps growing and developing and I am so proud of this project. We now have 20 children and adults who attend every week and 30 children on our books. We have split our session into two groups so those who are more advanced and learning to swim work in one group and our beginners work in another group. We have special swimming badges that we have made so the children can work towards completing skills to gain their badges and this can be something simple like blowing bubbles on the water surface to more complex skills like swimming 5 metres. All of the children now have a special assessment and plan and we work directly with the parents in the pool who we support to deliver the therapy. We have a Mexican physiotherapist who is learning the therapy and is joining us every week to deliver it as well as Edwin who is now trained in Halliwick and running the sessions too. We have 6 children in our swimming group (4 of who cannot walk and rely on wheelchairs) and we have also seen some lovely developments in our beginners group as well. We are also hoping to have a specialist come to PV for 3 weeks in March to implement some further training with a special focus on working with the Mums and Dads.
Sensory Integration Project This is our brand new project for 2015! Sensory integration therapy helps children and adults who have difficulties with sensory processing and is suitable for almost all kinds of physical and mental disabilities. It is an excellent therapy that can be used to improve attention, coordination, balance, motor processing, communication and social interaction as well as help to involve siblings and families into the therapy process. We are aiming to set up sensory integration programs in 4 centres and schools that care for approximately 300 children and adults with varying disabilities. There are no sensory therapy programs currently running Puerto Vallarta so this will be the first project of its kind. The project will focus on key areas including tactile, visual, auditory, motor processing and social interaction. We have 5 large sensory kit boxes which contain different types of specialist equipment. These sensory kits, which were funded by a donation of £1000 from Cannock and Burntwood Rotary Clubs, will be lent to the centres and schools we work with so that they can begin to implement this therapy with the patients that attend there. The key part of this project will be to deliver specialist training to the therapists, staff and families about how to use the equipment and we are planning on having a specialist come out to PV in March for 3 weeks. By delivering training with the equipment we will ensure that this project is a success and sustainable. In addition, there are so many common household items that can be easily bought and used for sensory therapy so with the training we are also hoping to target families at home who do not have access to a specialist school or centre.
All that is left to say is…
Thank you so much for your support with our work. I am absolutely delighted with the progress we have made with all of our projects but especially the postural management project. We want to ensure that all children and adults in PV with postural problems have access to our centre and can be assessed and provided with help and all those who are at risk of developing problems are identified and monitored from a young age. We have achieved so much over the past 12 months and we now have the beginnings of a very special project but we really do need your continued support to make this into something long lasting and even more fantastic. Please keep supporting us and spread the word!
Thank you for helping us to change lives