tag:blogger.com,1999:blog-80604045534581292942024-03-19T02:04:45.796-07:00Physiotherapy and DevelopmentAnonymoushttp://www.blogger.com/profile/05616282349607404885noreply@blogger.comBlogger10125tag:blogger.com,1999:blog-8060404553458129294.post-80175505851590694942018-08-14T06:37:00.002-07:002018-08-14T11:16:22.959-07:00 Early Childhood Development and its Connection to Disability<div align="center" class="MsoListParagraphCxSpFirst" style="text-align: center;">
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<span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt;">Early
childhood development (ECD) framework of UNICEF states that from conception
through birth to eight years of age is crucial timeline for child development.
Here, development reflects not only physical growth but also the cognitive,
emotional and interactions with each other</span><!--[if supportFields]><span
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style='font-size:11.0pt;font-family:"Calibri","sans-serif";mso-ascii-theme-font:
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style='mso-element:field-end'></span></span><![endif]--><span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt;">. The main
focus of ECD is to ensure that a child is healthy from all the aspects which mean
promoting optimal functioning and participation. Having said this, ECD is not
only limited to health as we know that health is largely influnced by its
determinants. For children, some of the
important determinants of health are mother’s health, family support,
educational opportunities and access to services. There are certain services that children would
need at the course of growth and development out of which nutrition as well as
immunization are the most important ones. These two types of health care are
directly related to preventing the unwanted deaths and promoting the health of
children for a long run. For young children,
every day environmental scenario is something new. Hence, they might need
facilitations to overcome such new challenges. For example, going to toilet for
the first time might need assistance from family members. Therefore, family care and stimulation provides
nurturing environment to the children which are also essential components of
ECD. The real world is an interaction with not only family members but also to
peers. Hence, facilitation of peer activities in the form of play is another
important area to stimulate the components (including emotional and cognitive)
of child development. Schooling is an important means of early child development
that provides further cognitive, emotional and physical stimulation to nurture
the growth and development. <o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt;">Now
let’s understand the scenario of children with disability from ECD point of
view. The scenario might look complex because the child is disabled now which
means he or she may not show the same level of activities compare to the child
of same age. So, how does the nutrition and immunization service work for such
child? What are added responsibilities of family members? Very importantly, how
do we ensure the peer interaction, play and educational support which are also
the important components of ECD? Before probing these questions it is quite
vital to detect the impairments. The important and perhaps the first step to
answer is, how do we confirm the impairment? What are the roles of health
workers, family and teachers for the detection?<o:p></o:p></span></div>
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<span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt;">From
the child protection act (1992), National Planning and Plan of Action on
Disability in Nepal, (2007), UNCRPD, to Incheon strategy (2012), there had been
mentioning of ECD and its components. Also, these commitments are gradually being
converted into the budgeted actions of Ministries as well as agencies, for
which we have to acknowledge the advocacy made by right holders and service
providers in childhood disability sector. According to the living condition
study, the commonest cause for disability in Nepal is congenital/by birth which
means more people start acquiring disability from the birth. The same study
reported that 43.4% of disability is acquired by birth to the fifth years of
life</span><!--[if supportFields]><span style='font-size:11.0pt;font-family:
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style='mso-element:field-end'></span></span><![endif]--><span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt;">.<b><i> </i></b></span><i><span style="font-family: "calibri" , "sans-serif";"><b>Actually,
real prevalence in children is more than what was reported because these
estimations were made based on Washington group questionnaire which is not
sensitive enough to detect the problems on developmental and cognitive
functioning</b></span><span style="font-family: "calibri" , "sans-serif"; font-weight: bold;">.</span></i><span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt;"><b><i> </i></b>(As explained below)<o:p></o:p></span></div>
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<span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt;">In
any settings the confirmation of disability is the starting point to address
the ECD need of children with disability. In fact, after the endorsement of
international classification of functioning (ICF) by WHO, the school of thought
to define disability has been drastically changed. But having said this, it is also important to evaluate
how far the signatory countries are progressing on shifting the medical model
of disability intervention to the biopsychosocial model as defined by ICF</span><!--[if supportFields]><span
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style='font-size:11.0pt;font-family:"Calibri","sans-serif";mso-ascii-theme-font:
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style='mso-element:field-end'></span></span><![endif]--><span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt;">. According
to ICF, disability is the state of functional limitation or participatory restriction
(because of functional limitation) due to the negative interaction between
medical conditions, personal factors (motivations, confidence, willpower of the
person etc.) and environmental factors. Here, environmental factor means not
only the physical environment but also other contextual elements like support
from family members, access to varieties of services, leadership & governance
of the sector etc. <o:p></o:p></span></div>
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<div class="MsoListParagraphCxSpMiddle" style="text-align: justify;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt;">I
would like to share a simple example which is based on my experience on working
with children with disability. There were two children living with bilateral
clubfoot, belonging to one of the hilly districts of Nepal who were detected by
“Early Detection” trained health workers. Both the family members could not afford
the transportation, accommodation and fooding expenses to go to nearest rehabilitation
center (100 KM away) where service charge for families belonging to poor
economic back ground is usually waived. Then the decision was made to cover out of
pocket expenditure of both families. Surprisingly, one family did not take the
child for treatment while the next did. Very recently, I had a follow up visit
to the same place and could gain a visible impact on a child who has gone through
the treatment while a child was walking properly and family members were quite
happy to the progress made by a child. The foot of a child who did not undergo treatment
was deteriorating. It was also discovered that father was uncooperative and drunkard.
