From clearing explosive weapons to helping entrepreneurs launch their own businesses to assisting people with disabilities and mine victims, Humanity & Inclusion has stepped up its actions in northern Chad since 2017.

Rachel Datché, 33, was traveling to see her sister when she stepped on an anti-personnel mine in Fada. After her right leg was amputated, she received an artificial limb and post-surgical care at the orthopedic and rehabilitation center in Kabalaye in 2020. Rachel (pictured above) is one of the participants in PRODECO, a vast development program coordinated by Humanity & Inclusion in consortium with three other NGOs. The four-year project to help restore the economic sustainability of the local population will wrap at the end of 2021.

“This wide-reaching program includes mine clearance operations, risk prevention, victim assistance, rehabilitation and economic assistance,” explains Jean-Michel Mathiam, who manages Humanity & Inclusion’s actions in northern Chad.

Legacy of war

The Borku and Ennedi regions were ravaged by civil war and conflict with neighboring Libya in the 1980s, leaving land contaminated by anti-personnel and anti-tank mines. Humanity & Inclusion recently completed its mine clearance operations in northern Chad, which helps people living in rural and agricultural areas earn a living by ensuring the roads leading to their villages are clear of mines.

In Faya and Kirdimi, more than 740 acres of land have been decontaminated through weapons clearance operations. More than 1,000 mines were destroyed by 120 deminers coordinated by Humanity & Inclusion and Mine Advisory Group MAG.

Teams also tested a drone mine detection system. The technology will revolutionize mine clearance operations worldwide.

Supporting small businesses

Since Oreike Bandy’s divorce four years ago, the 38-year-old mother has struggled to feed her family by selling bread at a market in Fada. She’s one of more than 1,000 people who have received a financial boost through a social fund to start her own business and become financially independent.

“I joined the village savings and loan organization [AVEC] and put aside some of my earnings each week to invest in the AVEC. This enables me to renew my stock of food products,” Oreike, pictured above, explains.

Ache Guene, 38, lost her husband four years ago and was suddenly faced with the difficult task of raising their five children alone. With help from Humanity & Inclusion, she also set up her own business and lifted her family out of poverty.

Maimouna Abass, a 30-year-old widow and mother of two children, now runs her own market stall in Fada, where she sells biscuits to earn a living.

"My life has changed. I can reinvest my profits in my business,” she says.

PRODECO project

In 2017, Humanity & Inclusion launched a large-scale development program called PRODECO in partnership with three other NGOs: Mine Advisory Group (MAG), the Swiss Foundation for Demining (FSD), and Secours catholique et développement (SECADEV). Humanity & Inclusion recently completed its mine clearance operations in northern Chad. The organization will continue identifying people with disabilities, primarily victims of mines or explosive remnants of war, in villages and communities to participate in the project through 2021.

After more than 30 years of war, humanitarian needs in Afghanistan are immense. Humanity & Inclusion is steadily resuming its activities in four provinces: Herat, Kunduz, Kandahar and Nimroz. 

Julio C. Ortiz-Arguedas, Humanity & Inclusion’s Country Director in Afghanistan, shares more information on the organization’s history in the country and how it has been impacted by the recent regime change:

Most of Humanity & Inclusion's activities with people in Afghanistan have resumed after a few days' interruption. Humanitarian needs are immense in a country devastated by decades of conflict and one of the most contaminated by explosive remnants of war and landmines in the world. Today, 80% of the Afghan population has some form of disability due to the presence of mines and explosive remnants of war, armed conflicts and limited access to health and nutrition services.

The rehabilitation center in Kandahar is the major activity of Humanity & Inclusion in Afghanistan. Humanity & Inclusion set up this center in 1996 and has been supporting it since. At the center we have a total of 53 staff working to support people for rehabilitation and psychosocial aid.

Support inclusive aid in Afghanistan

We were able to gradually resume activities. Since the Taliban took control of Kandahar on August 13, the rehabilitation center has served 240 men and 180 women, distributed 200 walking aids and fitted 50 beneficiaries with orthotics or prosthetics. These numbers represent a 50% increase over the average in the previous months: the end of the fighting, of the roadblocks and the increased security have allowed more people to access the center.

However, the Kandahar Mobile Team—comprising 15 members—could not yet return to the countryside, so it was deployed in the center and, in that same week, was able to accommodate 117 people.

People are coming every day at the center, sometimes from very far away—we had families who made a one-day trip to come to get treatment—as it is the only rehabilitation center for the south of the country.

