A Lesson in Resourcefulness

Although I've only been here one week, it has become very clear to me that the Ecuadorians do not waste what can be re-used.  The clinic is pretty well supplied with donated equipment that has come both from generous donations that our clinic coordinator, Nicole Falcone, has put together, and also from families who donate wheelchairs, activity chairs, adapted strollers, etc when their child has out grown them. What may just got tossed in the garbage in the US is re-fabricated, re-upholstered, dusted off, and adjusted for the next kid. Families are grateful for the equipment since it provides just a bit more ease in caring for these otherwise fairly difficult kids.

Remember that father I told you about? Here are the pictures to show you what he did.....

Here is the standard wheelchair that children with disabilities in Ecuador get. Pretty nice actually!

As you can see, the kiddo in this picture is fairly small, and fits nicely in the chair. (Pushing him is Maria, you'll read about her later. She does a great job of helping take care of her classmate, Carlos).  

 

 Here is Jonathan in his modified chair with his father! Jonathan is a big kid and has a hard time sitting up on his own.  As you can see, his dad build new arm rests that would serve as lateral trunk supports, added an activity table with a bolster between his legs since he tends to scissor his legs together, switched the back rest with the seat pan in order to provided a deeper seat pan to accommodate his long legs, re-positioned the foot plates to put the ankles and knees at a 90' flexed position. On top of it all, he is now in the process of making a cover to protect Jonathan from the blazing sun or pouring rain.  He made all of these modifications after hearing the OT and PT discussing ways that the chair could "theoretically" be better.  

I'm pretty proud too cause I was able to find a donated hand splint for Jonathan to wear at night since he loves to curl his hand up into a tight flexed fist.  

This is Andrea, and we were able to fit her today for this activity chair that was donated back to the clinic from a previous family. Andrea has no trunk control so this chair allows her to be in a much better position for her mom to feed her and to not have to spend the day in a crib or hammock, which is often the case for these little ones. (looking on is Leandro... you'll see more of him later) 

Here is Maria!

 She is one of two students in the cerebral palsy classroom at the local special education school.  Her teacher, Karina, noticed that Maria wasn't able to coordinate her arm in a way that allowed her to bring a spoon to her mouth. So she took a normal spoon to a local carpenter, asked them to add this wooden handle so Maria could grip the spoon better, then used pliers to bend the spoon. Now Karina reports that Maria is able to feed herself during lunch time.   

This morning we made a trip to the special education school to present them with a large donation that Nicole was able to get with the help of Catholic Medical Mission Board! There are about 12 sturdy wooden chairs of varying sizes, 3 standers, 5 pediatric walkers of varying assistance level, 3 car seats, and a tricycle. 

The Mayor was there to present the donation to the school. Here he is sitting with one of the school administrators, Nicole, and Maria. 

The classrooms of the special education school are modest, to say the least. This is the classroom for kids who are hard of hearing or deaf.  The age of the students ranges from 5 yrs to 18 yrs.  

Okay, so now I have to tell you all that I've fallen in love. It happened quickly and I swear I wasn't looking.  I guess they were right when they said "it comes when you least expect it".  His name is Leandro, and he's 5 years old. ;)   He has cerebral palsy, and he is one spunky kid! Nothing phases him. But the best part is that he loves therapy and is up for any challenge we present to him.  The OT who was here before me put him through a program called Constraint Induced Movement Therapy which consists of restricting the use of his "good" arm so that he is forced to use his affected arm, encouraging his brain to re-wire the pathways and re-teach these muscles to work. He wore this removable cast for 3 weeks, and came in for 3 hours of therapy 5 days/week during this time.  Some unforeseen challenges occurred during this time, such as having to recast the arm after he had dragged it in the water during a canoe ride to his town, but he and his mom were compliant with the program and he was motivated to get that right hand to work! In November, Nicole will be presenting his story as a case study at a Physical Therapy conference in Quito. Hopefully I'll get to join!  

Today I learned how to apply kinesiotape to his right wrist to encourage a normal pattern of wrist extension with grasping objects. I was pretty excited to capture this shot of him using that right hand in such a functional position! One of these days I'll get a picture of his smile- it's to die for. :) 

A lot has happened in just this one week! Imagine what a year will bring! Wow.