Although mother wanted her child to get timely treatment she was forced to get
bounded to her household chores and could not travel alone. Neither her husband
accompanied her to treatment center nor was she confident enough to travel
alone. From this example, it can be well understood that how important is the family
support which is one of the contextual elements. Even though the medical care
was guaranteed, the child did not have access to it because of contextual
barriers. Thus, only medical focused intervention may not always address the disability
issue that is why we need to visualize disability from wider lens which is the
combination of medical, psychological and social factors. <o:p></o:p></span></div>
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<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt;">Also, my experience says that
structural impairment (physical) disability are quite visible which might be
detected at the health facility or school level once after providing short term
training or orientation . But the detection of disability affecting emotional
and cognitive components of ECD might need more training and focus as these
types of impairment are not directly visible in a snapshot. Family members should be central to the
disability detection as they are in the best position to explain what they have
observed in child. Detection or medical diagnosis may not fully contribute to
address the ECD need of child. To facilitate
the early childhood development of children with disability, we need to know
what child can do and what not as per his/her age threshold. That’s why we need
to assess disability in terms of functioning across the domains of physical,
emotional and cognitive areas. <o:p></o:p></span></div>
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<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt;">As
explained above, ECD primarily constitute growth and development in physical,
emotional and cognitive aspects which means that each of these elements needs
to be assessed while we confirm the disability on children. In many stances
disability might appear as a mix of these elements. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt;">Let’s
talk about the very recent advancement on the data collection of the children
with disability (2-17 years). <b>UNICEF in
collaboration with the Washington group on disability statistics</b> has
developed the module on child functioning for identifying children with
disability on surveys. This module is precursor of previous tool like Ten Question Screening Instrument and previous short sets of Washington Group on
Disability </span><!--[if supportFields]><span style='font-size:11.0pt;
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}<span style='mso-element:field-separator'></span></span><![endif]--><span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt;">(6)</span><!--[if supportFields]><span
style='font-size:11.0pt;font-family:"Calibri","sans-serif";mso-ascii-theme-font:
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style='mso-element:field-end'></span></span><![endif]--><span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt;">. The new
child functioning module is more sensitive to previous tools as it is able to
detect the developmental and behavioral components of the disability in
comparison to previous tool. It means that now we have the tool in place which
can detect more complex and invisible type of childhood disabilities. The new
child functioning module might not include 0-2 years as same age group is not sufficient to confirm the functional limitation. In Nepal,
it is widely claimed that the present 1.94% prevalence of disability reported
by 2011 census is far more than the actual prevalence of disability as simple census data collection process might
had missed to detect disability that are
not visible. Hence, <b>THE NEWLY DEVELOPED MODEL BY UNICEF</b> gives an opportunity to ensure the inclusive data collection (covering all the aspects of ECD). For sure, partnership among right holders association, UN agencies, service providers and decision makers should be the key strategy to have such survey implemented in Nepal.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt;"> <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify;">
<b><i><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">I will be
writing my next blog on the link between early detection and inclusive
education from the perspective of ECD. Please stay tuned. <o:p></o:p></span></i></b></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt;">I
welcome your feedback and suggestions.<o:p></o:p></span></div>
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<i><span style="font-family: "calibri" , "sans-serif"; font-size: 9.0pt;">(This is my
personal blog where I present my personal write ups hence it reflects my view only)<o:p></o:p></span></i></div>
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<b><span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt;">References <o:p></o:p></span></b></div>
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style='mso-element:field-begin;mso-field-lock:yes'></span>ADDIN Mendeley
Bibliography CSL_BIBLIOGRAPHY <span style='mso-element:field-separator'></span></span><![endif]-->1. Early Childhood Development
[Internet]. [cited 2018 Aug 14]. Available from:
https://www.unicef.org/dprk/ecd.pdf<o:p></o:p></div>
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2. Eide AH. Living conditions among
people with disability in Nepal. SINTEF Rapp. 2016; <o:p></o:p></div>
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3. WHO (World Health Organization). World
report on disability 2011. Am J Phys Med Rehabil Assoc Acad Physiatr
[Internet]. 2011;91:549. Available from:
http://www.ncbi.nlm.nih.gov/pubmed/22726850<o:p></o:p></div>
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4. Cappa C, Mont D, Loeb M, Misunas C,
Madans J, Comic T, et al. The development and testing of a module on child
functioning for identifying children with disabilities on surveys. III: Field
testing. Disabil Health J. 2018; <o:p></o:p></div>
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5. Massey M. The development and testing
of a module on child functioning for identifying children with disabilities on
surveys. II: Question development and pretesting. Disabil Health J. 2018;<br />
<span style="text-indent: -32pt;">6. </span><span style="text-indent: -32pt;">Loeb M, Mont D, Cappa C, De Palma E,
Madans J, Crialesi R. The development and testing of a module on child functioning
for identifying children with disabilities on surveys. I: Background. Disabil
Health J. 2018;</span></div>
Anonymoushttp://www.blogger.com/profile/05616282349607404885noreply@blogger.com2tag:blogger.com,1999:blog-8060404553458129294.post-3142550740729004132017-05-20T11:56:00.000-07:002017-05-20T12:07:14.987-07:00Early Detection and Referral : The Better PrognosisIn a recent household survey on disability (Study on Living Conditions among people with disabilities in Nepal, 2015) 33% of respondents reported birth or congenital defects as cause of their condition. The same study also highlighted that 0-10 years of age bracket consisted of the highest number of children with disabilities. Many birth impairments cannot be prevented, however their negative effects on the development of children can be minimized through early intervention.<br />
Early suspicion, identification, proper diagnosis and screening of the cases are the major vitalizing steps for each health professionals to spot the "Early Detection" of impairments. Following "Early Detection" of the impaired children "Referral Mechanism" is next extensive gait of rehabilitation. Once the impairments are detected earlier and referred for appropriate service, the prognosis is much better compared to the neglected cases.<br />
