Helen Hyams’ Work in Ghana

Back in 2015 with retirement looming I approached the Beverley based charity Jacob’s well Appeal (JWA) about the possibility of using my skills as a Paediatric Physiotherapist on one of their projects abroad. A few months passed and then I heard from JWA that they had found through Sandra, their Project Worker, that there was an opportunity to volunteer at Tamale Teaching Hospital in Northern Ghana, to work alongside one of their Physiotherapists as I had experience of working with cerebral palsy patients.

So, after various injections against yellow fever, rabies and other diseases, malaria prevention tablets, and getting my visa I was on my way to Ghana in October. My husband Steve drove me to Heathrow and then Accra, the capital city of Ghana.

Sandra was at the airport to meet me. After an overnight stay in a guest house I went with Sandra to oversee the delivery of a JWA container to Ridge Hospital in Accra. We then took an internal flight to Tamale.

My first night in the hospital guest house was a real eye opener, bed sheets were not supplied! Luckily I had packed a sheet sleeping bag. I also found the cooker had an empty gas cylinder so no hot food either. Then the water supply ran out. After three days I was moved temporarily into a small two star hotel until the conditions at the hospital accommodation improved, but remained in the hotel for the rest of my stay.

On my first day Sandra introduced me to the Physio Department. Tamale is the largest city in Northern Ghana and has its own medical school and nursing college. Physiotherapy and more recently Occupational Therapy are degree courses at Accra University. Physiotherapy is fairly new profession in Ghana so many Heads of Departments are only in their thirties.

I was surprised by how large the Department was. There were heat machines, traction bed, wax bath, parallel bars and static bars. I felt I had stepped back twenty years! Equipment such as crutches, sticks and walking frames had to be purchased by the patients themselves.

The Children’s area was just at the end of the adult treatment area and consisted of two gym mats on the terrazzo concrete floor, and a small cardboard box containing a few rattles and picture books.

I had taken some toys with me, mainly Fisher Price type stacking rings, shape sorters and rattles. These were a welcome addition. My main task was to work alongside Esther, a qualified Physiotherapist and show her how we use the toys in the UK to encourage increased function in the children. Ghanaian children have very few toys at home so the opportunity to play can act as an incentive to engage in active treatment, rather than the passive treatment which is more often used.

Mothers are keen to bring their children for physiotherapy, fortunately many are diagnosed with cerebral palsy at a young age in Tamale so treatment can begin early. There is a lack of children’s mobility aids, standing frames and supportive seating, which we take for granted in the UK. Many severely disabled children spend a lot of time lying on settees or beds to stay safe and so have no sitting balance.

On my return to the UK I contacted a Physio called Diane whom I had met previously at an “ADAPT” conference (Chartered Physiotherapists in International health and Development). Diane had already taught an APT (Appropriate Paper based Technology) Course, in conjunction with the Cerebral Palsy Africa charity, for parents in Ghana. I enrolled on a one week APT course in Hampshire and learnt to make standing frames from cardboard and newspaper. We arranged to go out to Ghana in February 2017 and I visited Tamale I September 2016 to begin organising and informing people about the forthcoming course. Unfortunately, Diane was unable to come to Ghana in February, but arranged for Marian, a Dutch Occupational Therapist who has taught several APT courses in Africa and other places for Cerebral Palsy Africa to come with me to Tamale. Marian and I set off for Tamale on 23rd February to run our first two-week course. Jacob’s Well volunteer Liz Lyle  came with us as a helper.

Despite an extra day at Manchester Airport due to Storm Doris we made it to Tamale just 24 hours late. Marian had been on the last plane leaving Amsterdam so had stayed in Accra, thanks to Mandy Budge of Multikids School who also re-arranged our internal flights. The delay meant we had only a half a day to set up the course venue in the Physiotherapy Department at Tamale Teaching Hospital, visit the local market for essentials such as plastic bowls and wheat flour to make the paste and travel to the homes of two of our potential patients to assess their needs. Esther and a friendly taxi driver came with us to help with introductions and the language barrier. On the Monday morning we arrived at the Department at 8am and were in business by 9am meeting our course participants. They were from a wide range of backgrounds including nurses, a medical student, physio staff and Occupational therapists ,an art  teacher and student from the King’s Village School, Pastor , his wife and six week old baby, and a couple of mums. The CPA course to make chairs lasts for two weeks, but due to the Independence Day bank holiday one of the sessions was held on Saturday and we had a day off on Monday to watch the parade. Four chairs were made, one by each group of course students.

Dawuni in his chair

On the last Friday afternoon (one of the hottest at 48°C) there was a grand presentation ceremony when the hospital Directors and Administrators, some in their best robes, presented certificates to our course participants. The completed decorated practice stools and the chairs were on display. The hospital is happy to support the participants, now known as the Tamale APT group in continuing to provide chairs for more children.

This October we are off to Tamale again to run the second part of the course with the group learning how to make standing frames for the children. This time CPA are sending two Physios. Also Helen is *going to investigate the possibility of starting another APT group in Accra at Multikids in Spring 2018.