Saturday 29 January 2022

Blog 44: Sixty !

Its January 28th, it’s my birthday and I am sixty years old. I look back on my life and I’m amazed I’ve made it this far and that I’m lucky enough to be in Lesotho and in a position to build on the work I have been doing for the last five years to make a difference to the lives of children with disabilities here.

 

The previous day I arrived at Morija guest house late in the afternoon after a meeting with a lady called Tasha who is part of a recycling plastics project and works as a volunteer with a youth project called the Hub. Morija is the hip and happening place in Lesotho where artisans and interesting people hang out and futurist projects happen. I meet Tasha because I’m hoping that her recycling plastics can be widened to include cereal packets and thin card packaging. We need it to make brackets and rods to strengthen the cardboard furniture we are making for supportive equipment for children with disabilities, but I’ve something on my mind too. 

 

Making APT equipment is very time consuming and although I need to learn the processes involved it is not the best use of my time, I need to pass APT skills on to other people so I can spend my time focusing on physiotherapy, assessing, and treating children and training carers and people involved with the project. I would like Tasha and her associates to set up an APT workshop, so we can send in orders and measurements as required and parents with children with disabilities can buy the furniture. It fits with Tasha’s and the Hub’s ethos of recycling and raising environmental awareness, as well as being a potential business opportunity for them as APT can be used to make many products. If I can also raise awareness of children with disabilities and the issues surrounding this in Lesotho it’s a win, win all around.

 

Tasha gets it immediately and is interested, besides already having collected a load of thin cardboard for me. It is such a relief to get a positive response from someone with ideas of how they can help. We are still waiting for the ministry of social development to get back to us after requesting workshop space from them. It’s an empty building and all they need to do is say yes, but so far there has been no response to our letter of request hand delivered. These things take time and with the present space we are using being part of a building site for new accommodation, time is something we don’t have. Tasha says she will see if she can press some buttons with the contacts she has. 

 

After meeting Tasha, I go five minutes up the road to the lodge I am staying at and meet the owner Bridget and have an evening meal with her. Soon we are talking about APT and the protype chair I am carrying about joins us for the meal while Bridget enthusiastically dives into her recycling bin and tries to find cereal boxes for me. After setting up the lodge here over thirty years ago with her late husband she knows exactly the trials and tribulations faced when with working with any government organisations here. Doing voluntary youth work herself and with relatives working for NGO’s she also knows the stresses faced when trying to justify budgets to project supporters and produce statistics for strategic plans which tell nothing of the individual stories or unforeseen obstacles encountered every day. 

 

I discuss with her the case of a boy with a seriously infected foot that we have taken for private medical care. On route in the car, trying to take a medical history, I discover he also has a stoma, after an operation went wrong and left him with no bladder and bowel function. Only he doesn’t have any bags for his stoma and is trying to use a nappy instead so also has an infection around the stoma site as well as his foot. His mother is in working in South Africa and seems to have virtually abandoned him, he has no money to go to school, secondary education must be paid for in Lesotho, unless you can get help from the ministry of social development and for that you need a case number, which he doesn’t appear to have. In fact, he doesn’t appear to have any medical records despite having two major operations, having already had one leg amputated and a stoma. He has lost his bokana (a small medical records book issued at birth) and apparently, Maseru hospital, where he had his operations has lost most of its electronic records. The government hospital was in partnership with a private medical group, but the relationship went wrong, and the group pulled out with all the computers and the medical records which went with them. 

 

After spending all morning at the private clinic getting his wounds cleaned, we go to buy him some bags for his stoma. They are relatively expensive at 62 M each, hence why the boy is trying to make do with nappies. He could apply to the ministry of social development for help, but he doesn’t have a case number (see above). We buy him some bags and the following week go to the ministry of social development to see if they will supply him with bags or have a record of him, as originally he was supplied with bags by them. 

 

My heart sinks at the endless queue of people outside waiting hopefully to be seen, fortunately Thato says something magical to the man on the door and we go straight through to see a very bored looking administrator who looks like she has been welded to her seat for the last five years. She doesn’t bother checking her computer for any records and says we will need to get a birth certificate for him if we are to get him a social development number. This seems unlikely to happen even if the mother does return from South Africa in December and decides to become more proactive in getting him the care he should be entitled to. 