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Prevention, treatment and rehabilitation are possible for 70% of birth impairments in children. Of the visible birth impairment 25% are very severe resulting in early death, 50% are treatable or correctable whereas 25% result in long term disabling impairment despite of best of treatment. Here, "Impairments" are specific decrements in body functions and structures, often identified as symptoms or signs of health conditions such as club foot, cleft lip/palate and spina bifida. Most of the impairments such as Club foot, Spina bifida, Congenital Torticollis, Hydrocephalus, Down Syndrome can be easily visible during birth. <b>If these impairments are early detected by Health workers <span style="font-family: "times new roman" , serif; font-size: 12pt;">involved in newborn and child care (Auxiliary health
workers (AHW), Health assistants (HA), Auxiliary nurse midwifes involved in
delivery, post-natal care and immunization) then it could be the first line of intervention which would downturn the long term disability. </span></b><br />
<span style="font-family: "times new roman" , serif; font-size: 12pt;"><br /></span>
<br />
<span style="font-family: "times new roman" , serif; font-size: 12pt;">Let's take an example of a child born with Club Foot in some health post at Jajarkot (Remote district of Nepal). Health worker attending a child at birth if happens to detect the club foot at that very first stage and counsel the parents on pros and cons of early rehabilitation to take a child to the near by center for Ponsetti management at Hospital and Rehabilitation Center for Disabled Children, Banke, would help prevent a long term disability. This piece of information to the parents would mark a significant guidance to the family. </span>Unfortunately, what i have been observing is most these children appear to receive rehabilitation service at age of 10-15, by that time disability is neglected and the cost for rehabilitation soars high with poor <span style="mso-spacerun: yes;"> </span>prognosis. Isn't this due to the lack on the knowledge of early detection??? that results into late prognosis and generating long term disabilities in the country.<br />
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Consequently, training/educating Community Health workers, Female community health volunteers on how to early detect an impairment in child and provide the appropriate referral service to the detected cases would be one of the biggest investment in the country to strengthen the human resource for health. As per my experience, prior to training, conducting training need assessment to different levels of Health professionals such as Health workers who are posted in health post, primary health centers, Female community Health Volunteers who are the local women working voluntarily in the community is the fundamental step. The findings from training need assessment will provide a clear vision on the existing knowledge of each health professionals on the early detection, difference between impairments and disability, referral mechanism, management and follow up mapping of an impaired child. Therefore, creating a base of it, developing the content of Training materials can be decided. In addition to it, encouraging care givers to be the part of "Parent counseling" session would also some how mark a sense of satisfaction, determination, peace of mind and acceptance on the reality that they are not only the ones who have been blessed with that particular "Special Child".<br />
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<br />Anonymoushttp://www.blogger.com/profile/05616282349607404885noreply@blogger.com0tag:blogger.com,1999:blog-8060404553458129294.post-92180512590421948002016-10-29T23:52:00.000-07:002018-02-25T05:39:59.375-08:00Prolapse uterus and it's entangled factors: Her story is Nepal's story and I could not just jump into Diwali celebration without conveying her story to the sector, country and the world<div class="MsoNormal" style="text-align: justify;">
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Nepal is in festive mood of Diwali
(the festival of lights) and so is my family. This is a time for my family to
gather, eat and enjoy. Cousins and relatives are gathered for the feast. They just called me downstairs
to participate. <o:p></o:p></div>
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I just arrived from Gorkha which is a 5 hours
journey west from Kathmandu. Gorkha is the place where i am based to
support the rehabilitation of injured earthquake survivors through an
organization called International Medical Corps. As i arrived home, freshen up, had dinner but my mind was not letting me to go down stairs with my cousins to enjoy Diwali. So, i am aiming something new and different. Right
now, its 8 PM and I set my mind to do this write up about a woman with whom I met
in a health camp. Among the stories of various women with prolapse uterus, the story of Maya Gurung (name changed) was heart wrenching . Her
story shows how isolated and deprived the Nepalese Women are. She had a first degree
prolapse at the age of 20 and had been living with it till now. Her story says
how responsive our health and social system is? I believe her case represent
many Nepalese women living in various districts and villages of Nepal.<o:p></o:p></div>
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I was born and brought up in
Newari family which is one of the native inhabitants of Kathmandu, the capital
city of Nepal. During my childhood , i never felt how life in other districts of
Nepal would be like. Within one year, i got a chance to visit and stay in many remote corners
of Gorkha which is also an epicenter of Nepal earthquake 2015. I am proud to deliver
the rehabilitation services, being based in district level health system. Also one of the
greatest achievements for me was to gain an opportunity to understand the people,
their barriers and living situation. <o:p></o:p></div>
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The day before, was one of the
most memorable moments of my life as I was able to participate in the health
camp to deliver health service for women living with prolapse uterus in
remote villages of Gorkha. Within my organization, I played the pivotal role to
link rehabilitation services with sexual and reproductive health.
Thanks to my Organization for acknowledging the concept and
supporting me on full swing. I was also able to explain the importance of
preventive and rehabilitative role of physiotherapist to prevent and manage the
pelvic organ prolapse with concern official of ministry of health. For me,
it took almost a year time to formalize the process within my organization. The
day before was the first day I was involved as a team member of integrated camp
organized by District Public Health Office (Health tier in a district) for the
Women living with prolapse uterus and fistula. My job was to work in tandem
with doctors and nurses to deliver the comprehensive health services that also
included rehabilitation. <o:p></o:p></div>
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There are specific rehabilitation
protocols for the prevention and rehabilitation for prolapse uterus and fistula.
Many health workers are aware of Kegel exercise and thanks to previous training
programs to these health workers. The concept of exercises are always emerging
and changing as per new researches and so does apply for Kegel. On top of all, without the correct
demonstration and confirmation of perineum contraction, Kegel’s are most often
wrong and that gives opposite effect. Also programming the Kegel exercise
technique on daily activities like lifting the load is very important to
prevent the stress on pelvic floor.
Importantly, there are specific doses and implications for strength and endurance
for pelvic floor muscle that needs to factored in while designing the Kegels.