Images: A glimpse at daily activities at the Kandahar rehabilitation center, including physical rehabilitation and manufacturing of artificial limbs and braces. Copyright: HI

On a recent visit to a hospital in Les Cayes, Humanity & Inclusion’s staff met Oscar, who remains positive despite his home being destroyed and his leg broken in the earthquake.

On August 14, Oscar was just outside his home, walking down the narrow alley between two buildings, when he felt the ground begin to move.

“The walls swayed back and forth and I started to run,” he says. “I knew immediately that it was an earthquake, and that they could collapse at any moment." Before he could escape, the bricks began crashing onto him, cutting his arms and shattering his leg. Despite his broken leg, Oscar continued to run to avoid being buried by the rubble. 

The Humanity & Inclusion emergency response team has begun the training process for physical therapists who will be reinforcing local hospitals and a rehabilitation center in Les Cayes, Haiti.

Our experts are working with seven physical therapists and one physical therapy assistant who have already received all of the appropriate training to respond to routine rehabilitation needs. Most of the specialists have participated in past trainings conducted by Humanity & Inclusion.

Deliver emergency aid to Haiti

After the 2010 earthquake introduced her to the field, Humanity & Inclusion rehabilitation graduate Guetchly-Nise now finds herself treating those affected by the most recent disaster.

This week, Humanity & Inclusion teams in Haiti are training physical therapists and rehabilitation specialists in emergency rehabilitation to reinforce overwhelmed medical centers in Les Cayes. On Wednesday, one of the new recruits, Guetchly-Nise, started her first day responding to those who were injured in the earthquake. 

Just days after an earthquake hit Haiti, Humanity & Inclusion is providing assistance in hospitals in the country’s worst-affected region. A team of physical therapists trained to care for people with earthquake-related injuries will begin work this week.

The current economic crisis in Lebanon, which was aggravated by the deadly explosions in Beirut on August 4, 2020, is having a serious impact on communities living in vulnerable circumstances, including Syrian refugees and people with disabilities.

A young man and a teenager who receive care from the Mousawat Center, supported by Humanity & Inclusion, share their stories.

Mohammed Ali Raja, 26

Mohammed Ali Raja fled Syria to Lebanon in 2017 after a rocket attack left him with a spinal cord injury, causing him to experience paralysis from the waist down. His left leg had to be amputated. Humanity & Inclusion’s partner in Lebanon, the Mousawat Center, provided Mohammed with crutches and psychological support. They also referred Mohammed to the World Rehabilitation Fund (WRF), where he received a prosthetic leg and medical boots. Mohammad continues to receive for other health issues caused by his spinal injury.

On August 4, 2020, the Beirut blast killed more than 200 people and injured 7,500. For Mohammed, it triggered psychological trauma from his memories of the conflict in Syria.

“I was afraid to go to the bathroom after the blast because I was scared,” he says. “The feeling of fear got worse because I can’t escape if there is a problem.”

Due to the current economic collapse in Lebanon, Mohammed is in need of financial support. For example, the incontinence pads that he has to wear cost 100,000 pounds—more than $66—for a pack of 24. That is unaffordable at local salary rates, especially when Mohammed’s brother is the sole income provider for his family.

Mohammed’s hope for the future is to pursue education outside Lebanon, in a place where he can “work and be productive enough to cover my needs.” He would like to use his interest in biology to become a doctor or school teacher.

Mohammed Abboud al-Saleh, 14

Mohammed Abboud al-Saleh and his family fled from Syria to Lebanon several years ago. Unfortunately, he was struck by a car while crossing the street in Beirut. He suffered a spinal cord injury causing his legs to be paralyzed.

After 15 sessions at the Mousawat Center, Mohammed has made great progress. He can now stand with assistance and transfer himself from his wheelchair to a bed.

“There were movements I couldn’t do before, but now I can,” he says. “I am so happy.”

Being a wheelchair user is a day-to-day challenge for Mohammed. One time, his father was late to pick up him from school, so he was stuck on the third floor. His teacher was unable to move Mohammed by herself, so they had to wait for his dad to arrive and to call people from the street to help get Mohammed back down. It made Mohammed very upset and he said that he “felt lonely.” Like many places, schools often don’t have elevators or facilities for persons with disabilities. Even if they did, the current frequent electricity blackouts in Lebanon would likely cause a major issue.

Mohammed has big plans for the future. He would like to continue his studies and become a doctor or pharmacist. But his real passion is in acting! He posts challenges, pranks and sight-seeing videos to his thousands of subscribers on Youtube and TikTok.

