The dangers of not knowing

Ayo*, a local fisherman living in Nyamatongo Ward, never knew he had high blood pressure. He recently suffered a stroke that has left him with loss of motor skills on his left side as well as issues with his balance. This means he can no longer work to support his wife and four children. In Tanzania, there are no social services or payments to access when you are unable to work. To avoid the devastating consequences of this family falling further into severe poverty it is of utmost urgency Ayo regains his ability to earn money as quickly as possible.

Life after a stroke is never easy. That becomes even more apparent when you are living in a rural setting without many of the services and aids many of us take for granted.

Cedar Tanzania’s outreach team was introduced to Ayo in April this year, and has since worked closely with both him and the rest of his family. It was only during their initial assessment Ayo found out he has high blood pressure which is likely to have caused his stroke. Ayo now receives treatment in form of regular occupational therapy and medication. To make sure Ayo recovers, it is important everyone in the family understands the importance of the exercises Ayo needs to do as well as the importance of the medication to lower his blood pressure.

Dr Daniel Ndamo, Cedar Tanzania’s Occupational Therapist, has developed a programme for Ayo to follow and regularly checks in on him to see how he is progressing and if any adjustments are needed. Dr Ndamo has also created occupational therapy aids from recycled materials to make sure they are affordable and easily accessible for residents like Ayo.

Living in a rural setting creates many problems in situations like those Ayo is facing. One of them is using the toilet. Only squatting toilets are available throughout the Nyamatongo Ward and Ayo has difficulties using these without assistance and in privacy. Dr Ndamo has been able to provide aids and advice to the family on how best to support Ayo enabling him to perform personal hygiene independently and with decency.

* Name changed for privacy

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Thinking Outside the (Cardboard) Box

When we talk about our community based rehabilitation outreach programme  for people with disabilities, we often mention the provision of Occupational Therapy services alongside medical services.

But what is Occupational Therapy exactly? In the words of our Occupational Therapist, Daniel: “Occupational Therapy is a client-centred approach which is focused on the promotion of the health and well-being through meaningful and purposeful activities that are age and gender appropriate as well as culturally accepted”.

Even in most Western countries, Occupational Therapy is not something that is widely known. Here in Tanzania, where many people don’t even have access to very basic healthcare services, you hardly find a person who has heard of Occupational Therapy let alone is familiar with the practice.

There is only one university in the whole country that offers studies to become an Occupational Therapist and in 2019, Daniel’s graduation year, there were only 30 students.

Apart from the service and its health benefits being rather unknown, another challenge Tanzanian Occupational Therapists struggle with is the procurement of specialised equipment. Not only is it hard to find, but once sourced, it can also be really expensive.

To bridge this gap, Daniel got creative! It is really impressive what you can do with a little cardboard and a utility knife – but see for yourself what he has crafted!

Occupational Therapist Daniel explains below his innovative use of everyday materials to aid patients regain movement.

The Puzzle

The beloved children’s game can function as OT equipment. Daniel is presenting us a puzzle made out of cardboard for his youngest patients. It improves the children’s shape identification and problem-solving skills and further enhances their motor and coordination skills.

The Range of motion Arc

This interesting looking therapeutic equipment uses a bio-mechanical approach. It promotes and improves the range of motion of the patient’s shoulder, elbow, wrist and joint and is used in all cases where the range of motion of the upper extremities is limited, for example due to a stroke, burn or head injury.

Lid Activity

The lids are used to practice and improve grasping skills, hand-eye coordination and range of motion by opening and closing the lid. It is used for all cases in which the patient shows a limited hand function and, with practice, helps them to perform activities of the daily life such as opening and closing windows and doors or – you guessed it – bottles.

In case you got curious and want to see more of the equipment Daniel and the team have crafted, check out how he created a device for mirror therapy .

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Thank you.