Hospital is fortunate enough to have a well-established and well-staffed
rehabilitation unit operating both within the hospital and out in
the community. The rehabilitation department includes physiotherapy,
occupational therapy, speech and audiology and dietetic services,
as well as the support of community rehabilitation facilitators and
therapy assistants. Services include a busy outpatient department,
wards, 23 community clinics and numerous home visits and support group/community
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
Community Rehabilitation Facilitators (4)
Occupational Therapy Assistant (1)
General Assistant (1)
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
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 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.
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.
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.
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
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.
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.
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
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
- 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.
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.
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.
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.
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.
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.
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.
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!