My experience says that for Nepalese women, intervention focused at minimizing
the risk of pelvic floor stress by teaching the safe way of performing
household chores is the most important preventive method.<o:p></o:p></div>
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Let’s come to Maya Gurung a
50 year old's story that made me to pause my Diwali celebration and made my mind
to do this write up at first. She had suffered from first degree uterus
prolapse during her first post-partum phase, 30 years back when she had
delivered her first son. <o:p></o:p></div>
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Immediately after delivery, she
had to carry heavy water pots and heavy wood and walk for an hour which
resulted in first degree uterus prolapse. She thought that’s a minor problem and
did not feel like seeking the service from health facility which is 7 hours
walking distance from her village. For her, priority were household activities rather
than seeking the treatment. Neither her husband nor family insisted her to
visit the health facility. This made the situation worse and aggravated to
third degree prolapse. Now she has complications like incontinence and abnormal
vaginal discharge which is degrading her health and self-esteem. <o:p></o:p></div>
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Now Maya says “I have difficulty
on defecation, feels like I am dying with the pain “ Her day starts from 2 am
in the morning to carry cattle fodder and carry water pots from a mile. It’s sad that she has compulsion to continue
her activities of daily living with difficulties. She felt that she is not
getting cured and won’t live longer. This feeling have made her more depressed and stressed.
With her eyes full of tears says “I am worried about my youngest daughter who
is studying in grade 7<sup>th</sup> as she is the most precious part of my
life”. I was surprised to know that her husband is a drunkard who rather than
lending helping hands, snatches her money for gambling. She has a small farm
and this has been her source of income to run a family but her ideas and
thoughts are not taken for family decision making. Her degrading health situation
has left her low esteemed that’s why she does not prefer to participate in
community functions and decision making events.<o:p></o:p></div>
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Let’s assess Maya using the
International classification of functioning (ICF) model<o:p></o:p></div>
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<b>The main barriers for her was poor health seeking behavior which is linked to her and family illiteracy and
poverty level. Another one is distant health facilities that also further contributed to her
non health seeking behavior. The third one is our patriarchal culture in which
women are confined within the household chores which are stressful. In a course
of time, these three factors contributed for degrading health, low activity
level and participatory restriction in Maya’s life.</b><o:p></o:p></div>
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Maya’s story clearly depicts that
uterine prolapse is not only a health problem but it is entangled with
many issues like education, empowerment and economy of family. Therefore, a mutisectorial
, inter/intra departmental and inter/intra ministerial approach is a must.<o:p></o:p></div>
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This was the health camp where I participated, soon Maya will undergo hysterectomy and she will be cured.
But her other barriers will still remain the same that may further bring
complications like urinary incontinence and vault prolapse. Her husband is
still not supportive, her poverty line is still the same and she still has compulsion
to do heavy household works. There are many Mayas in Nepal who are living below poverty line. Isn’t it the time to think? Isn't it the time to
utilize the long experience(available data and lesson learn) to design the sustainable solutions?<o:p></o:p></div>
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Being a physiotherapist, I feel honored
to meet Maya and understand the situations of women living with prolapse in
Nepal. I know that my contributions to bring Maya to good living situation
through my physical therapy intervention are just like a drop in Ocean. Despite of all these, i am
hopeful that i was able to contribute at least a new and very important drop in the ocean, the
thing that has never started before(
Rehabilitation component added to prolapse uterus management). This has definitely ensured a multidisciplinary approach of care. Maya, now knows how to do her activities with minimal stress on her pelvic floor and what relieving position/exercises to do if she experiences a sudden difficulty. Again she will require physical therapy intervention after surgery to prevent the complications like incontinence and vaginal vault prolapse.<o:p></o:p><br />
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Nepal has 1800 physiotherapists
but not more than 20 quotas are allocated by ministry of health in the health
system. Ministry of health has Nepal health sector strategy, national prolapse
uterus management guideline, health worker training manual for fistula and prolapse uterus management,
national childhood disability management strategy, birth defect surveillance
and control plan as the guiding documents that strongly support to have physiotherapist
in a health system. Also there are sufficient human resources in the country
now. At this favorable situation (where human resources are available to fulfill
the service demands), Nepal should not make any delays to deploy
physiotherapists into the health system.<o:p></o:p></div>
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Anonymoushttp://www.blogger.com/profile/05616282349607404885noreply@blogger.com1tag:blogger.com,1999:blog-8060404553458129294.post-16525054795837900122016-09-07T18:55:00.000-07:002017-05-20T10:30:02.454-07:00A desired momentum for physiotherapy rehabilitation sector in Nepal<br />
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to World health organization, Physiotherapists assess, plan and implement
rehabilitative programs that improve or restore human motor functions, maximize
movement ability, relieve pain syndromes, and treat or prevent physica<a href="https://www.blogger.com/null" name="_GoBack"></a>l challenges associated with injuries, diseases and other
impairments. Physiotherapy prevents secondary complications which are the common
cause of disability if not rehabilitated well. Physiotherapy treatment has a
big role to play when a person’s function or mobility is affected by pain,
ageing, injury, disease, disability or long periods of inactivity. <br />
<br />
<span style="mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";"><span style="mso-spacerun: yes;"> </span>People who require physiotherapy service are getting
aware about the importance of it gradually but if we focus on districts of Nepal
still therapeutic culture for rehabilitation is not properly inculcated. This
is due to the lack of education and information to both public and health
workers.</span><br />
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<span class="A5">Under the auspices of National Health Policy 2014, Nepal Health Sector
Strategy 2015-2020 (NHSS) is the primary instrument to guide the health sector
for the next five years. It adopts the vision and mission set forth by the
National Health Policy and carries the ethos of constitutional provision to
guarantee access to basic health services as a fundamental right of every
citizen. Here, physiotherapy also falls under the basic health package of Nepal
Health Sector Strategy. Specially, after Nepal earthquake 2015, physiotherapy
rehabilitation units are established with the support of humanitarian agencies
in the affected districts but this new establishment should not be confined to
the rehabilitation of injured cases but also there is a huge unmet need not
related to earthquake. Thanks to these rehabilitation unit in district
hospitals that are delivering the required service in one end whereas from the another
end they have also given an example of what the rehabilitation in district
looks like.</span><br />
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Nepal
health policy 2070 assures to deliver all health service to people with disability.
