Archive for the ‘Physiotherapy / Rehabilitation’ Category

Heart Starting Point (Xin Qicheng), grassroots disabled rights organisation

Wednesday, January 20th, 2010

Huang Li was at home alone in Dujiangyan when the earthquake struck. Pinned under the rubble of her collapsed building, she remained trapped and undiscovered for 96 hours. She says the thought of her 9-year-old son losing his mother kept her alive for so long. Eventually, after four days of searching by local police, firefighters from Yunnan Province and volunteers, Ms. Huang was rescued and rushed to hospital. The extent of her injuries left doctors no choice but to amputate both of her legs and her left arm.

Through months of rehabilitation and treatment, Ms. Huang has retained her warmth and strength of spirit, and resolved to improve the lives of people with disabilities in China. With the support of Dujiangyan Disabled Persons’ Federation and the Department of Civil Affairs, she founded a disabled rights organisation called Heart Starting Point (HSP; their name in Chinese is Xin Qicheng: “xin” means “heart” and “qicheng” is “to begin a journey”). Her husband, Deng Ze Hong, gave up his popular out-of-town restaurant to be Ms. Huang’s full-time carer and co-director of HSP. He attends to every aspect of his wife’s life without complaint, despite suffering back strain from lifting her in and out of bed. “I’ve chosen the right guy,” says Ms. Huang, smiling. They are still living in temporary accommodation but expect to be back in their rebuilt home before the second anniversary of the disaster.

HSP was established to build on “the enormous support from all areas of society that helped us out of the shadow of fear and sorrow,” says Ms. Huang. “We hope we can show people, through our own experiences, that even though we are disabled, we still embrace life, and we can create wealth and value for this society.” It aims to support not only earthquake victims, but also people who were disabled before or since the disaster.

One of the primary missions of the organisation is to develop the means for disabled people to earn a living. So far they have opened a small workshop that trains people in the art of traditional Qiang Minority embroidery and other handicraft skills, setting up outlets as far away as Guangzhou, Hong Kong and Shanghai to sell the work. There are now more than ten disabled people creating beautiful designs to support themselves.

One of the hard-working cross-stitchers is 18-year-old Meng Hongmei from nearby Hanwang Town. She lost both legs because of injuries sustained in the earthquake, causing not only physical but severe psychological distress. Slowly, through informal counselling from Huang Li and others similarly affected, she has grown in confidence, come to terms with her injuries, and has learnt to walk again with the use of artificial legs. She has made new friends through HSP and enjoys her new creative outlet immensely.

Other important aspects of HSP’s work are to encourage the adoption of disabled access and facilities in local businesses and public areas; to help other groups and organisations to provide medical and psychological assistance to disabled people in the area; and help allocate funding (either raised themselves or donated by other organisations) to those that need it most.

HSP has established a growing network of people with disabilities in Dujiangyan — almost 200 members and counting — providing a hub of information about services help available, mostly disseminated through home-visits as part of their community outreach.

With their strong desire to improve society, not only in terms of the needs of disabled people, but also to show that they are just as valuable members of their community as able-bodied people, HSP has an important and long-term mission ahead of it, and SQR hopes they continue to grow and make a strong contribution to social development.

The Heart Starting Point (心启程) team with two of the SQR staff

See also: SQR’s Re-granting project.

20090119: Rehabilitation for those with physical injuries

Friday, February 27th, 2009

四川灾区的“王海清”现象

Professor Li said that there was a so-called “golden period”, which is three months after their injury. If proper treatment and rehabilitation services were provided within this period, possible disability could be avoided. More importantly, persistent treatment is also critical after the golden period if a full recovery is not achieved, or the patient may permanently lose the chance of a full recovery.
“Our survey in Jiangyou City demonstrated that, 65% of the quake-wounded people needed more active rehabilitation treatment. Accordingly, it is estimated that the total number of patient in such condition in Sichuan is at least between 6000-7000, whereas the services we had provided is far from enough.”

On Feb 11th, Professor Li was told by an official in Sichuan Provincial Department of Public Health that, the estimated figure on this issue was also 7000. “This conclusion is not a copy of our research posted on the internet but drawn from their own independent statistics collected from local departments of public health.” Professor Li added.

