Humanity & Inclusion is marking World Clubfoot Day on June 3 by highlighting the importance of early treatment. Providing care for clubfoot in the weeks immediately after a child’s birth can prevent them from growing up with a disability.

Clubfoot is the malformation of one or both feet and is visible at birth. If left untreated the foot never regains its normal position, with serious consequences for the child. They can never wear shoes, risk injury, and find it difficult to walk, especially over long distances. Because the child cannot take part in activities with other children, they also risk being excluded and stigmatized. 

“We can prevent this bleak outcome," says Uta Prehl, one of Humanity & Inclusion’s rehabilitation specialists. “But we must detect this malformation as soon as possible after birth. It’s one of the keys to successful treatment. The child can then be treated effectively, and the malformation corrected, and within months they can walk normally. Social workers also play an important role in the care cycle by working with parents to ensure they continue the treatment. If children are not followed up correctly and regularly, the malformation may not be properly corrected. So, it’s crucial to give caregivers as much information as possible.”

Treatment involves placing a cast—which is replaced every week for six weeks—on the child’s leg to steadily correct the foot. The tendons are sometimes operated on before the final cast. Humanity & Inclusion’s partner organizations then fit the child with an orthopedic brace made of a bar connecting two small shoes, which is worn for the first four months and regularly adjusted to appropriately correct the malformation. The child’s feet are checked until they are able to walk, and an X-ray is performed to check healing. The brace and shoes are normally removed between the ages of 3 and 4. The child continues to attend regularly follow-up consultations until they stop growing to prevent the malformation from returning.

For several years, Humanity & Inclusion has trained physical therapists in a number of countries to promote the early detection and appropriate care management of clubfoot. Teams continue to run these projects today, particularly in Burkina Faso and Sri Lanka, so children born with these malformations grow up without disabilities. 

Image: An adult's hands hold the out-turned feet of a small child in Cambodia who has clubfoot. Copyright: Lucas Veuve/HI

Srey Nuch has been living with paraplegia since she was 13. Humanity & Inclusion has helped her set up her own sewing business, but she doesn’t plan to stop there!

Srey was picking pods for a family meal from the top of a tamarind tree—a common fruit tree in Cambodia— when she fell to the ground.  The accident  left Srey unable to walk, and her family went into debt paying for her treatment. Her parents sold their belongings and borrowed money from village moneylenders. Srey's two older brothers dropped out school to find work. Since Srey was unable to stand, she also had to stop attending classes.

Unable to climb the seven steps into her family’s stilt house, Srey moved into a small outbuilding nearby. During rainy season, it was almost impossible for her to move around on the muddy floor.

“It was an awful experience, and it left me disabled, and with my family we went through a lot of pain and some really tough times," Srey explains. “It was hard. I couldn't move around, and that made me feel sad. But since I’ve been able to access rehabilitation services, I feel a lot more hopeful about the future.

A budding entrepreneur

Srey lives in a village near Humanity & Inclusion’s rehabilitation center in Kampong Cham, where she has received rehabilitation care since 2015. The team also gave Srey a wheelchair and leg braces.

"Srey Nuch's condition has really improved,” says Vimean Srun, a physical therapist for Humanity & Inclusion. “To begin with, she couldn't move her legs at all. So I began by doing physical therapy exercises with her and showed her mother so they could do them at home. We also gave her with a wheelchair. Initially she found it hard to move from the chair to her bed or the toilet. But she put in a lot of practice and now she moves around with her crutches and braces.”

Staff from Humanity & Inclusion’s socio-economic inclusion project also helped Srey put her plans to become a seamstress into action. She was given a sewing machine and material to get her business up and running. She also joined an inclusive community investment program, which taught her how to sew. Today, Srey’s an accomplished entrepreneur who makes beautiful clothes.

“I earn an income from my sewing skills, which helps my family,” Srey says. “I’m really grateful to Humanity & Inclusion and everyone who wants me to be part of the community."

When she’s not working, Srey is active in her village, does chores, and enjoys hobbies.

“With my braces, crutches and wheelchair I can move around the house, go out, and visit my neighbors” she says. “I can do a lot of things without help, like washing myself and my clothes, and cooking. I love cooking! I can even go into the garden and pick lemongrass to make my favorite dish!”