Likewise Nepal health sector strategy clearly mentions physiotherapy service
under the basic health package.<span style="mso-spacerun: yes;"> </span>Health
facility establishment, operation and up gradation guideline 2070 clearly
mentions about the provision of physiotherapist starting from the hospital with
25 beds. Despite
of having <span style="mso-spacerun: yes;"> </span>sufficient national qualified
physiotherapists, <span style="mso-spacerun: yes;"> </span>they are not being
mobilized in district health system this creates a big gap which is well
reflected by living situation of people with disability survey, has highlighted
that there is <span style="mso-spacerun: yes;"> </span>83% service gap on the
medical rehabilitation. In one side, Nepal has sufficient policy environment
and human resource to have rehabilitation service integrated in health system
whereas on the another side 83% service gap in medical rehabilitation depicts
the huge difference in paper and implementation, hence Nepal government
together with the support of like minded agencies should start thinking on how
commitment can be converted into the budgeted action. <br />
<br />
But
only having the human resource in the system may not bring a miracle to
address the service gap as there are lots of socioeconomic issues which remain
the barrier for people to access the hospital based services. Rehabilitation
services are unique in nature because it requires a periodic follow up ,
involvement of person and family members and also in many stances,
rehabilitation service has to be coupled with assistive devices and specialized
surgeries. There are villages in districts from where it requires more than a
day time to reach the district hospitals where we are assuming to have the
service. A person with disability/injury needs to come together with the care taker
(mostly family member) to get the service. The transportation and accommodation
cost is the hidden expenses here and also the productive time of another family
member who is accompanying to bring the person with disability for services.
This is the right time to think the hidden socioeconomic aspect of the beneficiaries
which are not often considered while designing budget for the program. One of
the best ways to minimize this barrier is to enhance the access to
rehabilitation services at the home village. Only the hospital based programs
doesn’t fulfill the need, the link of hospital based rehabilitation service has
to be created in community in the form of outreach and home visit. Also, the
local health facility staff needs to be trained on basic rehabilitation so that
early detection, referral and minor follow up is ensured at the community
level. One thing that all have to know is, earlier the detection and referral,
better will be the outcome of the rehabilitation but this is not the case in
Nepal. By birth disability accounts for 33.6% of the total cause. Similarly,
50.6% of disability onset took place within the age bracket 0 – 10 years. Both
of these facts suggest that most of the Nepalese acquire the disability by
birth and during the childhood. In my experience, most these children appear to
receive rehabilitation service at age of 10-15, by that time disability is
neglected and by that time cost for rehabilitation goes high with poor <span style="mso-spacerun: yes;"> </span>prognosis.<br />
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<br /></div>
Rehabilitation
is a bit expensive if person require the assistive devices like wheelchair and
artificial limb. There is always shortage of such device in market as there are
no local manufactures of the components and raw materials required for it. An
acceptable quality wheelchair suitable for rough terrain cost around 40,000 NRS
, below knee artificial limb cost around 30,000-50,000 NRS and above knee artificial
limb cost around 1,00,000 Nepalese rupees. Like the standard drug supplied by
government to the public through different health facilities, the priority
assistive device list has to be also made. In fact World health organization
has already made it recently. Poor socioeconomic status of the person should
not be the barrier to get such services; hence these sorts of devices are to be
also linked with the government health insurance package. Until and unless the
socioeconomic barrier are studied and side by side addressed, setting up the
rehabilitation unit in government hospital may not ensure the full utilization
of services.<br />
<br />
Anyone
going through this idea may have the notion that these are very expensive and
do not fall on the priority. Yes, priority for Nepal is to strengthen the
primary health care system which is linked to health promotion and disability
prevention. It’s universally accepted that prevention is the cost effective
measure to minimize the burden of health conditions. Therefore, budget aimed at
prevention should not be diverted to other channel and also it doesn’t mean
that huge investment in strengthening primary health care jeopardize the
possible allocation for rehabilitation services. The recent twitter (HM_Nepal) update
from health ministry revealed that the fund collected from health tax was 16,00,00,00,000
and the expenditure was 40,00,00,000. Not even 3% budget out of this resource
was spent. This is just an example of one budget heading. A rehabilitation set
up in districts with one physiotherapist, equipment, supplies and a month
community outreach doesn’t cost more than 10,00,000 on the first year but from
the second year(once equipment are installed) the cost even get down sized to
around 7,00,000-9,00,000 in a year with full fledged community activities. If 75 physiotherapy/rehabilitation units are established, the cost would be around 7,50,00,000. If this rehabilitation
investment is covered from the fund collected from health tax, rehabilitation
services would only burn 0.46% of this fund. It means with the existing expenditure
and added rehabilitation service expenditure the burning of this fund will not
be more than (3+0.46)% =3.46 % . Still 96.14% of the fund will be
unspent, out of which extra 0.5% is more than sufficient to enhances access to
rehabilitation service (addressing the socioeconomic barrier of getting the rehabilitation
service and covering the rehabilitation service from a health insurance package) The simple
example of one particular fund of health ministry proves that money is really
not a problem. Also there are sufficient policies and strategies to integrate
rehabilitation in health. Then, where is the barrier? This is something that
government, international agencies in this sector, service user community and
professional association have to be seriously looked upon. .<br />
<br />
<span style="font-family: "calibri" , "sans-serif"; font-size: 11.0pt; line-height: 115%;">There
are not enough contextual studies and researches done in the sector of
disability management and rehabilitation. Neither health system database gives
the exact data on disability and rehabilitation services. The non-state service
providers have their own database which differs from one to another. Therefore,
actors in this sector should focus on generating the properly validated
evidences in close collaboration of ministry of health which may give an
evidence based way forward to derive the budgeted activities for
rehabilitation. Also this expertise is new to ministry, therefore it’s very
crucial for stakeholder to deliver the unbiased technical support. With the continuous
