I arranged a 3-week placement experience in June following completion of my studies before starting work full time. This was through a charitable organisation called ‘Knowledge for Change’ who aim to provide better health facilities and standards of care in Uganda. I was placed at Kyaninga Child Development Centre (KCDC) in Fort Portal, Uganda which was set up by a British Physiotherapist and a British expat who shared a vision to develop a specialised service to support children with disabilities and their families to lead more independent and fulfilling lives.
At KCDC I worked closely alongside a multi-disciplinary team of professionals which consisted of occupational therapists, physiotherapists, speech and language therapists and special educational needs teachers. I worked mainly with children with cerebral palsy (CP) from a wide age group from 1 month to 20 years old. Each day was different but 70% of the work consisted of visiting children and their families in the community, who could not attend the clinic due to travel costs or difficulty transporting their child. Community visits consisted of outreach sessions at village health centres or home visits in some of the most rural settings.
Occupational therapists consider all activities that an individual carries out in a day, as occupations that an individual wants to do, or needs to do, for example getting washed and dressed in the morning or buying and cooking food. They support individuals who are not able to do these occupations either through mental illness or physical disability by problem solving their barriers and producing adaptive strategies, to enable them to be as independent as possible. At KCDC, I would encourage children with CP to engage in play activities which helped to increase their fine motor skills and hand function to work towards their long-term goals of carrying out occupations as independently as possible, such as self-feeding and washing themselves.
For children with CP and severe learning difficulties I would carry out sensory stimulation and hand over hand facilitation to enable them to better orientate themselves to their body and their surrounding in order to work towards function. Occasionally, I would go out with another OT to assess and provide wheelchairs for a patient. This was a rewarding experience as you could see how beneficial it was for the family, particularly when the child was older, and they could no longer carry them. I would often complete joint assessments with the physiotherapist to help decrease tone and reduce risk of contractures worsening by supporting children to weight bear and increase strength. This would then help children to be placed in more optimal positions to carry out occupations.
There is still a stigma placed on children with disabilities as Ugandans traditionally believe this to be witchcraft or that a child is cursed. However, with increased exposure to services such as KCDC and training ‘expert parents’ to educate their communities this is improving. Although there was a language barrier at times I was fortunate that other members of staff could translate for me. The Ugandan people were very welcoming and appreciative of the help I could give.
During my evenings I would attend the local frisbee group to meet local people or I would go out for dinner with fellow volunteers from the Knowledge for Change house. At the weekends I was fortunate to explore the surrounding areas of Fort Portal and gain a better understanding of the culture and people of Uganda.
I have found this to be a thoroughly rewarding experience and I would like to thank Knowledge for Change and KCDC for providing the placement opportunity. Finally, I would like to send my warmest appreciation to The Eleanor Peel Trust for helping to make this trip possible.