I've recently returned from another week of meetings in Gunjur. Working with our partners Tarud. (Trust Agency for Rural Development), we are trying to raise awareness of the needs of disabled young people in the 25,000 strong community, and support the development of services which will improve their quality of life.
We have developed a joint action plan which encompasses a wide range of projects - but we plan to start with Physiotherapy and Play. A strange choice? Well, with a bit of thought, Physiotherapy is just obvious - if you apply WHO estimates of the incidence of disabled people in Africa to Gunjur, you can calculate that there are around 3,000 disabled people in this large village - approximately 1,300 of them will be 17 years and younger. Without spending money or time on any more analysis, it is obvious that there exists a significant local need for a local physiotherapy service.
There is a great local health centre in Gunjur, but it has no infrastructure to offer physiotherapy to the community's disabled young people. 40 minutes away by car however, is the Royal Victoria Teaching Hospital which, amongst other things, trains physiotherapist. The trainee physiotherapists would benefit greatly from hands-on practical experience and the Gunjur Health centre would love to host a community-based physio service. Potential ripe for a bit of NGO intervention!
The RVTH are more than happy to transport their students and a qualified physiotherapist to Gunjur twice a week if we can build an appropriate facility to receive them. Initial discussions with Mohamed Cesay, the Nurse in Charge at the Health Centre, suggest that we will need something comparatively modest - a physio/teaching room with a couple of consultation rooms attached. Fortunately, space at the Health Centre is not a problem and we have already identified an appropriate site.
Architect's plans and budgets to follow!
But here's the thing - The truth is, we can have as many physiotherapists and smart buildings as we like, but if considerable work is not done beforehand to identify children who will benefit from the programme and encourage them and their families to attend, all other efforts will be wasted. Possibly the largest issue which affects disabled young people in the Gambia (and in many other places) is the stigma and social isolation which so often accompanies having an impairment. It is not at all unusual for disabled children to be kept at home and never taken out in public. They rarely attend school and are seldom, if ever, seen at community events and functions. So, while building plans are drawn up for a physiotherapy facility, we are working hard with our partners Tarud, to identify children who will benefit, and promote the service to families in the community.
But how best to do this? How best to meet children, find out about them and encourage families to bring them out of their houses? The traditional approach would be house-to-house surveys with clipboards and questionnaires. But we think we have a better plan - Playschemes! Fun, engaging and delivering immediate and obvious benefit to children - especially those who have been socially isolated.
As I write, a group of students from Marlborough are preparing to visit Gunjur in July and for part of their time, they have agreed to join local Gambian volunteers, including teachers and young people from the village to run a pilot playscheme for disabled young people for two afternoons a week at a local Pre-School. If the scheme is a success, we will continue with it while we develop plans for a more permanent Day/Play Centre for these young people. But of that, more anon . . .