advocacy of the stakeholders and professional association, already the focal
unit for disability has been operational in department of health services,
which is good example of joint effort by ministry and stakeholders. Now, the
similar initiative is required to strengthen the established focal unit in
department of health service so that its capable on converting the legal
commitments (policies and strategies) into the real action (integration of rehabilitation in
health).</span>Anonymoushttp://www.blogger.com/profile/05616282349607404885noreply@blogger.com0tag:blogger.com,1999:blog-8060404553458129294.post-19209813858525025992016-04-02T20:14:00.000-07:002016-04-02T20:14:08.354-07:00Observation and derived feelings ( views are completely personal)<br />
<br />
<br />
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Nepal is one of the world’s least developed countries where
denizens of rural part of the country faces real challenge in breaking the
barriers placed by geographical feudalism. Villages enveloped by undulating
pathways, slope and steep landmarks could be eye pleasing for most of us but
that’s challenging for natives of rural area. The wide geographical spread of
rural settlements pose particular health problems where <span style="mso-spacerun: yes;"> </span>carrying dozens of wood, water pots and cattle
fodder and walking miles are some of the daily house hold chores people are
engaged in. This kind of practice invites neck, back,<span style="mso-spacerun: yes;"> </span>knee osteoarthritis and one of the major challenges
that women faces is pelvic organ prolapsed.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="color: #1d1b11; mso-themecolor: background2; mso-themeshade: 26;">29 year old , Parbati BK( name changed)<span style="mso-spacerun: yes;"> </span>single mother of 3 says that she is the only
bread winner of her family.<span style="mso-spacerun: yes;"> </span>Walking for
an hour to fill water and gather wood and cattle fodder has been her daily
routine. <span style="mso-spacerun: yes;"> </span>29 years old , Parbati<span style="mso-spacerun: yes;"> </span>is a chronic case of back pain ( posterior
intervertebral disc prolapsed, PIVD) . She was handed a lumbar corset and
taught appropriate back exercises to easy her pain. In addition she was also trained on
proper ways of carrying load and taking frequent rest between her work. This
practice has helped her subside the pain making her more confident and enthusiastic
on what she performs. Sad that we cannot modify the topography but somehow it’s
possible to train local health providers and support community education
program on disease prevention, introducing physiotherapy intervention and
educating on ergonomic training and postural care as it’s impossible to suggest
natives of rural side, not to perform their activities of daily living. <span style="mso-spacerun: yes;"> </span>Sad, we don’t have adequate number of
physiotherapists in district level. This had marked a significant gap to
transfer the skills and knowledge on physiotherapy service. Teaching them the
proper ways of carrying wood and cattle fodder and useful exercises can
somehow offer long term sustainable solutions to Nepal’s health and development
challenges. </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="color: #1d1b11; mso-themecolor: background2; mso-themeshade: 26;"><span style="mso-spacerun: yes;"> </span>Health is considered as another
critical infrastructure of development. It is indeed true that only a person
with a sound mind and body can think and act rationally. </span></div>
<div class="MsoNormal">
<span style="color: #1d1b11; mso-themecolor: background2; mso-themeshade: 26;">Out of many I would
like to list few of the problems in health sector:</span></div>
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<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="color: #1d1b11; mso-themecolor: background2; mso-themeshade: 26;">Physiotherapy</span> treatment and facilities are not
available as required</div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Doctors and health workers hesitate to go to
remote areas</div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span>There aren’t enough health posts, sub health
posts, primary health centers in remote areas</div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Rural people mostly rely on witch doctors</div>
<div class="MsoNormal">
It seems to me that provision should be made to establish
well facilitated health post and hospital in remote areas where
physiotherapists and health workers should be encouraged to go to remote areas
with good incentives. </div>
Anonymoushttp://www.blogger.com/profile/05616282349607404885noreply@blogger.com0tag:blogger.com,1999:blog-8060404553458129294.post-75975615355663609452015-12-20T04:48:00.000-08:002015-12-20T06:53:12.295-08:00Traits of next generation development professional: Who we are and where we are?<a href="https://www.devex.com/news/meet-the-next-generation-development-professional-87514#">https://www.devex.com/news/meet-the-next-generation-development-professional-87514#</a><br />
<br />
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<div class="MsoNormal" style="text-align: justify;">
Amazing article that highlight
qualities that next generation of development professional should possess. Out
of the many information, I liked the approach of reverse mentoring,” which is
effective at creating a dynamic exchange between the “old school and new
school” to build respect to what each other brings to the table and ensure a
diversity of voices and experiences are represented<span style="background: white; color: #333333; font-family: "arial" , "sans-serif"; font-size: 11.5pt; line-height: 115%;">.</span> In fact it is a two way process of collecting the ideas or
ensuring the idea collection process inclusive of all which ultimately have
impact in an intervention.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
In usual mentoring process,
senior staff supervises and support the work of juniors’ which in fact is very
much required. But in reverse mentoring, senior staff supports the professional
development of junior but also senior get new and innovative ideas from the new
staff on topic such as social media, current trends and technology. But in our
national context there is a gap in between two level of staff even though it’s
not much visible (may be a topic for research??) , for example we have a
culture of prefixing Sir or Madam while calling the senior. Similarly senior uses
the term like Bhai(brother) and Bhaini(sister) to call. In fact using these
terms in a practice is absolutely fine and of course it promotes the
brotherhood in working environment. But sometime I really wonder, is this
something among the many factors that act as the cultural barrier for reverse
mentoring process in settings like ours? </div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
The article also highlights that in
10 years, the technology, skills and approaches used by development
professionals will be significantly different than they are today. If one aims
to dedicate the career in this field it’s also important to update with the new
technology and inventions happening in passage of time.</div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
Very importantly article mentioned
that apart of technical competencies one has to also have the soft skills,
that helps to properly frame the technical skills in humanitarian settings.
