As part of its support to Ukrainian hospitals, Humanity & Inclusion is providing specialized physical therapy training for health professionals treating burns patients, which requires special knowledge and skills.Read more
For 18 months, Longini was unable to walk; he had outgrown his artificial limbs and Covid-19 lockdowns prevented him from getting new ones. If he was going to get back on track, Longini needed replacements as soon as possible.
Longini, now 9, was born with lower limb deformities. When he was 3 months old, his mother, Elisabeth, took him to the nearest hospital, and he was referred to an orthopedic hospital in Ririma. As other children took their first steps, Longini was still unable to walk. When he was 3 years old, doctors performed a double amputation so he could wear artificial limbs later in life.
In between working odd jobs to support Longini and his younger brother, Elisabeth sought out educational opportunities for Longini. After years of searching, she found HVP-Gatagara—a leading center for the rehabilitation and education of people with disabilities in Rwanda. More than 30 miles from their home, the center includes an inclusive boarding school. At 6 years old, Longini was finally enrolled in school.
But Longini’s greatest dream was to learn to walk.
At nearly $900 each, artificial limbs are particularly expensive in Rwanda. Few patients can afford the assistance devices, including Longini’s family. Humanity & Inclusion stepped up to help. The complex housing Longini’s school also includes a rehabilitation center and orthopedic-fitting workshop supported by Humanity & Inclusion. For families unable to afford care, Humanity & Inclusion provides financial assistance.
Fitted with two custom-made artificial limbs, Longini took his first ever steps as a 7-year-old. In no time, he was running around and playing enthusiastically with his friends. His life changed completely.
As a growing boy, Longini regularly needs new artificial limbs. Unfortunately, the Covid-19 pandemic and the strict measures taken by the government to protect the population meant the orthopedic center had to close its doors. Longini outgrew his worn devices, and it was 18 months before he could be fitted with new ones in November 2021. Longini will need rehabilitation care and artificial limbs for the rest of his life.
‘A joy to watch him now’
Longini is in his second year of primary school, where he lives most of the time.
“When he comes home for the holidays, he can do small jobs around the house, like the dishes or sweeping the courtyard,” Elisabeth adds. “He loves being with other people, going out and running about the local streets with them. All children like him.”
A hard-working student, Longini repeatedly tells his mother he wants to finish his studies so he can get a good job, earn money and support his family.
“My son’s life hasn’t always been easy but it’s a joy to watch him now,” Elisabeth says. “It’s wonderful he’s included with other children. It’s so uplifting.”
After losing his leg in a road accident, Sandip was fitted with an artificial limb by Humanity & Inclusion and its partners.
In Nepal, road accidents are the second most common cause of injury. When he was 14, the truck Sandip was riding in was involved in a traffic crash in Chitwan. He was seriously injured.
“Doctors had to amputate his leg above the knee immediately to prevent further infection,” his mother Sukumaya explains.
Trials of isolation
The accident caused Sandip to have limited mobility. A sixth grader, he ultimately dropped out of school.
“Having lost my leg, I was ashamed to go out or to school,” Sandip says. “I did not see myself going anywhere as I could not walk. As a result, I started staying home, playing games on my phone, and cutting myself off from the outside world.”
Fortunately, Sandip’s family heard about an upcoming health screening camp in their community, providing different services for children with disabilities. These services were implemented by Humanity & Inclusion and its local partners, including Autism Care Chitwan Society, as part of the UK-funded Inclusive Futures Program.
The power of rehabilitation
After the health screening camp, Sandip was referred to the National Disabled Fund, Humanity & Inclusion’s partner, which provides rehabilitation services. The teenager was fitted with an artificial limb, but he didn’t believe he would ever walk again.
“Initially when we met Sandip, he wasn’t convinced by the idea of having rehabilitation care,” says Ramesh Baral, an inclusion officer working with Humanity & Inclusion. “He didn’t trust anyone. He didn’t even believe that an artificial limb and exercises would help him walk.”
“During counseling, we showed him some videos of people with disabilities who have achieved milestones in their lives through rehabilitation care, like walking, going to school, working and dreaming big,” Baral adds.
The counseling helped Sandip understand the power of rehabilitation and realize his own potential. Sandip is determined and making massive improvements. After just four days with his new artificial limb, he found it easy to walk by himself with the parallel bar. Through a 15-day process, Sandip learned how to use his artificial limb through. He completed gait training and learned to balance, stand, shift weight, sit and stand from a chair, and go up and down stairs.
“Training to walk with my new limb is hard work and sometimes painful, but I am confident that when it is over, it will be okay,” he told us.
Sandip’s parents now see a positive future for him. They have seen a change in their son’s attitude, and now Sandip smiles and shares his ambitions and his love of learning.