Srey ’s aspirations don’t end there: “As well as sewing, I am going to start raising chickens to earn more and help my younger brother go to school,” she says.

Top image: Srey sits in her wheelchair at her sewing machine in Cambodia. Copyright: Stephen Rae/HI
Inline image: Srey sits at a table while preparing one of her favorite meals at her home in Cambodia. Copyright: Stephen Rae/HI

Ceasefire between Gaza and Israel enables local teams in Gaza to launch rehabilitation services for more than 500 people.

Twelve days after the most recent escalation of violence in Gaza, the parties involved have announced a ceasefire. 

This long-awaited break comes after nearly eight days of constant bombings resulted in 242 lives lost between Gaza and Israel, including 67 children and 43 women. More than 1,700 people are injured.

“We’ve been waiting for a ceasefire,” says Laurent Palustran, Humanity & Inclusion’s country manager for the region. “We can now start responding to humanitarian needs with more ease and be able to intensify the distribution of a lot more aid than what we’ve done so far.”

According to a recent report by the UNWRA, approximately 91,000 people have been internally displaced, over 66,000 of whom have sought refuge in 58 UNWRA schools opened as emergency shelters. Humanity & Inclusion teams have conducted needs assessments of those displaced people to determine next steps. 

“We’re starting to get clearer data thanks to these evaluations,” Palustran explains. “We have identified over 500 people in these shelters that have disabilities and are in need.” 

Reham Shaheen, Humanity & Inclusion’s Rehabilitation Task Force Coordinator in Gaza, explains the needs of the vulnerable populations the organization serves in areas of conflict.

“Psychosocial support is one of the greatest needs,” Shaheen says. “Many will lose a limb or an organ and will have psychological needs afterwards. People really need mental health and counseling to cope with the current situation. Then there is great need for multidisciplinary rehabilitation services, like physical therapy and wound dressing sessions to prevent disabilities after injury.

“Usually the needs of injured people change after a few weeks. There is either deterioration or improvement in their condition, so there is dire need for assistive devices and rehabilitation support as well.” 

Humanity & Inclusion is prepared to distribute mobility aids such as crutches, walkers and wheelchairs, along with Infection Prevention and Control kits to keep wounds clean and prevent infection that could lead to long-term ailments. 

The Covid-19 pandemic has not let up in Gaza, with Johns Hopkins reporting a total of 304,532 confirmed cases since the start of the pandemic, and 3,448 deaths between Gaza and the West Bank.

“This escalation occurred while we’re being hit with a second wave of Covid-19,” Shaheen explains. “We have two emergencies, so there is a need for hygiene kits. People need to have clean environments to be able to avoid illness, and in terms of injuries, to keep their wounds clean to avoid any infections.” 

Image: A Humanity & Inclusion physical therapist assists an injured civilian in a rehabilitation session in Gaza in 2018. Copyright: Hardy Skills/HI

After losing his right leg in a motorcycle accident, Kuch, 8, quickly learned to walk again with an artificial limb made for him by Humanity & Inclusion.

After visiting family in Cambodia’s Takeo province in April 2019, Kuch and his parents crammed onto the seat of their motorcycle for the long drive home. Motorcycles are a common method of transportation throughout Cambodia. 

Suddenly, there was a loud bang, then silence. A speeding motorcyclist hit them head-on. In the blink of an eye, their lives had changed forever. 

Cambodia has the third-highest motorcycle death rate in the world. In 2019, 30% of new patients at Humanity & Inclusion’s physical rehabilitation center in Kampong Cham were victims of road accidents.

Two life-saving amputations

As Kuch’s parents regained consciousness, they realized with horror that their son was in a critical condition. His right leg was broken and caught in a wheel. For young Kuch, this marked the start of a terrible ordeal. After being pulled from the wreckage, he was rushed to a nearby hospital. The next day, he was transferred to a hospital in Cambodia’s capital city of Phnom Penh. When they arrived, Kuch’s parents were shocked to learn he needed an amputation to save his life.  

Six months later, Kuch’s family visited Humanity & Inclusion’s rehabilitation center so the boy could be fitted with a prosthetic leg. Unfortunately, Kuch’s stump became red and infected, and he experienced high fevers. When medical staff examined him, they made a disturbing discovery: unless Kuch had another amputation, he would likely develop sepsis. Kuch returned to the hospital in Phnom Penh, where he spent months in recovery and experienced a serious drop in morale.

