SGAA Activities in 2003
Jalalabad
This year has been extremely busy in all of SGAA's clinics and centres.
Patient figures are higher than ever in Jalalabad with an average of 600 new
patients registered every month for physiotherapy treatment and 140 orthopaedic
devices cast, moulded and fitted every month in the orthopaedic workshop cast.
Among adults, 40% of physiotherapy patients have back and sciatic problems,
among children the main category consists of those suffering cerebral palsy, followed
by polio. The orthopaedic workshop primarily concentrates on making
polypropolene plastic callipers for polio sufferers and prostheses for mine
victims.
The component workshop which makes wheelchairs and mobility aids as well as orthopaedic components such as prosthetic feet has been very busy supplying not only the programme in Jalalabad but SGAA's two centres in Kabul and 3 Swedish Committee workshops in Taloquan, Mazari-Sharif and Ghazni. Over 30 wheelchairs a month are produced, 50 pairs of elbow crutches, 20 wooden trolleys and 20 walking sticks.
2 New Physiotherapy Centres
In January 2003 SGAA was given a grant by the British Embassy of Kabul to
build 2 new physiotherapy centres in the compounds of 2 regional hospitals in
Laghman Province and Kunar Province. This will mean that permanent physiotherapy
services can be established in the hospitals for in-patients and out-patients.
The construction and equipping of the clinics was completed by the end of the
summer. The clinic in Chagerserai hospital Kunar was opened by the Governor of
Kunar on 26th August and SGAA's phyisotherapy assistant, Mr Nabi started work
there the next day. The clinic in Mehtarlam hospital, Laghman was opened on 28th
September by the Deputy Governor of Laghman and the UK Director of SGAA, Mrs
Eleanor Gall. This clinic is run by SGAA's mobile male and female
physiotherapy team who travel every day from Jalalabad to hold physiotherapy
clinics. In both clinics there are separate male and female treatment rooms and
a room for the health educators to do health education training and disability
awareness.
Training
Of the original 25 physiotherapy students who started a 2 year course in
Jalalabad in February 2002, 19 are now in the final stages of their second year.
Since September 2003 they have been working every day in the physiotherapy
clinics to gain practical experience. They were also able to benefit from a one
week course run in May by Mrs Karoline Munsch, an experienced Bobath trainer
from Germany who volunteered to come and teach SGAA's physiotherapists in
Jalalabad on the latest developments in this field of paediatric physiotherapy.
SGAA physiotherapists see over 110 different types of cerebral palsy children a
month and their objective is to help the parents improve the quality of life of
their child at home by practising exercises with him or her and using
appropriate aids. SGAA has a full-time carpenter who makes wooden CP chairs and
seats fitted for each child. When the students graduate in February 2004, SGAA
hopes to find them jobs in regional and district hospitals and community based
programmes where they will have an important role in identifying disability as
well as treating it.
In August 4 new bench technicians (one woman and three men) were employed in Jalalabad to strengthen the orthopaedic workshop which has long waiting lists. Three of the new technicians are amputees. They will be given an 18 month practical training in orthopaedic technology. Eventually SGAA would like to open a satellite orthopaedic workshop in Kunar which is difficult to reach from Jalalabad and where many requests have been made by local communities for additional services.
Health Education
This department has also increased its activities. Apart from giving health
education sessions to over 2,000 people a month at SGAA's clinics and in local
schools, the team also provide training sessions for other health workers in
disability awareness, both in Kabul and in Jalalabad. Once a week the male
health educators also go to local villages and visit SGAA's patients who have
been issued callipers or mobility aids to see how they are coping in their
homes. This feedback is useful not only for the physiotherapy and orthopaedic
staff to know how their patients are progressing but also to identify other
potential patients. Often families do not realise that help can be provided for
a disabled member.
Kabul
SGAA services in Kabul have also been busy this year. SGAA runs a
physiotherapy clinic for women and children in the northern suburb of Khairkhana.
New premises for the project were found in June with more space for treating
patients and easier access for wheelchair users. Over 950 treatment sessions are
provided for patients every month by 1 full time physiotherapist and 2 part-time
assistants. 4 health educators also visit local schools and health clinics to
talk about disability and hygiene. This area serves the Shomali plain north of
Kabul which saw some of the heaviest fighting during the Taliban period.
SGAA's second project in Kabul is the Kabul Orthopaedic Centre which it has been supporting with fellow agency Ashram International for the past year. The centre has treated 2298 physiotherapy patients in the last 12 months (Oct 02 to Sept 03) and fabricated 1165 orthopaedic appliances. SGAA has provided technical training for the staff and funds for local materials and salaries. The aim of this project has been to improve the quality of services and SGAA hopes that now the centre is working at a much improved level, other donors will step forward to support its vital services.
Monitoring
During the year several visits were paid by SGAA's consultants and
committee members to Afghanistan to monitor progress. Additional lectures and
training were provided by - Mr John Lamb (Orthotist), Mr John Fixsen (Paediatric
Orthopaedic surgeon) Mrs Paddie Chanmugam (Physiotherapist) and Mrs Jeanne
Hartley (Physiotherapist) . An evaluation of the project was also carried out in
May for the European Commission and the recommendation was made that the
European Commission should continue to support SGAA.
Funding
A lot of money has been poured into Afghanistan in the past 2 years and yet
there are still enormous needs. Many Afghans are frustrated by the slow pace of
reconstruction and the growing lack of security in many parts of the country.
The government itself is concerned that international donors are losing interest
in the country especially since the war in Iraq started.
SGAA itself faces a difficult future. Contracts with two major donors, the European Commission and The Diana, Princess of Wales Memorial Fund were completed at the end of September and SGAA has not been able to find new long-term donors to replace them. Disability at the moment is not a priority amongst donors who fund health services in Afghanistan. Fortunately SGAA has been able to generate additional funds by holding a sponsored walk (see below) and other events during the year. However 2005 may well see the charity reducing services in Afghanistan rather than expanding to meet the growing needs.