CEREBRAL PALSY AFRICA (CPA)

Introduction

Cerebral Palsy Africa has been working in Zambia since July 2006. Our partners in Zambia are the Zambian Association for Physiotherapists in Cerebral Palsy (ZAPCP), Action on Disability in Zambia (ADD Zambia) and the 'Apters' who have run their Paper Furniture APT Workshop in the grounds of the main teaching hospital in Lusaka for almost 20 years.

Zambian Therapists Run Training Course

We were delighted to be able to support our two Zambian trainers to run their first course alone with no CPA trainer present. Micah Simpamba and Prisca Kalyelye ran a course, in November 2010, covering the assessment and handling of children with cerebral palsy for 16 Community Based Rehabilitation (CBR) workers attached to the Ndola Diocese Community Based Rehabilitation Programme in the Copperbelt. All of the participants felt they had learnt a great deal from the Workshop especially the practical aspect. These were the same CBR workers who did the APT course with Jean last year so they are now very well able to work with children with cerebral palsy.

Visit to the Zambian Association of Physiotherapists in Cerebral Palsy (ZAPCP)

In July/August 2010 Dr Lesley Dawson and Patsy Rochester spent two weeks in Zambia with the general aim of increasing the capacity of ZAPCP in serving the needs of its members.

The aims of this visit were to;

Advise ZAPCP how it can provide specialist training for members.

Develop the capacity of ZAPCP to run training programmes.

Advise ZAPCP how to link courses to local academic institutions so that they will have national recognition.

Enable ZAPCP to convince local government and non-governmental agencies that the courses taught should be locally funded and valued.

In order to achieve these aims they ran a training of trainers course for 50 physiotherapists from all over Zambia which was a huge success: “very comprehensive, detailed and exciting, educative and interactive”, were some of the comments.

In addition they ran two short training sessions on “Negotiating Skills and “Suggestions for Improving Committee Meetings”.

Accompanied by Prisca Kalyelye, they met with the Deputy Director of Clinical Services in the Ministry of Health at which they discussed the possibility of the MOH supporting the training programmes that ZAPCP can now undertake. Cleto Mweemba, the physiotherapist employed at the MOH agreed to continue to pursue this.

All in all it seems ZAPCP has benefited a great deal from Lesley and Patsy’s visit.

Training for Community Based Rehabilitation Workers, June 2009

Jean and Ken Westmacott took three other volunteers with them to the Copperbelt to help set up workshops which will be used by the Community Based Rehabilitation workers attached to two different programmes, Wukwashi wa Nzambi and Ndola Community Based Rehabilitation to make chairs and standing frames. The workshops were arranged to have workstations to ensure efficient production and tools were supplied. Training reminders on measuring children, using good APT techniques, working with therapists and the adjustments that may be necessary for producing made-to-measure chairs and standing frames were also given.

Before they left the trainers made sure that those who would be working in the workshops were put in touch with physiotherapists who could prescribe equipment for the children and organisations who could help them to collect cardboard.

Kennett and all three of the volunteers raised funds for their own fares and the course was extremely productive with each participant making a piece of equipment to take back to their workplace.

Local Trainers Undertake First Course, April 2009

The two physiotherapists in Zambia that we have been nurturing to become trainers themselves, Micah Simpamba and Prisca Kalyelye, have since taught a course of Community Based Rehabilitation (CBR) workers on a new programme in Kasama, in northern Zambia. We sent a volunteer, Pete Skelton, a physiotherapist with experience of teaching health workers in developing countries, to teach Micah and Prisca as much as possible about teaching and learning and how to develop a programme that is appropriate for the level of CBR workers.

Micah demonstrating treatment to CBR workers in Kasama

These CBR workers are volunteers and their educational levels rather mixed so choosing the right level and style of teaching was a challenge. While Micah and Prisca did well on the actual teaching side they found it difficult to pitch the level appropriately and to use other teaching methods beside didactic lectures.