Back to his old self

Once Kuch’s stump had healed and after numerous rehabilitation sessions helping to strengthen his muscles, Kuch was finally ready to be fitted with his prosthesis in June 2020. Determined to heal, Kuch enthusiastically practiced his walking exercises and became comfortable with his artificial leg in no time at all.

"After his leg was amputated, my son couldn’t walk anymore,” explains Kuch’s mother. “He even found it hard to use crutches and he couldn’t go far without getting tired. Everything was an effort. He even had trouble getting up when he bent to pick things up. And our house doesn't have a toilet, so we have to go outside. It was all really complicated for him. Fortunately, since he was fitted with his prosthesis, Kuch has changed a lot. He can help me with the housework, go shopping for food, visit and play with his friends and go to school.”

Kuch continues to visit the rehabilitation center, which is a 90-minute drive from his family’s home, for follow-up care and repairs to his prosthetic. Humanity & Inclusion donors cover the family’s food and transportation costs during these routine visits. The team also checks in with Kuch at home. Kuch will continue to receive new artificial limbs as he outgrows old ones.

"I would like to thank Humanity & Inclusion and donors for making it possible for my child to receive the help he has,” adds Kuch’s mother.

After months of waiting, Kuch returned to school, walking nearly a mile each way. He enjoys studying and making friends. 

"I love playing football with my friends,” Kuch says with a big grin on his face. “When I grow up, I want to be a doctor.”

Header image: A young boy named Kuch grins outside a rehabilitation center in Cambodia. Inline image: Kuch, whose right leg is amputated, sits on a padded table at a rehabilitation center in Cambodia. He's wearing a mask. Copyright: Stephen Rae/HI

Abdullah was playing outside with his friends, when an airstrike blasted his village in Yemen. After doctors amputated his leg, Humanity & Inclusion helped Abdullah stand tall again.

The attack in December 2019, deeply affected Abdullah, 12. Not only was he gravely injured, but his cousin, who was like a brother to him, was killed. In an effort to save his life, Abdullah was rushed to Al Kuwait Hospital in Sana’a, where his leg was amputated.

The hospital is more than five hours from Al-Hudaida, where Abdullah lives with 11 siblings and his parents in a small house. Until recently, the village was the scene of frequent fighting and airstrikes. Living in poverty and isolation, Abdullah’s family does not have access to health services, electricity, food or water. The nearest school is miles away. For Abdullah and his family, getting the boy fitted for a prosthetic leg seemed out of reach at first.

Confined to the hospital for almost a month, Abdullah struggled with the grief of losing his cousin. He worried he would never play, walk or run again.

Traumatized, Abdullah was afraid of the doctors who came to see him. He screamed whenever physical therapists tried to do rehabilitation exercises with him. He was completely lost. Everything frightened him. 

Humanity & Inclusion’s team took the time to reassure him and build his confidence. The team gave him psychological support and rehabilitation care. He went from using a wheelchair to crutches.

Then, the team fitted him with a below-the-knee prosthetic leg, and conducted rehabilitation sessions to help strengthen his muscles and teach him to walk again. The team also taught Abdullah and one of his brothers how to maintain and clean the artificial limb.

Abdullah is now walking with the help of his new leg. He will receive new prosthetics as he grows.

Humanity & Inclusion in Yemen

Yemen has been devastated by an ongoing conflict that began in March 2015. Humanity & Inclusion teams work in nine health centers and treats patients from all over the country. Since Humanity & Inclusion began its operations in Yemen six years ago, teams have treated 30,000 people, many of them victims of the conflict. More than 3,000 people were victims of explosive weapons such as bombings, explosive remnants of war, landmines, and improvised explosive devices.

Humanity & Inclusion has provided more than 35,000 crutches, walkers, wheelchairs and other mobility aids to people in Yemen. More than 500 people have been fitted with prosthetics and orthotics through Humanity & Inclusion's collaboration with the Sana'a Physical Therapy and Prosthesis Center.

In additional to physical rehabilitation, nearly 23,000 people have received psychological support from Humanity & Inclusion. More than 800 Yemeni health workers have been trained in early trauma response. Support Yemenis with disabilities affected by the ongoing conflict.

