Ripple Africa’s Disabilities and Rehabilitation Project started in January 2012 and aims to improve the quality of life for people in the local community who are living with disabilities. The Project operates in the Fukamapiri area of Nkhata Bay District, with a catchment area of roughly 18,000 people – it is estimated that there are over 400 people living with disabilities in the local community who are in need of treatment, rehabilitation, and support. The objectives of the project are to:

• improve the quality of life of people living with disabilities in the local community
• identify people in the community who would benefit from rehabilitation services
• provide clinical rehabilitation support for the disabled
• improve the skills of family members to help promote self management
• provide mobility aids and rehabilitation equipment where needed
• identify patients needing clinical support and refer them to relevant services where applicable
• provide families and patients with access to support groups
• reduce social stigmas and enhance community understanding of disability.

Ripple Africa works in partnership with existing government systems to identify, treat, and support the people in the community who have previously been unable to access help. We estimate there are about 200 people in our catchment area who are in need of support but are not currently accessing treatment, and it is these people that our Disabilities and Rehabilitation Project aims to reach. All services are completely free to the patient.

Malawi’s government provision for people living with disabilities is serviced at a national level through MACOHA (Malawi Council for the Handicapped); however, areas are so large and funding so limited that thousands of patients slip through the system without identification, treatment, and support and unfortunately this is common for many with disabilities in Africa.

When the project started, Ripple Africa employed its own Community Based Rehabilitation Coordinator, Collins Chanika, who helped Ripple Africa develop the project and was the first to carry out that role but who sadly passed away in 2015. This project was then put on hold for almost two years, but we were delighted to meet Matilda Mwale, a locally based Special Educational Needs teacher who joined our team in January 2017 and is ensuring that the great work that Collins started continues. Matilda:

• identifies patients who could be considered for the project
• conducts regular home visits to provide clinical rehabilitation
• identifies candidates needing mobility equipment and arranges for the order/delivery/use of such equipment
• organises community support groups for carers and patients and
• makes referrals to relevant partnership bodies where applicable.

In addition to this clinical care at household level, the project also encompasses an awareness campaign to tackle the social stigma and misunderstandings surrounding disabilities in the community. This campaign is the first of its kind in our area, and Matilda conducts regular talks about disabilities to local primary schools, secondary schools, church groups, and local health clubs within the Fukamapiri area.

Our disabilities project in Africa includes funding for referrals, mobility aids, and equipment such as crutches, sitting/standing frames, push carts etc. which can be constructed locally.

Larger specialist items such as wheelchairs, made-to-measure prosthetics, or specialist surgeries may on occasion need to be handled outside this budget and funds for these are raised on an individual basis; however, the majority of cases will be able to fit within the arranged budget, and many rehabilitation cases require no aids or funding at all besides access to our rehabilitation services.

This disabilities project is supported by Ripple Africa’s overseas physiotherapy volunteering programme, which benefits from the input of physiotherapists, doctors and nurses who can provide care and specialist advice.

Some of the disabilities that the project has dealt with include:

• cerebral palsy
• club foot
• congenital malformations
• muscular dystrophy
• down’s syndrome
• amputees
• post-traumatic injury
• arthritis
• burns
• blindness
• developmental delay
• hydrocephalus
• stroke
• microcephaly.

The goal in every case is to identify the person who needs support and work to improve their quality of life and enable them to live as independently and as happily as possible within their local community.

The desire to lead a productive and independent life is a universal human need; however, for people living with a disability, this desire can be compromised by a physical, medical, or mental condition, which can severely hamper an individual’s quality of life. This is true for people living with a disability anywhere in the world; however, in Malawi, living with a disability can be a life sentence. A lack of identification, treatment, rehabilitation, and support can mean a disability is a complete barrier to participation in local society.

• People with disabilities are often ostracised.
• Many local people believe that a disability is the result of witchcraft or “black magic”.
• Many people with movement restrictions are physically unable to leave their homes.
• Children are unable to attend school because they can’t get there.
• Some patients, who have suffered an injury and would be able to make a full recovery with proper rehabilitation, develop a permanent disability simply because they didn’t have access to any services.

Every person with a disability deserves an equal chance of living a better life! Ripple Africa’s Disabilities and Rehabilitation Project provides that — and brings hope and happiness to people who may otherwise have given up.

We have more than 130 clients registered on the project. We are running four physiotherapy and support groups each week and families are able to effectively help each other which is reducing the isolation that such families often feel. Take a look at our News section to read some of the positive stories.

Matilda, our Community Based Rehabilitation Coordinator, is told about patients by health staff in the area, schools and other members of the local community. She then visits to make an assessment and find solutions to the problems identified before creating a manageable and achievable plan for the client and family to work from. She works closely with parents and carers to teach therapies that they can use at home between visits.

Matilda is supported by Ripple Africa’s volunteer physiotherapists, nurses and doctors who visit clients with her, advise on physiotherapy treatments and help develop the aids and exercise programmes that are required. Where we can, we use local workmen to help us make walking aids etc., rather than buy expensive equipment.

We work in partnership with Malawi Council for the Handicapped (MACOHA), local clinics and a local NGO called 500 Miles who supply patients with prosthetic limbs. We also provide transport for clients to attend orthopaedic clinics at Nkhata Bay Hospital.

We intend to continue the project and are currently seeking secure long term sources of funding to ensure its long term success. We would ideally like to take on assistants to help Matilda to expand the number of disabled people that we are able to support through this project. If you would like to help us, either as an individual or corporate donor, please get in touch.