Blog 25: The next challenge

It’s been a roller coaster week. I’ve laughed, cried and torn my hair out, sometimes all at once. Manyanye and Mr Chabalala have struck a deal and the building work has started, however since then the physio hut has taken on a life force of its own and has changed position, shape, size and interior. A couple of times I thought I knew what was happening but now I realised I don’t and I have felt powerless to get what I believed was best for the children. Mamello assures me it will be fine and maybe it will be if the path is completed. Having to negotiate a boulder strewn path was not part of the vision I had in mind for the children to gain access to physiotherapy.

I feel that I have been naïve and not been forceful enough. I thought getting the equipment here was the hard part and the notion of room 10 m x 12 m with a sink and lights was a relatively simple concept. The builders wielding pickaxes, with looks that threaten GBH when I say that 6m x 8 m is not big enough, clearly think otherwise. It’s not their fault they are stuck it the middle of it all trying to carve out the foundations through solid granite with a hammer and chisel. 
     
Away from the building work and despite the present small space I’m trying to operate in, we’ve managed to make things work. The strategy is to chuck all the equipment we don’t need outside and make some space for the children inside. Working with up to ten children at a time is only possible because I am blessed with two physiotherapy assistants. These lovely ladies are both working very well, although the language barriers occasionally lead to misunderstandings and confusion for the three of us. This is especially because Malineo and Joalane like to please and say “Yes” to everything, although they might mean “No” 

We work around it and we must be on some kind of wave length as many of the children are making great strides, literally, and are surpassing my expectations of them. They are discovering standing balance, sitting balance and reaching and touching things that have remained out of the grasp of their flailing limbs up to now. Ten days is a short time but not when you’ve got kids who are so enthusiastic about everything.

I am very pleased with the equipment. The children have all grown since last year and all needed bigger boots and walking frames to continue their progress. When you are trying to work out the best sizes to bring it’s a miracle that things have worked out so well. Several children have to share the same pieces of equipment, so it is often a compromise. I have not used some of the equipment before either, so it’s a bit of a test for me as I turn knobs, get stuck to bits of Velcro and try work out where straps go.   

I find adjusting the standing frames particularly taxing, but they are proving of great benefit in helping the children that have no balance grow stronger. The static bike has been a boon to a couple of the bigger boys frustrated by their legs, but who now find they can pedal a bike independently. Their faces light up as their legs wizz around. Some serious gaffer tape adjustments are needed to the broken pedals, but we seem to have got it sorted.        

The type of children that that Phelisanong take have now changed and the bigger children that use to lie all day on their back are now longer accepted. Younger more mobile children with a chance of making some progress now fill their places. One of these is the child with the festering club foot. I asked Mamello to take her to clinic to take a swab to identify the bacteria which has prevented this wound from healing for the past two years. When she returns I note they have tested for TB and debrided the wound, which looks heaps better.

On a roll Mamello brings me a 5-year-old boy with bilateral club feet. He has been put in plaster casts sometime back but is still so pigeon toed he can barely walk with out stumbling over his own feet. I have never treated club feet before and in these situations I ask myself two questions:

Could I make the problem worse?

Could I make things better?

If the answers are “No” and “Yes” respectively then I will have a go. I have found over my last three visits to Lesotho that common-sense and reasonable medical knowledge can go a long way. Tokelo looks at me with deep suspicion a I get some scissors out and he starts to sob. I think, he thinks I’m going to operate on him.

My taping skills leave something to be desired. As a physio there are a hundred different taping courses you can go on and I have always resisted; Blue Peter skills were never my calling. Anyway, I end up with a pair of feet which look much straighter and find him a very nice pair of orthopaedic boots to hold them in position.

The following day I check him and stretch his feet keeping the tape on. He is still not convinced that I’m going to do something terrible to him, but I win him over by playing “This little piggy went to market” with his toes. I guess he didn’t understand a word, but it certainly made him laugh and there is obviously something universal in the “Wee wee all the the way home that appeals to all children. The third day I see him he just falls asleep while the rest of the little ones in house 4 clamber all over me desperate for attention. 

There are visitor’s mid-week, Hijinx special theatre company on Wednesday and Sentebale people on Thursday. I go through the motions but to be honest I’m rather distracted by the ever-changing dimensions of the physio house. It’s so frustrating and bewildering if it wasn’t for the improvement in the kids and feeling I was letting them down I would have left by now. Manyanye has come with the Hijinx people and says I must come to an agreement with the builder and Mamello. I thought I had, but I have found it was all a mirage and would like Manyanye to step in like a knight in shining armour with a pickaxe.

The Sentebale people look impressed by the equipment. “Do you know says the lady “these are the only walking frames of their kind in Lesotho?” I didn’t, but I’m not surprised. She is referring to the five posterior walkers which I have brought here, with a little help from my friends. They are top of the range, cost hundreds of £’s and are great for the kids. I am baffled why Sentebale, as a rich Lesotho charity for vulnerable children, did not feel they could help me get the equipment here when I asked them.

Friday brings more site meetings. I am down amongst the footings convinced the building has shrunk again. The men wielding the pick axes look at me suspiciously. Before I have time to put my tape measure away Mr Chalabala appears back from his sojourn in south Africa.

“Mme Jan how are you?”

“I am not good. The buildings too small, there’s no water, or electricity, we can’t even get to it (I point to the rocky track) and if you make a path it will direct water through the door” (I point to the slope) and there’s no space for a playground” 

He gets out his tape measure, “No, look its 10 metres long.”

“We said 12”

“There’s not enough money” 

“Well make an equipment store to make more room inside”

“There’s not enough money”  

“Well put a lintel in the wall so one day when we have the money we can build an adjoining equipment store”

“Okay” and he shouts to a man with a pick axe to make it so.

Mamello turns up and agrees that Phelisanong will pay for the concrete to make a path. Mr Chalabala agrees that he will make it so that a river doesn’t run through the door. I tell him I will kill him if it does (such are my limited negotiation skills)

Mr Chalabala gives me a lift up the road in his truck to buy some bread. Half way up the track he gives a lift to a man. I don’t know who he is, but he has been standing outside the office this morning watching me running up and down the path with the kids. He shouts excitedly from the back of the truck at Mr Chalabala

Mr Chalabala: He says you are blessed by God working with those children

Me: I want to be blessed by a good builder

Mr Chalabala: He says he will pray for you

Me: Kealeboha (Thank you) I need all the help I can get

Mr Chalabala: I am going to my Uncle’s funeral tomorrow

Me: Oh sorry

Mr Chalabala: I will call you after and we will go for Maluti beers at Mountain Top View

Me: Oh (thinking how many beers does he think it’s going to take to get me to agree to further shrinkage of the physio house)

Anyway, hopefully Mr Chalabala will forget by the time he’s done the funeral thing. I say goodbye and get out of the car and buy my bread then go back to Phelisanong. We have a great afternoon session with a dozen kids, sticky lollipops and some very interesting music as the kids form a backing band to my sax.

As I leave I notice that the crater in the path, that I complained voraciously about to Mr Chalabala after one of the kids fell into it with her walking frame, is being filled with cement. He said it would be done by the end of the day and he has kept his promise. It’s a small miracle and maybe Mr Chalabala will come through or maybe it will come down to the prayer power of the man in the back of the truck.  

As look at Mothimkhulu wobbling towards me in fierce concentration, holding onto his trouser pockets to stop his arms waving about and the joy on Kamohela’s face as he walks with a frame, after serious treatment to try and shrink the tumour in his brain, I have no choice but to keep trying to get the best deal I can for the kids.