Header image: A boy named Abdullah holds his amputated leg while waiting to be fitted with a prosthetic in Yemen. Copyright: ISNA Agency/HI

Inline image: Abdullah, 12, practices walking over obstacles with his new prosthetic leg in Yemen. Copyright: ISNA Agency/HI

Amid rising tensions, Humanity & Inclusion is implementing health, logistics and inclusion projects in the Central African Republic. Based in Bangui, Bambari and Bangassou, its teams are ready to help people caught up in the worsening conflict.

"The Central African Republic has entered a new cycle of violence," explains Coralie Frémion, Humanity & Inclusion’s Program Director in the Central African Republic. "Since mid-December, there has been a resurgence in fighting between government forces and their allies on the one hand, and the Coalition of Patriots for Change on the other."

Population severely affected by conflict

The Central African Republic depends on imports for certain food, fuel and industrial products. 

"For the last two months, traffic along the country's main road from Bangui to Douala in Cameroon, through which most imported goods usually transit, has been disrupted by insecurity and armed violence,” Frémion says. "This has impacted everyone in the Central African Republic because it has caused a spike in inflation."

The price of rice in Bangui, for example, increased 43% in January 2021. 

Since December, the crisis has resulted in more than 120,000 new internally displaced people in addition to 600,000 people who were already displaced. A quarter of the country’s population–1.3 million people–are internally displaced or living in neighboring countries

"This raises serious concerns about the protection of civilians and humanitarian actors," Frémion explains. "Yet despite this context and the insecurity, Humanity & Inclusion and many NGOs continue to provide assistance."

Work continues despite challenges

In partnership with Première Urgence Internationale, and with funding from USAID's Bureau for Humanitarian Assistance, Humanity & Inclusion is working to distribute supplies in the Central African Republic. Humanity & Inclusion's six-person logistics team is on stand-by to deliver essential aid on behalf of all humanitarian organizations working in the country, transporting supplies including medicine, vaccines, Covid-19 kits, and kits of essential items such as blankets, plastic sheets, soap, school supplies and construction materials.

Humanity & Inclusion’s transport of humanitarian cargo by air is likely to play an increasingly important role in keeping supplies available. Air freight is sometimes the only way to reach the most vulnerable people easily and quickly, and Humanity & Inclusion’s program covers 24 destinations. 

In addition, Humanity & Inclusion physical rehabilitation project has provided care to several injured people in Bambari, a town in the center of the country, where armed clashes have taken place. In January, 70% of Humanity & Inclusion’s patients were wounded in the conflict. All had bullet wounds. 

Humanity & Inclusion’s nine-person team provides physical therapy, psychosocial support, mobility aids, prosthetics and orthotics to people with disabilities and injuries in the region.

Image: Workers wearing vests and face masks load a truck of supplies in the Central African Republic in November 2020. Copyright: Adrienne Surprenant/HI

Faiso’s right hand was burned severely by hot water in 2017, causing her to lose the ability to complete basic tasks like writing, bathing and getting dressed. Two years later, Faiso’s mother reached out to Humanity & Inclusion for support.

In 2019, Humanity & Inclusion hosted a routine awareness event, informing people living in the Ifo Refugee Camp in Kenya of the rehabilitation services its team provides. After the session, Faiso’s mother decided to take her daughter to Humanity & Inclusion’s rehabilitation center.

The team assessed Faiso’s hand and determined she would need surgery to regain full range of motion. Before surgery, Humanity & Inclusion provided psychosocial services to Faiso and her family to create a supportive structure for her recovery. 

After the procedure, Humanity & Inclusion conducted home visits to provide additional counseling and rehabilitation, helping Faiso gain the ability to independently feed, dress and bathe herself. After 22 at-home rehabilitation sessions, Humanity & Inclusion’s team determined Faiso had regained the use of her right hand.

Faiso's care was supported by a multi-year project funded by the U.S. Department of State's Bureau of Population, Refugees, and Migration, with the goal of strengthening the environment for refugee and host communities in Kenya through the provision of community-based services including protection, rehabilitation, and psychosocial support.

Faiso, now 10, is in grade one at the Sunlight Primary School. During Humanity & Inclusion’s most recent home visit in January 2021, Faiso was joyful and bonding with her siblings. 