Therefore, it’s not only technical but also an interpersonal trait that person
needs to have to become a successful humanitarian professional.</div>
<div class="MsoNormal" style="text-align: justify;">
Proud to be the part of
humanitarian setting! <br />
<br />
The content here mentioned is my personal feeling. </div>
Anonymoushttp://www.blogger.com/profile/05616282349607404885noreply@blogger.com0tag:blogger.com,1999:blog-8060404553458129294.post-9649416836819182632015-11-24T04:42:00.001-08:002016-09-07T19:35:48.929-07:00The 16 Days of Activism for No Violence Against Women and Children: I Empower Women<div class="separator" style="clear: both; text-align: center;">
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<h2 style="clear: both; text-align: center;">
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<h3>
<b><span style="font-family: "calibri" , "sans-serif"; font-size: large; line-height: 107%;">I Empower Women</span></b></h3>
<div>
<ul>
<li><span style="font-family: "calibri" , sans-serif; font-size: 14.6667px;"> 31 million girls at primary level and 34 million at lower secondary level are not enrolled in school</span></li>
<li><span style="font-family: "calibri" , sans-serif; font-size: 14.6667px;">In 2014, global military spending stood at $1.8 trillioni , while experts cite a $26 billion financing gap to achieve basic education for all by end of 2015.</span></li>
<li><span style="font-family: "calibri" , sans-serif; font-size: 14.6667px;">Education is a public good, a fundamental human right upheld in int'l l & regional human rights conventions & treaties</span></li>
<li><span style="font-family: "calibri" , sans-serif; font-size: 14.6667px;">Girls and young women’s education may be cut short by early or forced marriage</span></li>
</ul>
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<br />Anonymoushttp://www.blogger.com/profile/05616282349607404885noreply@blogger.com0tag:blogger.com,1999:blog-8060404553458129294.post-35319150416395408072015-11-01T00:23:00.001-07:002016-08-14T22:53:04.523-07:00Prolapsed Uterus Prevention and Physiotherapy Intervention: Statistically Correlated but to be Implemented in Nepal<!--[if gte mso 9]><xml>
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<div class="MsoNormal">
“I can’t sit and walking is impossible, I feel like a part
of my body is falling down. Feels like dying slowly.” These are the piteous
lines I have been hearing from the female clients.<span style="mso-spacerun: yes;"> </span>Sundari Khatri (name changed) is one of the
hundreds of thousands of Nepalese women suffering from uterine prolapse. A
mother of 4, holds her belly as she limps behind her mud house to get her
sickle and slowly disappears in the wood. </div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Uterine Prolapse: A HIDDEN<b style="mso-bidi-font-weight: normal;"> </b>TRUTH<b style="mso-bidi-font-weight: normal;"> </b>OF NEPALESE
WOMEN. The uterus (womb) is a muscular structure that is held in place by
pelvic muscles. If these ligaments and muscles stretch or become weak it can no
longer hold the uterus causing prolapse. A 2007 study by the Center for
Agro-Ecology and Development reported that in Nepal, women with uterine prolapse
are considered impure and isolated. About 32% did not tell anyone about their
condition, of which 66% cited embarrassment as the reason for their silence,
while 10% believed it was normal for a woman’s uterus to prolapse. Women try to
suppress their problem just for the fear that her husband will marry
another<span style="mso-spacerun: yes;"> </span>women<span style="mso-spacerun: yes;"> </span>if he gets a hint. So, she tolerates the pain
and engages herself in house hold chores from dawn to dusk, carrying dozens of
wood, cattle fodder, water pots and never fails to carry her children to feed
and serves In laws and husband<span style="mso-spacerun: yes;"> </span>without a
break. This is a concealed agony of Nepalese women.<span style="mso-spacerun: yes;"> </span>Engulfed by shame and fear she keeps on
tolerating<span style="mso-spacerun: yes;"> </span>her pain. Most of the women
in village gets married before<span style="mso-spacerun: yes;">
</span>menstruation. Probably,<span style="mso-spacerun: yes;"> </span>this must
be the phase where she doesn’t even understand what marriage and commitment
actually is.<span style="mso-spacerun: yes;"> </span>Greed for sons has been
deeply rooted in our society mainly for socioeconomic and religious reasons.
Therefore, women are obliged<span style="mso-spacerun: yes;"> </span>to
conceive until they give sons to the family.High prevalence of<span style="mso-spacerun: yes;"> </span>uterine prolapse in Nepal is a human right
issue as a result of early pregnancy, strenuous house hold chores during
pregnancy and even during postpartum period, unsupportive husbands, gender
discrimination, lack of access to healthcare and education<span style="mso-spacerun: yes;"> </span>are some of the strong reasons for prolapsed
uterus.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Social stigmas which has been deeply rooted in our society
must be cast off.<span style="mso-spacerun: yes;"> </span>Government should make
sure for the budget allocation for the treatment by not focusing only on<span style="mso-spacerun: yes;"> </span>surgical intervention but also advocate on
educating society regarding preventive program approach , reproductive rights
as Human/women rights , incorporating uterine prolapse with reproductive health
education<span style="mso-spacerun: yes;"> </span>and accepting the outcome
measures. Once the problem is eradicated or minimized women may no longer be
the victims of such dreadful agony. Women and girls have right to live free
from all sorts of discrimination and violence and to control their sexuality
and make choices about reproduction. NGO n INGOs in partnership with local
government agencies<span style="mso-spacerun: yes;"> </span>should<span style="mso-spacerun: yes;"> </span>facilitate free health camps and workshop ,
conduct street play, organize sports competition and interaction program with
youths. Introducing<span style="mso-spacerun: yes;"> </span>safe health and
population studies in school curriculum not only helps prevent the issue but
also facilitates girls to fight for their right and dignity. </div>
<div class="MsoNormal">
<span style="mso-spacerun: yes;"> </span>Physiotherapy plays a
vital role to prevent prolapse worsening and reduced prolapsed uterus symptoms.