“Now, I want to read and get help to improve my mobility,” Sandip explains. “Education is my new ambition! I need to study hard so I can get a job and become independent. I have to turn my dreams into reality. I plan to open a mobile repair shop or start working after I complete my education.”
Sidra and Marwa are sisters, Syrian refugees, and living with disabilities. Both receive physical therapy care in Lebanon at Mousawat Rehabilitation Center, a Humanity & Inclusion partner.
Sidra, 15, and Marwa, 16, live with their family of seven in a tent in the Faida Camp for Syrian refugees, in Bekaa, Lebanon. They fled from Syria in 2011, at the beginning of the war.
Sidra has cerebral palsy and Marwa has scoliosis. Both disabilities cause pain and make it difficult for the sisters to walk and to move. They receive treatment at the Mousawat Rehabilitation Center, to improve their walking and balance, and strengthen their muscles. Physical therapy helps ease their pain and increase mobility, making their daily lives easier and empowering them to go to school.
During the physical therapy sessions, the girls do exercises to strengthen their arms, legs and core. They use weights, the treadmill and the bicycle. These exercises have a psychological effect, too: to gain physical strength and ability is the first step to boost self-esteem and combat anxiety.
Marwa’s scoliosis affects her physical and social functioning in a similar way. Marwa has experienced several accidents. For instance, she once lost her balance and broke a knee while playing. The injury limited her movement for months, and caused her distress and anxiety.
“I had a fear that my health situation wouldn’t improve before the school reopened, and I would have to walk with a limp in front of students,” Marwa says.
They both love playing with other children, but they experience bullying because of their disabilities. By improving their mobility, physical therapy sessions have helped the sisters feel more included at school.
“I see my children happier and more excited about life than ever before, whether during daily life activities, helping out at home, learning, playing or even when leaving the house,” their mother says.
“I hope when we are grown up we will be able find jobs and be able to help our family,” Marwa explains.
Mohammad Rasool manages Humanity & Inclusion’s programs in Kandahar, Afghanistan, where the organization has been running a rehabilitation center since 1996.
Due to a collapsing economy, drought and consequences following years of war, the humanitarian context has significantly deteriorated. Since U.S. military troops left and the government was overturned in August, people have been flocking to the Kandahar rehabilitation center.
What kinds of people visit the rehabilitation center in Kandahar?
The vast majority of people are victims of the war and of explosive weapons. Last November, I met an 8-year-old girl from Zabul Province, which neighbors Kandahar. A mortar bomb hit her house while she was playing at home with her cousins. She was badly injured in the blast, and she was taken to several hospitals for treatment. Her father and family live on very little income, unable to afford the cost of transportation to Kandahar. After many difficult months, her family finally managed to transport her to Kandahar where she received treatment. Unfortunately, by then, her left leg had to be amputated.
Humanity & Inclusion’s team at the center worked with the young girl for several weeks as she recovered from the operation. We provided rehabilitation sessions to increase her mobility, strength and balance. Finally, when she was ready, measurements were taken and she received a prosthetic leg.
What is the rehabilitation landscape in Afghanistan?
The rehabilitation needs are immense. People come to the center every day, sometimes from very far away. For some families, the journey to the center takes an entire day, as there are only two rehabilitation centers that serve the south of the country. Since August 2021, we have seen a major increase in patient numbers. More people have been able to access the center since the fighting; roadblocks and strict security measures have ended. Now, we receive more than 100 people a week at the Kandahar center.
How strong is the connection between disability and explosive remnants of war?
Based on our data from the center, the majority of the people have acquired disabilities following contact with explosives, landmines and other remnants of war. In Afghanistan, the prevalence of disability is very high: 80% of the Afghan population has some form of disability due to the presence of mines, explosive remnants of war, armed conflicts and limited access to health and nutrition services.
What is the general situation in Afghanistan six months after the Taliban seized power?
More than half the population is in need of humanitarian assistance. People are really struggling with poverty, displacement, drought, and the ongoing risks associated with improvised explosive devices. The country’s health system is overwhelmed and the economy is collapsing. Many struggle just to get food. With no more cash in circulation, civil servants have not been paid for months and people are unable to buy goods.
How is Humanity & Inclusion responding?
Humanity & Inclusion provides rehabilitation care as the medical system in the country is unable to meet the current demand. As physical therapy services are scarce, we have a national plan to train more than 120 physical therapists over the course of a 3-year curriculum. Humanity & Inclusion also provides psychosocial support to many people experiencing stress and anxiety since there are very few mental health services in the country. We also conduct risk education sessions, as the presence of mines and explosive remnants of war remain a daily threat to the population.
Teams in Kunduz and Herat started providing cash assistance to support families with the lowest income. We will provide between six and nine allowances of $200, targeting 1,600 families. This financial support will enable them to buy food and access basic services like medical care.