“I am very grateful for the support I was accorded by the Humanity and Inclusion team from Ifo camp.,” she says. “I was at first afraid of the surgery but after the counseling session by the Humanity & Inclusion team, I accepted to undergo the procedure. My mother was also very supportive. She would always encourage me to continue with the counseling sessions for recovery. Now I can move my right hand without any challenge or discomfort and eat comfortably, I can even draw using my hand and also help my mother in doing light house chores like sweeping the floor.”

Saisa developed such serious health issues after being pricked by a poisonous thorn that her leg had to be amputated. Humanity & Inclusion is providing rehabilitation and psychosocial support for Saisa.

Saisa, 10, was attending a birthday party in the Kakuma Refugee Camp in Kenya last year when she was pricked on the left foot by a poisonous thorn. After a week of traditional treatment, Saisa’s condition continue to worsen. Her leg was turning black and her skin was peeling. Her mother took her to the International Rescue Committee hospital, where doctors determined Saisa was experienced gangrene. She was admitted to the hospital and, two days later, her leg was amputated.

After surgery, Humanity & Inclusion’s pediatric rehabilitation workers worked with Saisa to shape her stump, help her manage phantom pain and teach her exercises to expand her range of motion. She also received psychosocial support to process the trauma and grief of losing her leg.

Saisa continues to receive care at Humanity & Inclusion’s rehabilitation center in the refugee camp, focusing on physical exercises to strengthen her muscles and train her balance, as well as psychosocial support to improve her self-esteem.

Soon, Saisa will be equipped with a prosthetic leg. In the meantime, Saisa has learned to walk with crutches. Saisa’s parents and her six siblings are also learning about the stages of grief so they can support Saisa on her journey to recovery.

“Saisa can finally go out and play with her friends without my supervision,” says Rihad, Saisa’s mother. “In the hospital, I was stressed and I thought my daughter had become useless. I never knew that someone would help me. When I went home, the Humanity & Inclusion people came to my house and now my daughter is a person again.”

When schools reopened this year, Humanity & Inclusion made sure Saisa was transferred to an inclusive school within her neighborhood.  Her confidence is growing each day, and she has big dreams for her future.

“I want to be a businesswoman when I grow up and sell many things,” Saisa says. “I am very happy that I can go to school now.”

Image: A young girl named Saisa uses crutches as she walks with her friends at the Kakuma Refugee Camp in Kenya. Copyright: HI

Malik was 13 when his home in Syria was bombed. From his leg amputation to rehabilitation, his road to recovery in Jordan with Humanity & Inclusion has been long. 

Malik is one of many victims of bombing during the conflict in Syria. This is his story, in his words: 

I’m 20. I came to Jordan from Syria seven years ago. I was injured in an air attack when I was 13. 

We were at home, celebrating a family marriage. When the house was bombed, I was with my father. He and my uncle were also injured, but not seriously. Mine was worse because I was in the room where the bomb hit. There was thick smoke. I couldn't see a thing. My mother opened the doors and windows so we could breathe. I really thought I was going to die. 

I passed out when I got to hospital. When I woke up the next morning, we were in an ambulance at the border on the way to another hospital in Jordan. 

They amputated my leg straightaway, but I had no idea I’d lost it for the first fortnight. I was in shock and alone in hospital. It was really hard without my family. It was a few months before my mother could join me. 

I was depressed and, for the first three years, I was in a bad state psychologically. I had injuries all over my body, which needed care, and I got the treatment I needed to move different parts of my body.

I was fitted with my first prosthesis in 2014. When I saw I could walk again, I felt blessed! I was going to be able to move, work and study again! I spent a year in rehabilitation with Humanity & Inclusion, learning to walk. 

I went back to school in 2015 but stopped shortly afterwards because I found it hard to accept my disability. I mostly stayed home. I was really depressed and shy. It took me years to get over it. Around 2017, I began to make new friends. I hated it when people saw me as someone with a disability. 

I've overcome my anxiety and nervousness now. I can move around, study and work. 

I’m now a voluntary worker at Humanity & Inclusion, which also helps improve my English because I left school early. I help identify people with disabilities, who may need rehabilitation services or specific support, and their medical needs, and give them information on other accessible local services.  