It’s sad that<span style="mso-spacerun: yes;"> </span>Government does not
recruit enough physios in their district health system where maximum number of
uterine prolapse cases have been deeply rooted. Systematic channelization of
physios would definitely help prevent and manage the situation which has always
been the challenging part in the context of Nepal. Physiotherapy not only
prevents the prolapse but also helps prevent post surgical complications like
urinary incontinence and vaginal vault prolapse.</div>
<div class="MsoNormal">
PHYSIOTHERAPY TREATMENT helps strengthen the pelvic floor
muscles which supports the uterus, bladder, small intestine and rectum. </div>
<div class="MsoNormal">
You might benefit from doing Kegal exercise if you have:</div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Leak a few drops of urine while sneezing,
laughing or coughing(stress incontinence)</div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Have a strong, sudden urge to urinate just
before losing a large amount of urine(urinary incontinence)</div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Leak stool (fecal incontinence)</div>
<div class="MsoNormal">
<span style="mso-spacerun: yes;"> </span>Nepalese Women do
lots of stressful household job which are simply unavoidable and this
predisposes them for the pelvic organ prolapse. It’s very impractical to ask
women <span style="mso-spacerun: yes;"> </span>avoid such activities as they are
linked with their bread and butter. Therefore, work pattern modification
(ergonomy) , management of coexisting health condition like lung and abdominal
diseases<span style="mso-spacerun: yes;"> </span>and<span style="mso-spacerun: yes;"> </span>awareness raising is very important. On top
of that Physiotherapist who can really help to prevent as well as manage the
prolapse should be the part of Nepalese health system.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
Anonymoushttp://www.blogger.com/profile/05616282349607404885noreply@blogger.com1tag:blogger.com,1999:blog-8060404553458129294.post-80899283834254261942015-10-19T05:27:00.000-07:002015-10-19T05:27:14.187-07:00ZOOM IN PRIVATE SECTOR<!--[if gte mso 9]><xml>
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<div class="MsoNormal">
<span style="font-family: Georgia,"Times New Roman",serif;"><span style="font-size: small;"><span style="color: black; line-height: 115%;">Private sector can be
referred as the citizen sector, which has a group or individual approach to
employ most of the workforce in a country. An easier way to think of the
private sector is by thinking of sectors that are not operated or owned by the
government for example private hospitals, clinics, private schools, private
transport, banking, department stores, restaurants, tourism industry. Private
sectors can develop sustainable long-term relationships with local community by
offering humanitarian aid and creating vocational training centers to train and
place disabled worker in private firm. This creates a firm grip in the
community by facilitating the company’s effort in doing business in the area.
These flourishing sectors can highly contribute as a fundraiser in the field of
disability and also provide an equal opportunity to a person with disability by
supporting them as a source of bread winners of a family. Let’s not forget that
a disabled person is someone who is differently able and can be <span> </span>asset to a family if given an opportunity to
reach out depending on his level of disability. Private sector should hold a
strong grip from grass root level</span><span style="line-height: 115%;">
</span><span style="line-height: 115%;">to act during humanitarian crisis.
Here the grass root level signifies the local level- the local business that
flourishes in the community this is often the first responder after a crisis. </span></span></span></div>
<div class="MsoNormal">
<br /></div>
<span style="font-family: Georgia,"Times New Roman",serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<span style="font-family: Georgia,"Times New Roman",serif;"><span style="font-size: small;"><span style="color: black; line-height: 115%;">An enormous number of
physiotherapists work in private hospitals, clinics. It’s quite affirmative
that these PTs get maximal number of clients with disability. Healthy networking
and link up with private firms can be beneficial to get a proper data of
disable clients that have been undergoing treatment and their records on
successful stories. This can be one of the best methods to reach many unreached
and meet the many unmet needs of people with disability to make allowance for
education, employment, provide them with transportation facilities, special
discount in restaurants and other public places. People with speech and
hearing, physical impairments are often dominated and are isolated<span> </span>from our society. A provision should be
passed to give job offers to such impaired people in non-government organizations
such as restaurants and schools.</span>
Such provision will definitely help them to generate income, achieve respect in
the community, increase confidence, make more friend and explore many more new
abilities overall a life changing experience by employees with disabilities. <span style="color: black; line-height: 115%;">It’s good to see how private sector are
operating and ensuring how their operations are being widely benefited to
emergency, preparedness and response at global , national and local level.</span></span></span></div>
Anonymoushttp://www.blogger.com/profile/05616282349607404885noreply@blogger.com1tag:blogger.com,1999:blog-8060404553458129294.post-41198892993232346932015-10-18T04:08:00.003-07:002015-10-18T21:46:19.085-07:00Role of Physiotherapist(PTs) in Humanitarian Crisis <div class="MsoNormal">
<div style="text-align: justify;">
Humanitarian
crisis is defined as a series of events that are alarming in terms of natural
disasters, epidemics, famine, conflicts, wars and exclusions. Life is uncertain
to predict on crisis that may pound in one’s life leading to an unstable and
hazardous situation affecting an individual, community and nation as a whole.
Humanitarian crisis are often interconnected and complex and several national
and international agencies play vital role to overcome the events by adding
hopes, smiles, positivity to the survivors.<o:p></o:p></div>
</div>
<div class="MsoNormal">
<div style="text-align: justify;">
<br /></div>
</div>
<div class="MsoNormal">
<div style="text-align: justify;">
PTs play a
major role in the rehabilitation of survivors who are left with physical
injuries such as amputation, spinal cord injury, head injury, fractures and
other forms of disablement. Treating disaster survivor would always be
challenging task to PTs as one should take a note of their emotional outburst
and psychological stress with lots of patience. PTs should be channelized from
preparedness to response and relief after disaster as a fundamental part of a
team. In preparedness phase community as a whole should be able to respond when
catastrophe occur by collaborating with community partners to plan training,
exercising, equipping. During response phase depending upon the worst hit areas
PTs should be mobilized. Quick assessment to manage huge case load should be
kept in account. Prescribing exercise, chest physio, safe transfer, early bed
mobilization, assessment for mobility aids and prosthesis and orthosis are
major responsibilities of PTs. During post disaster phase PTs should encourage
patients for regular follow-up to prevent further complications.<o:p></o:p></div>
</div>
<div style="text-align: justify;">
<br /></div>
<div class="MsoNormal">
<div style="text-align: justify;">
Therefore PT and rehab professionals have major part to act in humanitarian crisis to
prevent long term disability and enhancing standards of living.<span style="font-size: 10pt; line-height: 115%;"><o:p></o:p></span></div>
</div>
Anonymoushttp://www.blogger.com/profile/05616282349607404885noreply@blogger.com1