Humanity & Inclusion in Afghanistan
Humanity & Inclusion has worked in Afghanistan since 1987 and is active in the five provinces Kandahar, Nimroz, Herat, Kunduz, and Kabul. The organization’s actions include physical rehabilitation, psychosocial support, mine risk education, training of new physical therapists and cash assistance.
Annually, Humanity & Inclusion assists approximately 9,000 survivors of conflict and people with disabilities at the physical rehabilitation center in Kandahar alone. Additionally, mobile teams support thousands of internally displaced people, returnees, and people with disabilities annually.
Currently, Humanity & Inclusion has 370 staff, including 114 women, based in Afghanistan.
In its ongoing support of Haiti earthquake survivors, Humanity & Inclusion works to fill the rehabilitation gap in affected communities.Read more
Prabin, 5, lives in southeastern Nepal with his parents. He was born without the lower part of his right leg.
“Because of the disability of our child we were worried about his future,” says Sunita, Prabin’s mother.
A community mobilizer from Community Based Rehabilitation-Biratnagar (CBRB), a local partner organization of Humanity & Inclusion, met Prabin and referred the family to seek services at a rehabilitation center.
At first, Prabin was hesitant to be fitted with an artificial limb. Specialists worked with the boy and his parents to better understand how the device would work, and how it would help him. A month later, he was eager to have a new leg.
“This was a wonderful change for our little boy, as he quickly accepted the prosthesis and began playing, running, and even jumping like any other child of his age,” Sunita explains.
Prabin attends school and loves to play with his toys.
Ambika Sharma, a specialist in artificial limbs and orthopedic braces at CBRB, worked with the family.
“Initially, it was challenging to fit Prabin with an artificial limb because he was not accepting,” Sharma says. “But his parents made it possible with their supervision and guidance. It was an amazing experience for us to see him happy with prosthesis.”
As Prabin gets older, he will need to be fitted with new devices.
“Growth is an important aspect of a child's life,” Sharma continues. “As their bodies change, prostheses have to be adapted or changed in the similar manner to accommodate them. Just as they outgrow shirts, pants, and shoes, they will outgrow their prostheses."
These rehabilitation services are supported by USAID.
In Sierra Leone, Humanity & Inclusion is helping survivors of a fuel tank explosion access specialized rehabilitation care.
On Nov. 5, 2021, the explosion of a fuel tanker in Freetown killed more than 100 people and injured another 100. Facing a fuel shortage in the country, people gathered around the wreckage, collecting gasoline that leaked from the truck – then it exploded.
Humanity & Inclusion set up an emergency response to assist people burned in the incident, as well as survivors experiencing psychological trauma. After identifying affected individuals, the organization helped them gain access to mental health and specialized physical therapy. Almost two months after the explosion, survivors share their stories of recovery.
Humanity & Inclusion visited 201 people impacted by the blast: 133 family members of people killed or reported missing, and 68 survivors of the incident.
Among them was Mohamed, who received rehabilitation care for severe burns.
“I got burnt on my left ankle. I didn’t know what to do after being injured and I was afraid that the police would come and take me if I went to the hospital,” he says. “So I went back home and tried to take care of it on my own.”
Mohamed lives 15 miles from the site of the explosion.
“I was home when the Humanity & Inclusion team located me,” he explains. “They advised me to go to the nearest hospital to avoid infection. I received a treatment, including physical therapy, which is helping me. I don’t know what would have happened if I hadn’t gone to the hospital, as I couldn’t walk without a crutch. Now I am getting better day by day.”
To help patients get to their medical appointments, Humanity & Inclusion provides reimbursements for transportation costs.
“I am receiving treatment at Rokupa Government Hospital, about 30 minutes away from where I live in Old Wharf,” explains Mariatu, who was also injured in the incident. “Considering my condition, it’s difficult for me to attend daily care, as I have no income. Humanity & Inclusion supports me with transportation fees. It is so far the best support that I’ve received. I am now getting better every day.”
Humanity & Inclusion also created and distributed 800 leaflets with information about burn care, burn prevention and first aid tips to explain the complications risk and the importance of follow-up care.
Burn care expertise
When caring for burn injuries, physical therapy is essential during acute care in the hospital and long after discharge to avoid secondary complications and long-term functional limitations, which may lead to disabilities. With support from Humanity & Inclusion, 44 survivors received physical therapy.
Humanity & Inclusion deployed a physical therapist specialized in burn care to provide capacity building support for rehabilitation workers at the National Rehabilitation Center. The National Rehabilitation Center also deployed one rehabilitation worker in a community center to ensure continuity of care after the patients are discharged from the hospital. At the emergency hospital, 17 nurses and nine physical therapists were trained in burn care and physical rehabilitation care for patients with burn injuries.
“We are grateful for the burn training we have received,” says Emily, who leads the rehabilitation team. “The training was short but our team acquired vast knowledge, which is going to help us in our practice.”