Insufficient capital is the major fact that has brought Wang Haiqing and many people like him to this quagmire. Professor Li and his team had proved this by their firsthand experience.
The China Rehabilitation Academy has been appealing to organize a national aid group that could give some support to people  in need. When this proposal was finally approved by the Central Department of Public and the aid team was ready to entre the quake-hit region with100 medical experts, local government had no choice but to refuse their kindness – they couldn’t afford it. “The financial aid had not arrived yet. No money for first aid, not to mention rehabilitation. The experts we brought over didn’t charge a penny for seeing patients or other services. Local government or hospital only needed to provide meals and accommodation. However that was also unaffordable.”

Dec 31st, all medical financial aid was stopped. Those wounded had to leave for home. “Afterwards, there were not that many quake-injured people taking rehabilitation in Chengdu. None in Huaxi Hospital or Hospital of Orthopedics, some in Chengdu No.2 People Hospital…Now the biggest rehabilitation center is Mianzhu City People Hospital and a county level hospital, only because they had the support of our project and the Hong Kong Fuyou Fund.”
According to a staff in Sichuan Provincial People hospital, there are still dozens of patient who couldn’t afford to pay but also wouldn’t leave the hospital. So far, there’s no relevant policy released working on this issue. The hospital didn’t kick out these people for humanitarian concern, which left them an enormous financial pressure.

Jiang Tao, the spokesman of Sichuan Provincial Department of Public Health, told the journalist of China Economics: “From 12th May to 31st Dec, this period was defined as emergency aid period, in which to see a doctor was gratis for both injured people and ordinary patient. So far there is no respond to our proposal calling for new medical assistance policy.”

Then how much money on earth are we talking about.

It is calculated by Professor Li: “it is approximately 3000 per person. Even if all of the 7000 wounded are from poverty stricken families, it still needs only 210 million to solve this problem. Not to mention we will certainly make assessment on every family’s financial condition, make sure the money was spent on people who need it the most.”

Of course it was agreed that such capital should be provided by the government instead of individuals or non-government organizations since administrative order on searching and helping people like Wang Haiqing would be a lot more efficient than any other efforts.

励建安教授告诉中国经济时报记者,地震伤员的康复有三个月的“黄金期”,如果那时能持续做好,就能少去很多麻烦,可惜都早早出院了。“黄金期”过后,未得到有效康复的伤员依然应该坚持救治,否则他们就将永远失去恢复健康的机会。

“江油现场调查的结果实质性地表明,65%的患者需要积极的康复医疗。据此推算,四川需要康复医疗的患者至少在6000—7000人以上。而我们已经提供的服务远远不足!”

2月11日,四川省卫生厅的官员告诉励教授,省厅的预计值也是7000人。“我昨天问了卫生厅官员,厅里的数字7000人是不是根据我们在网上公布的预计来的,回答说不是,说是他们根据各地卫生局报告的统计结果。”励建安对本报记者说。

在资金短缺的问题面前,康复医疗救治不能到位——这是地震伤员一步步陷入困境的最主要因素。
一直在灾区为伤员的后续康复治疗奔走的励建安教授以亲身经历证实了这一点:“中国康复医学会提出组织国家康复医疗队来支援,终于得到卫生部的认可,组织了国家康复医疗队。列了180—190人的医疗专家名单,最终落实能来的有100人左右,当地不要。开始,第一批的是要的,但后来就不要了。因为连当地一些康复机构的基层工作人员的工资都付不起,国家的钱又没有到位,急救的钱都没有到,就更别说康复的钱了。国家的钱就始终进不到医院,专家来了,看病服务都不要钱,但是吃饭和住宿当地要安排,就连这一点地方都有困难,以后的批次便干脆不要了。”

“去年11月中旬,通知说全部撤退,12月31日,所有的医疗费用停止,伤员动员回家。许多医院的伤员出院,华西医院,此后就一个也没有了,骨科医院一个没有,省人民医院有几十个,成都第二人民医院有一些,现在最大的康复中心是绵竹市人民医院,一个县级医院,是因为有我们项目的支持,有香港福幼基金会的支持。”