I’ve got quite a busy afterwork routine. I see friends and at night I produce content for my YouTube channel. I make funny clips out of existing videos. I also play online with friends.

My dream is to study art and drama.

Image: A young man named Malik sits in a chair at his home in Jordan. He is a Syrian refugee.

Kimhouy, 8, was born with limb differences. For the past two years, she has received care from Humanity & Inclusion and has learned to walk with artificial legs. 

Kimhouy was born with dysmelia, a congenital abnormality that causes missing, shortened or other limb differences. As an infant, doctors amputated both of her legs, her left arm and some of her fingers.

Until the age of 6, unless someone carried her, Kimhouy would just sit on the floor. She didn’t know what it was like to walk. And it was almost impossible for her to take part in family activities. Born with a serious disability and into an extremely poor family, Kimhouy has experienced a lot of hardship, but she maintains a positive outlook on life. 

Barriers to routine care

Kimhouy's parents are both day laborers in Cambodia. Her mother works on farms and her father on construction sites. They hire out their labor when they can and barely earn enough to support Kimhouy and her three siblings. The family experiences regular spells of unemployment. Because of their irregular income, Kimhouy does not get continuous care. Even though the family lives only an hour from Humanity & Inclusion’s rehabilitation center in Kampong Cham, where she receives follow-up care, her parents struggle to arrange for her to get routine treatment. Humanity & Inclusion’s team has visited her at home to provide follow-up care, but encourages regularly visits to the rehabilitation center because it is vital for Kimhouy to have her prosthetics repaired or be fitted for new ones as she outgrows them.

“We’ve been providing Kimhouy with follow-up care since September 2019,” says Vimean Srun, head of the physical therapy unit at the Kampong Cham center managed by Humanity & Inclusion. “Unfortunately, she is not always able to come to her appointments because of her family’s situation. Last November, the last time she visited the rehabilitation center, her prostheses were too small because she’d grown so much. At that age, you need to change them regularly."

Still, Kimhouy’s mother tries her best to ensure her daughter keeps making progress.

“I would like to thank Humanity & Inclusion for covering the cost of our accommodation, transport and food when Kimhouy needs to visit the center for rehabilitation or new prostheses,” her mother says. “We couldn’t afford to help our daughter otherwise. I hope Humanity & Inclusion will continue to support people with disabilities for a long time to come.”

Determined to stand tall

Kimhouy loves visiting the rehabilitation center, which her mother heard about from a friend who lives with a disability. The first day she met Humanity & Inclusion physical therapists and orthopedic technicians, her life changed. She wants to keep improving and become more self-reliant.

"My daughter has been so happy since she was fitted with her prostheses,” her mother adds. “She can walk, get out of the house, ride her bike and play with friends. She stays clean because she can stand instead of always having to sit on the floor. I’m extremely grateful to Humanity & Inclusion and the donors who have made this possible.”

At the rehabilitation center in Kampong Cham, Kimhouy channels her enthusiasm into her goal of walking better. 

“Kimhouy is a bright girl and extremely determined,” explains Srun, the physical therapist. “She’s always in a good mood and willing to do the exercises we suggest. She really enjoys her physical therapy sessions and knows the whole team. She has a smile for everyone. We also give her advice on her day-to-day life. We are proud of her and glad her prostheses mean she can go to school now.”

After she was fitted with her artificial limbs in 2019, Kimhouy started school, but getting there sometimes proves challenging. Her school is one-and-a-half miles away from her home, and it’s hard for her to travel alone. Her older brother or friends usually go with here, but–too often for her liking–she misses class when no one can help.

"I like going to school,” Kimhouy says. “Sometimes it's hard for me to stand up. Sometimes I fall down when I'm too tired. Some of my classmates make fun of me because of my disability, but I try not to take it seriously. I like to play in the playground with my friends and I want to be a teacher when I grow up.”

Header image: A young girl named Kimhouy sits on a bench while a physical therapist fits her for artificial legs at a rehabilitation center in Cambodia. Her mother sits nearby. Copyright: Stephen Rae/HI

Inline image: Kimhouy smiles from inside a toy car at a rehabilitation center in Cambodia. Her left arm, which is amputated, rests on the toy car's door. Copyright: Stephen Rae/HI