 

On top of all his physical needs this boy needs social and psychological support. He didn’t tell anybody about the wound in his foot because he was worried his leg would be amputated and he has been equally reluctant about sharing the problems with his stoma because he is a teenage boy and how can he share such matters? Brigitte nods, the story is not unusual she and says she has a friend in the village who had an accident and needed a stoma, and his bags are now paid for by a friend in America. So often these tales are the same, if you have no means and can’t get outside help you are doomed. 

 

I wake in the morning wondering about how to get APT workshops set up, how to help the boy with the stoma and how on earth I can see at 70 families by the end of the year and give them any quality on care or follow up visits with all the other things I need to do. 70 was the figure I was pressed into giving in a strategic plan, having already said that 100 families was unrealistic. Brigitte just laughed when I told her last night and thought I was being ambitious trying to cover 30 families in Maseru and set up APT workshops. 

 

One thing that has recently happened to assist with these with these unrealistic forecasts is earlier this week I finally purchased a car. This has been a long running saga when money I transferred out here from my Barclays account on December 13th was sent back by First National Bank (FNB) because I incorrectly transferred it in Rand rather than Sterling. The money has never been retuned to me since. The matter has been complicated by trying to contact Barclays from abroad on a mobile phone which I need to top up with scratch cards and so by the time I have been waiting in a queue for at least 20 minutes I’ve either run out of credit or signal. FNB consistently said that they returned the money on December 14th but eventually after many visits and phone calls I find out they didn’t return it to the 29th of December. 

 

The British High Commission (BHC) help me out with the use of their phones to call Barclays at the beginning of January and Barclays say they will launch an investigation. The following week I am back down the BHC and speak to Barclays again who said FNB has sent it back, but it was in a “holding bank” and should be returned to me soon. On the back of these reassures I send out a second lot of money to buy a vehicle. 

 

The following week I go back down at the BHC again and Barclays inform me my money has been returned but they have sent my money back to FNB because something was wrong with the reference detail. I don’t know whether to laugh or cry. “After waiting nearly 6 weeks for my money you have sent it back to FNB?” I say incredulously. Kevin from global payments updates my case and then informs me my money has now been sent back from FNB and resides in Barclay’s back office and legally should be sent back to me within 6 days. I wonder why an electronic transfer can’t happen immediately as whenever I make a payment on my Barclays Visa card in Lesotho it reflects in my Barclays account within a minute. Kevin says he doesn’t know but will call me and check the money has been reflected next week.

 

Meanwhile the second lot of money I have send out arrives within 3 days, I purchase a 4 x 4 which has good ground clearance, tyres with tread on them, brakes that work, doors that you can open, no strange under carriage noises and most magnificently aircon. We can finally visit children in a degree of comfort and safety, without feeling utterly battered by a local taxi that is unfit to drive on tarmac, let alone off road. I also feel liberated by having my own transport again, even if I am not yet brave enough to face downtown Maseru traffic as the Honda CRV is somewhat wider than I would prefer to drive with a detached retinae in my left eye. I feel so good don’t get completely stressed out by not hearing again from Kevin and not having my money reflected into my account from Barclays as promised. It looks like next week once again, I will have to return to the BHC, borrow their phones, and continue the saga of trying to get my money back from Barclays. Another stress and another draw on my time. 

 

Anyway, as it’s my sixtieth birthday I try and put all these things aside, go for a hike to see some amazing dinosaur prints, take a swim in a rockpool, realise I have lost my sunglasses, hear a thunderstorm approaching but think I have enough time to go back up to the prints and see if I left my sunglasses there. The storm hits me as I arrive back at the prints and my life is in danger, lightening is serious business here with over 250 people estimated to die a year in lightning strikes in this part of Southern Africa. I realise plastic sunglasses are not worth dying for and run for my life back to the lodge. I dry off and recover for a dinner with Bridget, a couple of friends from the village and a couple of young guests. After a tasty and convivial meal, I get my sax out and we have a magical moment of musical connection and fun as people join in banging and shaking whatever they can find to make a rhythm section. Deep conversations follow about the joy of music and art. I go to bed very happy. I won’t forget my sixtieth birthday. Tomorrows another day and battles with Barclays and the ministry of social development can be put on hold for a short while as I mark a significant milestone in my life with a little celebration   

