Changing Lives in Hard Places

written by Carson Abrams*, MedSend physical therapist serving in the Middle East
Hannah
The young girl, 8 years old, carefully ascended the 4 steps into the therapy center. She held one crutch in her left hand, and she was careful with each step, watching where she put her feet and pausing before standing on each frail leg.
Her left ankle chronically turned in and under when she walked.
Hannah* was 2 years old when she had an illness with a very high fever, leaving her with very weak arms and legs.
In contrast, her strong and healthy father’s frame filled the doorway, walking patiently behind her. Her father wanted to help her, but couldn’t afford the fees for a private doctor and grew weary with waiting for the system to provide for her needs. So he went to a local metal worker and described his daughter’s problem, hoping for a solution. Together with the metal worker, the father created a well thought out metal brace, with padding in the right areas, to support and stabilize his daughter’s ankle. When we saw Hannah the first day in the clinic, her brace, once a great fit, was now too tight around her ankle and her skin showed clear signs of damage. We met her immediate needs by providing a better fitting, plastic ankle-foot orthosis that would give her the support she needs, and protect her delicate skin.
We’re hoping to meet her long term needs and encourage the father’s entrepreneurial spirit by providing him with basic principles and precautions for making this type of brace for his daughter, and consulting with him and the metal worker to improve his design so that he can help his daughter long into adulthood. I count it a victory that with one visit, we were able to meet her immediate medical needs, observe and heavily encourage the father’s ability to produce a great solution for his daughter from local resources, and plan to go deeper in relationship with the father and the metal worker to improve their design, and possibly serve some of the other children at our center through their ingenuity.
Esther
Esther* is an energetic 7-year-old girl with a high level of functioning and with cerebral palsy. She’s been working hard at physical therapy for many years and her mom faithfully brings her twice a week to the center demonstrating her obvious care for her daughter. During a tea and bread break during one of her therapy sessions, I observed Esther having difficulty feeding herself. She was able to easily tear off a chunk of bread but struggled to bring the piece of bread to her mouth using her right hand. I asked the mom why Esther didn’t eat with her non-affected left hand – her mom shared that because of their cultural views, Esther was only allowed to use her right hand. When Esther would bring her hand up towards her mouth – her right hand would wind up over her right shoulder with her wrist bent at such an angle that the food in her grasp was pointed away from her mouth. I brought out a brace that had been donated from the US and found that it was the right size, and that it happened to be for a right hand. Upon placing Esther’s hand in this brace, her wrist was held in a neutral position – so that when she brought her hand to her mouth, she was able to maintain enough control to keep her hand in front of her mouth! Esther’s smile lit up the room and her mom was effusive with thanks to God as she watched her daughter eating in a pattern that was much more normal, and required significantly less struggle than she had just been demonstrating.
Salome
Salome* is an 8-year-old girl with severe autism. Her mother stays home with her and her brother, and her father is a teacher at a local high school. Salome was developing normally until around the age of 3 when her language began to regress and changes in her physical behavior were observed. After a short time, she stopped using her hands for anything – for eating, for play, or even to protect herself. Her parents reported that if she tripped, instead of reaching out to catch herself, she would pull her hands away from the ground and fall fully onto her head and torso. She would keep her palms pressed together or in her mouth. Eventually, she became fully non-verbal. Her parents were broken over the change in their beautiful daughter who had demonstrated no signs of prior illness. They read online and met with local autism support groups to figure out what they could do to help their daughter. They hired a full-time caregiver to provide a full day’s worth of stimulus and therapeutic interventions with their daughter to hopefully help her develop and proceed from her current state. They did everything possible and available to help their daughter. They heard about our center and brought her to us to see if there was anything the “foreign physical therapist” could do to help. I listened to all of the steps and activities and reading that they had done to aid their daughter and I could think of nothing more than I could offer than what they had already researched and provided for their daughter. I shared this news with them, wanting to be honest about the limitations of what we could offer, however, I also offered for them to come to the center to participate in therapy there several times a week. During the course of time that they brought Salome to the center for therapy, we were able to provide respite for the mother, we were able to provide a community around the mother who had previously been isolated at home with her ill daughter, and we were able to provide a new environment to Salome with people who loved her, were kind to her, and worked to provide quality care and sensory stimulation that was appropriate for her. Eventually, Salome stopped coming to the center for therapy, while we were unable to help meet her physical/medical needs – we spent many hours praying for her and her family, and we loved her and her family tending to the other needs that so often accompany illness and disability.
*names changed for security reasons
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