First day at Hope House

This morning, Michelle and I (Kristina) spent our first day at Hope House observing and helping with patients.  Hope House is a children's hospital on the border of Niamey that caters to children with neurological disorders, particularly those that require casts and bracing.  Especially children born with club feet who require casting to correct them.

We started the morning with a 6 month old who had damage to his brachial plexus during childbirth and was left without any movement in his right arm so that it remained stuck behind him.  With PT at Hope House, the child was able to move his arm around, though he did prefer his non-affected arm, and had strength to reach for and hold onto toys.  Michelle got to spend a lot of time evaluating and treating him.

In the meantime, I was able to watch a young boy who suffered a stroke at 13 so that he had flexion contractures in his right arm at the elbow and wrist (both of these joints were stuck in flexion and were essentially unusable).  He was getting new cast in a series of casts to bring his wrist into extension so he could utilize it.  He had a lot of pain with placement of the cast where he attempted to bite and kick his therapists, but he also seemed to understand why he had to endure so much pain and left without actually having bitten anyone.

We also saw a girl and a boy get fitted for AFO's (a brace) because they could not dorsiflex their foot so that their foot dragged on the ground when walking and they have to bend their knee and lift their leg to keep it off the ground.  This disorder was due to anti-malarial injections, which are often placed in detrimental spots in Niger so that the medicine destroys the nerves in the leg (in these cases, the sciatic nerve from placing the injection in the buttock).  In addition to not being able to walk well, they had no sensation in their affected foot, thus both had histories of severe injuries to the feet because they could not tell when they were burning them or stepping on something sharp.  So, when they get their AFO's later this week, they will be protected from injuring their foot and they will be able to walk with a normal heel to toe gait pattern.

Finally, Michelle and I got to help remove bilateral leg casts from a little child who was getting casted for club feet.  She had originally been casted and then received a surgery to finish the process, but her shoes meant to be worn to protect the feet while they healed broke and her mother did not know to return to PT to get new ones, so by the time the therapist saw her again, her feet had begun to return to their "clubbed" posture, so she had to get more casts.  It was really nice to be hands on, but we unfortunately had to leave in order to make it to our next place before we had a chance to attempt the actual casts.

Overall, the experience was a great one!  We saw a lot and got to be very hands on.  Our therapist spoke English well enough to discuss what was happening with us and our host came along to help translate as she was available.  At least one of us will be returning there Thursday to help with a support group for kids and parents with Cerebral Palsy.   We'll be sure to keep in touch!

-Kristina & Michelle