Monday 10 January 2022

Blog 43: Of Covid and Cardboard

It’s the week before Christmas and I’m crawling around on the floor with Thato trying to stick bits of carboard together. I’m feeling rough and it’s not helping that the flour glue we have made is not working and looks nothing like the man on the You Tube video says it should. I’ve had enough, it will have to do, I spread the glue over the boards with my hands, slap them together and go and lie down before I fall down. This appropriate paper technology (APT) is in theory simple and certainly cost effective but is going to take some working out if we are going to be able to use it.

 

APT has been successfully introduced in a number of low-income countries as a means of producing bespoke furniture and equipment for children with disabilities. In my previous job working with young people with disabilities in Powys teaching Health Board, I spent a lot of my time ordering specialist equipment for clients, especially chairs and standing frames. Such equipment is vital for children who need postural support to sit and stand up. It costs thousands of pounds but if it can be clinically justified it is normally provided by the health board. What I didn’t do was make it myself, I’d get a rep in to demonstrate the equipment, measure up the client and suggest various options and accessories.  

 

In the past I have managed to bring in some specialist equipment into Lesotho, but ultimately this is not sustainable, especially as children get bigger and grow out of it. Many of the children with cerebral palsy we have been visiting around Maseru cannot sit up without support. This means they are left either lying on the floor, or they are propped up with cushions in slumped positions which don’t support their spines, enable them to socialise, or allow them to be stable enough to use their hands. We need to find a way to make cheap and effective furniture out of flour, water, carboard and paper that will breach this gap, hence the present preoccupation with APT. 

 

The first step is to make boards by sticking corrugated cardboard together with flour glue to make a board about 2 cm thick. Each layer of corrugations is set at across the grain of the previous layer so when its dry two or three days later, you have something strong that you can start to make furniture out of. The client is measured, the various parts needed to make the item of furniture cut out, sewn, stuck together, carboard brackets and rods added and then the whole thing covered with a couple of layers of paper. Head rests, removable tables, foot raises, and various accessories can be added, seat and chair backs tilted and adjusted as needed. Finally, you should end up with a very robust, specialised piece of furniture for the cost of some flour. 

 

The next day we finally manage to solve the glue problem, chuck away the previous days cardboard away, which hasn’t stuck, and start again, this time with much better results. We leave our boards weighed down with various boxes to dry. My throats on fire and I decided to take a covid lateral flow test. I’ve brought a bunch with me after taking them twice a week for the last 18 months as an NHS worker, always with negative results. 

 

I’m not surprised that within a few seconds it shows I’m positive. Over the last 3 weeks I’ve visited 17 families, been to various meetings and events and shared numerous local taxis. People do wear masks and the major shops and businesses are very keen on hand sanitiser, but there is little testing here, few are vaccinated and basically people carry on with life regardless of any covid symptoms. There is little option when you live in poverty and there is no such thing as a furlough scheme. 

 

Considering I’ve had my injections and booster I am surprised how ill I feel, especially as my immune system is normally pretty good. For at least a week I feel wretched with a sore throat, cough, cold, loss of appetite and no energy. I can only conclude that after nearly two years of living a fairly sanitised life in the UK with numerous lock downs, social distancing and PPE, my immune system has gone to sleep. Eventually it remembers what it must do and fights back with the assistance of various plants and potions from the garden and a Lesotho cough mixture.  

 

Left feeling rather ragged from the experience I go away at new year to recover my fitness and get back my mojo. It’s no good starting the year feeling like a limp rag doll. Reinvigorated by the mountains and rivers I return to get to grips with APT so we can work with families with children with cerebral palsy to provide them with the furniture their children so desperately need. We have made a useful contact with the director of disability which will hopefully lead to being provided with workshop space in Maseru to set up an APT workshop, that’s the plan for 2022. With covid now behind me it’s now all about the cardboard, happy new year !