When asked if he could go anywhere, Mohammed suggests a few places, all within miles of his home.

“I’d like to play with my friends and go for walks around the building and around these areas,” he says. “My biggest dream is to walk again.”

Covid-19 has presented numerous challenges, changing the way Humanity & Inclusion teams around the world work with the communities we serve. One of those challenges was figuring out how to safely continue providing rehabilitation to people with disabilities. The answer in many places? Telehealth.

For instance, take Priti, a 3-year-old girl living with cerebral palsy in Nepal. Doctors suggest she do regular physical therapy sessions to improve her condition, but her parents find it difficult to afford treatment on top of other living expenses.

A community member and former patient referred Priti to Community Based Rehabilitation Biratnagar (CBRB), a local partner organization of Humanity & Inclusion, for physical therapy and assistive devices.

Priti completed three physical therapy sessions at the center and received a specialized chair that helps stabilize her body and maintain upright sitting posture. She can also use the chair during daily activities like playing and eating.

Then, as the second wave of Covid -19 swept through Nepal reinstating travel restrictions, Priti completed four telerehabilitation sessions by video. Physical therapists gave Priti’s family advice on continuing home exercise to help Priti grow stronger and checked on the condition of her chair.

“It was difficult for me to continue regular exercises on my own during this pandemic as I could not remember techniques taught by the physical therapist,” says Priti’s mother. “With regular video calls, I am satisfied and happy with the services that helped me to continue exercises."

After three months of regular rehabilitation services, specialists have noticed that Priti’s neck is growing stronger and that her arms and legs are more flexible.

Many people living with disabilities, like Priti, lack access to regular follow-up services that they need because of Covid-19 safety measures and travel restrictions.  

“Through the provision of telerehabilitation, another easy way of reaching out to the individuals who need such services, we tried better at our level,” explains Rinki Adhikari, CBRB physical therapist. She added that telerehabilitation can be an alternative way of making rehabilitation services accessible for people in the future.

Humanity & Inclusion’s Covid-19 response in Nepal

These physical rehabilitation activities are supported by USAID and managed by Humanity & Inclusion. The program supports the establishment of a sustainable, integrated, public-private rehabilitation system in order to improve the mobility and functional independence of victims of conflict as well as other adults and children in need of rehabilitation services in Nepal.

With Covid-19, the program has adapted to offer telehealth services and distribute information to prevent the spread of coronavirus. So far:

• 922 audio messages have been broadcast in four different languages on the radio
• 257 accessible video messages have been broadcast in four different languages on television
• 10,726 posters and leaflets have been delivered to government and rehabilitation stakeholders
• Health workers have received 275 sets of personal protective equipment; 16,750 pairs of gloves; 32,500 masks; 62 gallons of disinfectant; and 19 gallons of hand sanitizer
• 7,067 physical therapy sessions have been conducted, including 3,390 telerehabilitation sessions
• 483 assistive devices have been provided to people with disabilities or injuries
• 678 people received essential medical items
• Specialists have offered guidance to government officials related to inclusive health and rehabilitation and to rehabilitation care for people with Covid-19

Header images: Priti sits in her special chair to help her posture while eating and playing. At center, her mother helps her with exercises during a telerehabilitation session. Inline image: A CBRB Prosthetist and Orthotist teaches a woman to re-learn to walk, gain balance, strength and mobility with their new prosthetic device in a parallel bar at the rehabilitation center. Copyright: CBRB/HI

Saisa’s leg was amputated after an unknown critter stung or bit her foot, causing a serious infection. With help from Humanity & Inclusion, she is learning to get back on her feet and has already returned to school.

Saisa, 10, lives with her parents and seven brothers and sisters in Kenya’s Kakuma refugee camp. At a birthday party near her home, Saisa was bitten or stung on her left foot. After the injury, her leg became gangrenous and required a life-saving amputation.

"Saisa was 2 years old when we arrived in Kakuma,” says her mother, Rihad. “My daughter was in good health. And then this happened. One day she went to play with her friends and the next morning she told us she’d been bitten or stung by something. We don't know what. At first, I thought she’d had a nightmare, but then things got worse.

“We took her to hospital, but we were under lockdown because of Covid-19, so we were sent away before she could be treated. Back home, her leg started to swell up and got worse, so we returned to hospital."

The doctors spotted the first signs of gangrene and, to save her life, amputated her leg below the knee.

