Below is a report from a Specialist Occupational Therapist, Angela McLeman, who visited us in August 2015 and is a great insight to the work here at LVDC.
In August 2015, I had the great privilege to visit Lake Victoria Disability Centre (LVDC), Musoma, Tanzania with my daughter and friend’s son. I had heard about the work of the centre through my colleague, Katherine Triscott, school nurse, who had visited in 2014. My profession is occupational therapy from which I graduated 25 years ago and my specialism is children with physical and learning disabilities. Katherine returned from LVDC with descriptions of the aims of the centre, its founder and director, Dennis Maina, and stories about the lives of the young people who attend. This inspired me to visit and offer my skills as an occupational therapist.
LVDC was founded in 2002 by Dennis. He started with a large room in Musoma town centre, and through various funding sources and donations, he has acquired land and built accommodation to expand and accommodate the number of people in the community who require support. As word spreads about the work of the centre, numbers of students seeking support are increasing year on year.
Dennis provides strong leadership to the work of the centre. His drive to improve the lives of the disabled people in his community is inspirational, and his vision to build a lasting and sustainable infrastructure, providing support in the long term, is well underway. Inclusion and equality are clearly the underpinning values that Dennis holds dear, and are very forward thinking within the context of many inequalities with regard to health, wealth and disability.
Dennis has recruited excellent tutors to support vocational training in metalwork, woodwork, and sewing. Students are learning valuable skills and producing much needed disability equipment such as wheelchairs, hand-propelled trikes and supportive seats. Lectures in sign language are inclusive of students who are hearing and deaf, and are stimulating and memorable. So much so that I have returned with more signs than Swahili.
The focus for students with a more significant learning disability is on literacy, numeracy and life skills. These students may not have had the opportunity to attend school in their early years or required specialist educational methods that were not available within their local school. This is an area that could be further developed at the centre with a view to outreach to their homes to maximise their life skills within the context of their communities.
Dennis has a holistic philosophy and very much considers the impact of disability on the person, within the context of their family, within their school setting and within the wider community. When providing a wheelchair to a local disabled person, Dennis considers the impact this may have with regard to their access around their home, their school and for toilet facilities. Whilst out on fieldwork visits, I witnessed the incredible transformation of a young man with learning disabilities and cerebral palsy. At 25 years old, he sat on the ground and mobilised on his hands and knees. He had acquired lower limb contractures and callouses on his knees, shins and feet. When his family needed to take him anywhere, they did so in a wheelbarrow. Provision of a wheelchair made by the students at LVDC transformed him dramatically. With practise, he will learn to propel himself without relying on others, he is upright, and most importantly, has gained dignity.
During my visit, I was able to contribute to the Health Care Assistant training course, covering the topics of disability awareness and Basic Life Support skills. I observed medical staff from the local hospital providing lectures in physics, mathematics, anatomy and nursing skills. This course not only provides income to the centre for students who are able to pay, however also increases skill levels within the young people of the area. This contributes towards Dennis’ aim to create a sustainable structure of health care and expertise within the area with local wage rates.
￼Through clinics arranged by Dennis, I met a number of children and adults with a range of disabilities. I was extremely humbled by the distances they had travelled and their patience to wait to be seen. All were keen to improve the quality of their lives and that of their children, and were grateful for any advice. For the children with cerebral palsy my aims were to promote active function in their affected limbs, encourage the development of life skills and reduce the risk of contractures in later life through stretching programmes. I was also able to assist the children with absent upper limbs through provision of feeding cuffs and by teaching them alternative ways to carry out everyday tasks.
There was a high percentage of people presenting at the clinic with absent lower limbs for whom there was little I could offer. There is great need for a prosthetic service within the area. At present, the nearest clinic is in Nairobi which incurs considerable costs both from the limbs themselves and from travel, accommodation and visas. This is prohibitive to all of the individuals I met.
In summary, my experience at LVDC has invoked a myriad of thoughts and emotions that are contrasting and contradictory. On the one hand, I was deeply distressed at the lack of facilities for those with disabilities out-with LVDC, the poor attitude and understanding towards those with disabilities, and the inequity of access to good quality healthcare. On the other hand however, I was inspired by the work of Dennis and his team to improve the lives of disabled people within Musoma and the surrounding communities, and by the resilience and quiet determination of the people to make their situation better. The centre promotes positivity, and the people who attend are happy and engaged. I am heartened by Dennis’ determination to create appropriate facilities within LVDC and, whilst my visit was brief, I anticipate that my commitment to support him and his team is lifelong.