Staffing
Chief Physiotherapist (1)
Senior Occupational Therapist (1)
Psychologist (1) (vacant)
Junior Speech and Language therapist (1)
Junior Audiologist (1)
Junior and Senior Dietician (Vacant)
Community Service physiotherapists, occupational therapists and dietician
Community Rehabilitation Facilitators (4)
Occupational Therapy Assistant (1)
General Assistant (1)

Wards
Male and Female (medical, surgical and chronic), paediatric (medical, surgical, malnutrition, high care) and maternity wards are covered by rehabilitation services. Conditions seen include burns, CVA, orthopaedics, spinal, general surgical and medical, pulmonology, developmental delays (paediatrics), speech and language pathologies and psychiatric. Maternity ward has a 'high risk baby' program which targets neonates at risk, teaching mothers KMC and feeding techniques, as well as screening these neonates on a 3-monthly follow-up basis. Antenatal classes are also given once a week, a paediatric stimulation class is given daily, and ward in-service training programs are run.

Once a client is discharged, extensive advice and training is given to the relatives and directions to their homes taken should a follow-up home visit be required. The influx of cellular phones and improved network coverage (although still scanty) has assisted follow-up extensively!

Outpatients
Outpatients are seen daily, and usually referred for follow-up consultations at their closest clinics in the community. A wide variety of conditions is seen, including musculo-skeletal, neurodevelopmental (CP, DD), neurological, pulmonology, sports, cognitive, communication pathologies, nutritional and audiological conditions. Therapists work closely together in the multi-roomed department, ensuring a multi-disciplinary approach to each clients' problem. Social Work is situated close by, and the services of a psychologist once a month is greatly appreciated. Most clients are only able to attend Therapy once a month due to logistical and financial problems, so emphasis is placed on self-treatment, education and empowerment.

Clinics
31 mobile clinics exist within the health ward, of which Rehab services 23 on a monthly basis. These clinics range from well-maintained, fully-equipped brick structures (residential clinics) to four-walled structures in varying degrees of disrepair (mobile points) to clinics held under a tree or in a school classroom.

14 clinics are attended with a full ambulatory team- dental, an eye nurse, a social worker and therapists. The other 9 are attended with mobile PHC nurses. Any variety of conditions are seen, often requiring a multi-disciplinary approach and knowledge. A short health education session is done prior to starting a clinic, and, should there be sufficient time, a supportive visit to the nearby school can also be performed. Exercise and income-generating support groups meet at these clinics where the local Community Health Worker supervises them and the therapist communicates with them and addresses any urgent problems.

Home Visits
Four Rehabilitation Facilitators perform home visits, conduct awarenesses, assist in community mobilization and rehabilitation and assist in field-training for Community Health Workers and Home Based care volunteers and the integration of disabled children into mainstream schools. They work closely with support groups, Disabled People Organization members, Tribal leaders and other stakeholders, addressing specific community needs and issues.

Community Rehabilitation Facilitators complete a 2 year training course in basic Physio, Occupational Therapy and Speech Therapy techniques, with emphasis on community mobilization and rehabilitation, networking and lobbying for change.

Outreach Programs

CP Clinics:
CP clinics are run once a week at the hospital by Occupational therapy and Speech Therapy. CP children from outer-lying areas are seen monthly at clinics, or at home by
the CRFs once they are older.

High Risk Baby Clinic:
Babies who have been exposed to certain risk factors before, during or after birth are entered into the HRBC from Maternity ward. Here the baby is screened by a therapist, and the mother counseled appropriately. The pair are then followed up in 3-monthly intervals at their closest clinic so as to identify any developmental problems early enough and provide appropriate intervention and/or referral.

CHW and HBC training:
CHW and HBC volunteers are grouped according to their geographical location and training is provided twice a week to groups on various topics by a therapist and assistant. The sessions take the form of a review of knowledge of available services and referral criteria (and the efficacy and acceptability of these services), a 2-3 hour interactive discussion/lecture and a case discussion and knowledge application section.

Topics covered so far include:
- Early childhood development: milestones, risk factors, nutrition and breastfeeding and stimulation 0-5 years old
- School-going age children: the services available and the problems they face
- Business and financial management (very basic)
- Strokes (CVA): risks, prevention, early detection, handling, referrals

The topics are suggested by therapists and chosen by CHW and HBC's, as the applicability and usefulness are of essence.

Radio slots:
Maputaland Community Radio supports Umkhanyakude rehabilitation departments once a week with an hourly slot. Topics follow a logical sequence, and are similar to those addressed at the weekly CHW/HBC training sessions. The slots are interactive and community members are able to phone in with questions and discussions.

Hydrotherapy:
All functioning support groups who exercise regularly are able to attend a session in hydrotherapy at Kosi Mouth Nature Reserve once every four months (Every second Friday a group is taken for the day to the reserve). For some clients, this is the first time they have ever seen the sea! After a frolic in the ocean, a hydrotherapy session and the collecting of sea-water and sand, lunch is shared by everyone and plans are made for the following exercise day.

Chronic Care sewing group:
Due to logistical and financial reasons, many a client with TB ends up spending up to four months in the ward during their streptomycin. A sewing group is run by the occupational therapy assistant with donations from Ms C.M Bezuidenhout's curtain business. Women then pay R5 which buys them a needle and thread, and are taught basic sewing techniques. Some of the bedspreads and pillow cases which emerge are fantastic! The women are then able to take these home to sell, along with their new-found skill.

Wheelchair repair project:
This is a joint effort between DPSA (Disabled People South Africa) and the Department of Health. Two 'wheelchair repairmen' (who have some sort of disability) are trained per institution in the maintenance and repair of community and institutional wheelchairs, in an attempt to prolong the life of wheelchairs over rugged terrain as well as reduce waiting lists and costs to the institution. These repairmen are paid a monthly salary, and the hospital supplies the spare parts.

Manguzi Hospital has just succeeded in accommodating this workshop within the hospital grounds, which will improve communication between therapists, clients, repairmen and hospital stores/management departments, providing a better quality service for all.

Health and Wellness:
Through the assistance (and insistence!) of community members, the rehabilitation department has assisted in developing a community fun park (which will hopefully, with funding, develop into a community gym) and affiliating an athletics club. Scholars from nearby schools are targeted in regular programs by the physiotherapists and dietician covering exercise, nutrition and healthy lifestyles.

Open Days and student support:
Manguzi Hospital hosts annual open days, where scholars from all over are allowed to attend speeches, ask questions and view the departments. Scholars who want to gain more experience can shadow a therapist for up to a week, and the rehabilitation department helps to provide them with information and assistance in applying to various universities.

The hospital also assists in the Friends of Mosvold and Department of Health Bursary schemes, and scholars who receive these bursaries are able to return home during the holidays and assist in their relevant departments. This sort of support and experience goes a long way!