A support network

Humanity & Inclusion’s physical therapists immediately began providing Saisa with the care she needed. She was also given psychological support to cope with the distress of losing her leg. Saisa continues to visit Humanity & Inclusion’s rehabilitation center, where she is supported by a multidisciplinary team.

“I first met Saisa just two days after her amputation,” explains Stella Mwende, a physical therapist. “We initially focused on treating her stump and giving her emergency psychological support. She was then referred to the rehabilitation center, where she was given rehabilitation care once a week. We started by doing exercises with her to increase her flexibility and strengthen her muscles. We also gave her a pair of crutches.”

Saisa has already learned to keep her balance and get around using the crutches. Humanity & Inclusion also built parallel bars at her home to help in her recovery.

“Saisa can go out and play with her friends at last without me running after her all the time,” her mother says.

Humanity & Inclusion teams also supported Saisa’s family through this tough time, explaining the different stages of grief that Saisa was experiencing. Her family learned how to reassure her and encourage her to learn new skills and become more independent.

“I found the hospital really stressful because I thought I was going to lose her,” Saisa’s mother explains. “Once we got home, some people from Humanity & Inclusion came and now my daughter feels more hopeful about the future.”

Back to school

Humanity & Inclusion’s inclusive education team also helped find a place for Saisa at an inclusive school near her home.

“We’ve put a plan in place so Saisa can return to school under the right conditions,” explains Caleb Omollo, an occupational therapist. “The first decision, which we took with Saisa and her family, was to transfer her to a school closer to home, where the teachers are trained in inclusive education and are used to assisting children with disabilities. We have assigned an educational assistant to monitor her progress at school and to look after her welfare both inside and outside the classroom.”

Saisa walks to school each day with a classmate named Ana.

"We’ve also put in place a system to make sure Saisa feels safe on the way to school,” adds Caleb. “We want Saisa to feel she belongs to her school and her community as soon as possible, so she can play a full role in every aspect of society.”

She also attends psychotherapy sessions to help her rebuild her confidence and reconnect with others.

“We work on her interaction with other children, and we help them learn from each other,” Caleb says.

Saisa is now waiting to be fitted with a prosthetic leg from another service provider, which should happen soon. Humanity & Inclusion will continue to support Saisa with the services she needs to move forward.

“It’ll be good to play with my friends again when I get my prosthesis,” Saisa says. "I'm really glad to be back at school again now. I want to be a businesswoman when I grow up and sell a lot of things!”

Header image: Saisa completes classwork at school. Inline image: Saisa with her mother. Copyright: A. Patient/HI

After Riad, 20, lost his leg in a shooting, he feared that he could not care for his family. Today, with the help of Humanity & Inclusion’s psychosocial support, physical therapy and a new prosthetic leg, he can’t wait to show his family what he can do.

On February 15, Riad and his family heard gunfire outside of their house in the Central African Republic. The shooting continued for hours, so they fled in search of safety. Like many others, they sought refuge in a mosque in Bambari. But their safety was short-lived, as gunmen soon entered and opened fire on the families inside, taking several innocent lives. Riad was shot twice, once in his left ankle and once in his right leg. He lay wounded on the ground until the next day, too afraid to seek help until then. By the time he was taken to the hospital, his injury had become so severe that his right leg was amputated 21 days later.

The operation was a success, but Riad worried about the future. He lives with his mother, his siblings and their children in Bambari. His greatest fear after losing his leg was that he would not be able to take care of his family. After the amputation, Humanity & Inclusion psychosocial specialists helped him overcome his fears, cope with the pain, and start adjusting to life with a disability.

Always accompanied by his older brother, Riad has been attending physical therapy with Humanity & Inclusion specialists twice a week in Bambari. Ready for an artificial leg, Humanity & Inclusion recently paid for the brothers to visit the Central African Republic’s only fitting center in Bangui.

“I can’t wait to receive my prosthesis,” Riad said during his fittings. “I hope to be able to walk again and take care of my mother. I’ll be able to go get food and spend my day working outside of the house. I think I’ll feel brave again.”

After a week of casts and learning to walk again, Riad received his new prosthetic leg.

“I used to look at my leg and cry, but now I feel stronger,” he says. “I feel that I will have less to worry about from now on and I’m so grateful for the support I’ve received from HI, from my amputation until now. I can stand up and walk again. I can’t wait to show my family!”

Header image: Riad practices walking with his new artificial leg at a fitting center in Bangui. Inline image: Riad and his brother at a rehabilitation center in Bambari. Copyright: A. Servant/HI