Bobath Training Course June/July 2008

Zambia is probably the only country where we work with enough physiotherapists involved with children with cerebral palsy to justify the very big expense of bringing South African tutors to the country to teach an 8-week Bobath Course. We were delighted to have been able to do this in June and July 2008 when 21 Zambian physiotherapists completed the course. In addition CPA funded two Malawian physiotherapists and one Ghanaian physiotherapist to travel to Zambia and attend the course. All received their certificates and the South African tutors wrote in their report that they found the participants to be of a very high standard.

APT Course in Ndola November 2007

There were 19 participants on the course all from the Ndola district. Fifteen of them worked for the Community Based Rehabilitation (CBR) Programme run by the Catholic Diocese.

They worked out that between them they take care of 1113 children with cerebral palsy in their district.

Hands on training for CBR worker

Jean Westmacott ran the course assisted by Peter Fitzmaurice. Participants made chairs and standing frames from waste paper and cardboard and they all worked extremely hard. They were delighted to be able to make such useful equipment for the children.

Follow-up Course in Zambia, 2007

Six participants attended the follow-up workshop in Lusaka taught by Maria Ash. The small number was because many of the participants on the July 2006 Elementary Course were students who have worked with children for a number of years as diploma holders, and are now upgrading to degree courses, had their final exams at the same time. The feedback from participants was very positive and they liked the format whereby each 3 participants brought a child and presented it to the group demonstrating how they assessed the child and what treatment they were carrying out. This gave the trainer the opportunity to assess how well they had put into the practice the knowledge and skills they had learnt on the original course and it gave the participants the chance to think with the whole group about how well they had assessed the child and how they might improve or develop the treatment.

Maria working with participants during a practical session

One day Workshop in Livingstone

Nine participants took part in this workshop which took the same format as the Lusaka workshop. Participants found it very helpful but they all said it was too short.

APT Follow-up in Lusaka, 2007

During November 2006, the APTers with Kennett Westmacott’s help changed the layout of the room including a wall of shelves for storage, made a press for making APT boards from recycled cardboard, and started a batch production system making part pieces of chairs in 5 different sizes and jigs to assist in their construction. The batch production work began with the plan of using Fridays to mass-produce boards and to cut piece parts ready for the next week’s production.

Chair in jig and cutting the ends of rod

When Kennett returned briefly in 2007 he found the Apters in the UTH workshop were doing well with the batch production of chairs and were making one-piece standing frames that are now far more stable. The workshop was looking smart with lots of part pieces for chairs stacked on the shelves and APT assistive equipment waiting for painting or delivery. Whereas in 2006 they were making 25 pieces per month by March 2007 they were able to make 44 thanks to the batch production.

Covering with white paper

Two Zambian Physiotherapists Trained in 8-week Bobath course in South Africa

Prisca Kalyelye and Micah Simpamba both did their first Bobath courses in 1998. They needed to do the second in order to start on the road to becoming tutors. They were accepted to do the 8-week Bobath course by the South African Neuor-Developmental Therapy Association (SANDTA) and they did the course in Johannesburg from February to April 2007. They did very well according to the course leader, Gillian Saloojee. She has agreed that they will be good candidates to have further training with a view to becoming fully qualified Bobath tutors in time.

Therapy Training 2006

ZAPCP requested a training programme for their newly qualified physiotherapists because the Ministry of Health had recently agreed to employ more physiotherapists in primary healthcare clinics and they needed specialist training in working with children with cerebral palsy. ADD Zambia offered their premises in the University Teaching Hospital as a venue for the course. In July 2006, CPA ran a two week course in the assessment, treatment and management of children with cerebral palsy. This was followed by a two day Bobath Introductory course given by a tutor from the London Bobath Centre who came as a volunteer.

Appropriate Paper-Based Technology (APT) Training

The 'Apters' who run a workshop also in the University Teaching Hospital making special chairs and standing frames from waste paper and cardboard for children with cerebral palsy also requested a course in new designs and improvement in production methods.

Two of the 'Apters' with some designs for prone angled standing frames.

Jean Westmacott came from People Potential to work with them on new designs and in November, her husband Kennett spent a further two weeks setting up batch production and advising on management.

Kennett shows how to do batch production