Treating The Handicapped [Archives:1998/02/Reportage]
By Yemen Times Managing Editor
Handicap International started its activities in Yemen in 1994 by providing orthopedic assistance to leprosy patients at the Medinat Al-Nour (City of Light) Hospital in Taiz. Since then, they have developed a larger project for the disabled people of Taiz, Ibb and Lahaj. The center has been open to the public since December, 1996. They provide orthopedic appliances for people who suffer from physical disabilities. Their goal here is to make the center self-sufficient within 5 years. Also their other goal is to train staff that will be able to provide assistance to physically disabled people in all the villages in surrounding areas. Handicap International has started sixty projects similar to this one in nearly thirty countries. They are also fighting for a total ban on anti-personnel land mines.
Mr. Laurent Biot is the program director of Handicap International. He has been here in Yemen for 7 months.
Q: Why was the center established in Taiz? A: Our first project, in 1994, was in Taiz. We were working with the National Leprosy Control Program in the City of Light Hospital. We built up a small orthopedic workshop making basic appliances for the leprosy patients, mainly crutches and sandals. The director of the National Leprosy Control Program asked us if we could come to Taiz to help them on their project, so we came. This project is now autonomous. We are no longer involved in this project. The Ministry of Public Health asked us to provide a wider range of projects in Yemen to treat all types of physical handicaps. It was the ministry in Taiz that contacted us and since we were already here, we decided to stay in Taiz. Taiz is the center of a highly populated area. Before, there was just one orthopedic workshop in Sanaa. It is a big center, but it is very difficult for people from the southern regions of the country to go to Sanaa to get treatment or to get appliances. So we decided to remain in Taiz.
Q: What kinds of handicaps do you treat? A: We have paralyzed, cerebral palsy and polio patients, mostly children. Many little children suffer from clubfoot, totally malformed feet. When it is diagnosed very early, it is possible to treat it with the aid of some appliances. We treat all the post-trauma accidents, or post-trauma injuries like fractures.
Q: Who are the most affected by these kinds of handicaps? A: Our statistics show that about 60% of our patients are children, 25% are male and 15% are female. We really try to increase the number of female patients because the number of handicapped women is about the same as handicapped men. Women stay at home more and they are less willing to go to a center to be rehabilitated. Of the 5 physiotherapists we trained, two are women. The women who have come for treatment are very confident and come back many times, which is very important for them.
Q: How many patients have you treated? A: Since March/April 1997, there were over 4,500 treatments distributed among 1,500 patients. Patients must come more than once because of physiotherapy, which requires numerous visits. We have delivered 1000 orthopedic appliances.
Q: What are the main reasons for these kinds of treatments? A: Polio counts for about 20% of the patients that come to us and there are so many orthopedic deformities, all kinds of congenital leg deformities. Cerebral palsy patients are mentally stable, but they don’t have the control of their limbs because their brain is damaged.
Q: Do you treat any war victims? A: We have some war victims, but not a lot at the moment. I think the main reason for this is that we don’t provide prosthetics – artificial limbs. We’ll begin providing artificial limbs this month. I think that many war injuries are due to land mines. I think that when we begin work on amputations, the number of war victims visiting the center will increase.
Q: Are there any foreign doctors? A: In our center there is one Belgian physiotherapist and one Belgian orthopedic technician. The task of these two people is to train local Yemeni people from the Ministry of Health in orthopedic techniques and physiotherapy. Until now we have trained assistants and one administrator. We are working with two Yemeni doctors who were educated in physical therapy abroad and they are the only real doctors at the center. They work in the center everyday.
Q: How many patients come to the center in a day? A: In one day, we see around 10 or 15 new patients. Q: Are they coming from Taiz only? A: So far publicity has not been a priority for the center. Our first priority is training the staff. Of course, people come when they hear that the center exists. This month we’ll begin advertising to cover a broader area so more people will come from the Taiz periphery and the governorates of Ibb and Lahaj. Right now, people are coming from Taiz city and the villages around it.
Q: When will your project end? A: After 3 years there will be no more expatriates. working in the center. We will then support them financially and continue supervisory visits for 2 years. And after 5 years, the center should be totally self sufficient in every way.
Q: How many beds does the center have? A: We don’t have any beds at the moment. Many patients will begin getting prosthetics and they will need a long rehabilitation period. It’s difficult for patients coming from the villages to go home everyday, they need to stay at the center. So we plan to enlarge the center this month. In February, we plan to enlarge the current workshop, and we’re discussing with the Ministry of Public Health the possibility of adding beds.
Q: Are there people who got rid of their handicaps? Are there any good results? A: Yes, for example, children with clubfoot can walk after 2 months of treatment. It will be even more spectacular when we begin prosthetics.
Q: What is the level of cooperation with other public health organs? A: I think the autonomy of the center after we are gone is a very crucial. A good cooperation with the Ministry of Health offices in Taiz is also important. They are working to try to get the ministry in Sanaa to help fund our center, which will be helpful for the community. Also, we’re working to find other sources of funding from within the private sector. I think it is very important that the public, private and other civil sectors get involved and work together to better the community.
Q: What other goals does the program has? A: Another point of the program is to cover the areas of Ibb, Lahaj and maybe Aden. In December we had a two-week training session in physiotherapy for some people from the CBR program (Community Based Rehabilitation). This program is organized by the Ministry of Insurance and Social Affairs and by Radda Barnen. It is for the villages around Taiz, Lahaj and Aden. We are training some of the CBR workers in physiotherapy so they can continue the treatment in the villages. I think this training was very successful. I hope we can continue with this kind of work in the future.
Q: Where do you get your financial assistance from? A: A proportion of 50% of our five-year project is sponsored by the EU, 30% is sponsored by the Ministry of Health. We must find a local sponsor for the remaining 20%. Our association, Handicap International, has to find all their financial sources in Europe or in Yemen. In Yemen, the Dutch and British Embassies have already given us some money for the project.
Q: Any last comment? A: The last thing I want to mention is that Handicap International is very much involved in the removal of land mines. We participated in the regional conference in Sanaa. The 1997 Nobel Peace prize was given to the International Campaign to Ban Mines. This campaign was founded in 1992 by six international NGOs and Handicap International. We are working in many countries like Cambodia, Mozambique, Angola and Afghanistan, where there are a large number of mines. We are doing mine awareness, mine clearance and orthopedics and prosthetics for mine victims. Here in Yemen we are not directly connected with the mines but we’ll begin providing prosthetics to landmine victims soon. We are always very aware of all the problems of mines in Yemen and other countries. We’ve only been here three years, which is a very short time for an international organization. We are totally open to developments in the field of treating and rehabilitating handicapped people in Yemen because we are specialized in this field.