2月6日下午,四川省人民医院的工作人员对中国经济时报记者说,目前,国家和省里还没有相关政策下来,医院完全是基于人道主义的考虑,没有将付不起钱的患者赶走,但是医院已经不得不考虑面临的巨大经济压力。
2月10日,四川省卫生厅新闻发言人江涛对中国经济时报记者说,地震发生之后到12月31日之前,国家定位为应急救助时期,在这个时期内,灾区的地震伤员乃至普通病人,看病都是不花钱的。12月31日之后,国家没有出台政策,省卫生厅为此曾多次向上提交报告,希望能出台政策,但是到现在还没有回音。
资金,究竟需要多少?励建安教授测算说,“如果比照在江油所做的,均摊下去,可以算为平均每人3000元,即使这7000名患者都是困难家庭,也只需要2100多万元便可以解决一个这么大的问题,何况我们还可以对患者家庭做评估,保证将资金用在最缺乏经济能力的患者身上。”
一位志愿者对中国经济时报记者说,这笔钱,如果依靠社会,将难免会遗漏未被发现的“王海清”,如果政府出资,并且发动各级医疗机构切实查找,就能基本为地震伤者尽到人道主义的义务。
[SQR's approx. translation into English]

20090113: news.sohu.com: Chuan Kong Rehabilitation Centre (Chuan Gang kang fu zhong xin) opened

Thursday, February 26th, 2009

川港康复中心在四川挂牌成立 港府拨逾2亿援建

2009年01月13日  来源:中国新闻网

http://news.sohu.com/20090113/n261727006.shtml

(图片来源:大公报)

Chuan Kong Recovery Centre opened on 12th January 2009

Chuan Kong Recovery Centre opened on 12th January 2009

On 12th January 2009, the Chuan Kong Rehabilitation Centre (Chuan Gang kang fu zhong xin), funded with 224 million Yuan from the Hong Kong government, officially opened in Sichuan Provincial People’s Hospital. This is the first rehabilitation centre the Hong Kong government has funded in mainland China and also one of 20 projects that the Hong Kong government plans to work on as part of its support for Sichuan.

The rehabilitation of the injured in the May Quake is a very important part of post-quake relief. Tang Yingnian, Hong Kong SAR Financial Secretary, expressed his concern and support on this issue when he and the Hong Kong inspection group visited Sichuan recently. Afterwards, the Hong Kong and Sichuan governments signed a letter of intention of Constructional Support from Hong Kong Government on 7th Nov 2008, when the initial 2 billion reconstructive support funds were approved. The main objective of this project was to establish a modernized rehabilitation system that would provide rehabilitative treatment and related training.

Also, on 22nd Dec 2008, the Chuan Kong Rehabilitation Training and Development Project, part of the Stand-Up Program that was started by the International Ethnic-Chinese Orthopedics Association, officially received financial aid from Hong Kong government.

It is understood that the Chuan Kong Rehabilitation Centre, consisting of a Training Centre and Orthopedic Limb Centre, occupies 27 thousand square metres, with 350 rehabilitation beds. Wei Hong, the vice governor of Sichuan Province, stated that CKRC will be a critical base that provides directions and training to rehabilitation centres in 39 substantially quake-hit townships, forming a rehabilitation network covering the entire province.
At present, the preparatory work and personnel training are underway. 4 rehabilitation professionals have already started work in Sichuan Provincial People’s Hospital, guiding and participating in rehabilitative work on those injured in the quake.

由香港特区政府拨款2.24多亿元人民币援建的川港康复中心,12日在四川省人民医院挂牌成立。据悉,这是香港特区政府在内地成立的第一家康复医疗中心,也是首批香港特区援川重建20个项目之一。
地震伤员的后期康复是灾后重建的重要内容。此前,香港政务司司长唐英年率团考察四川时曾表示,将积极支持四川地震伤员的康复工作,首批20亿援川重建基金获批后,香港特区政府与四川省政府于去年11月7日签署了“香港特区援建川港康复中心意向书”,在四川省人民医院内建设永久性的现代化康复医疗中心,建成集康复治疗与培训指导为一体的一流康复中心。
12月22日世界华裔骨科学会“站起来”计划“川港康复培训及发展中心项目”也正式获得香港政府资助。

据了解,包括川港康复培训中心和肢具矫形中心在内的川港康复中心,建筑面积为2.7万平方米,设康复病床350张。四川省副省长魏宏表示,将以川港康复中心为龙头,对全省39个重灾县的康复分中心给予康复培训和指导,形成全省康复网络。
目前,康复中心的建设前期工作和人才培训正在加紧进行中,“站起来”计划行动中的4位康复专家已常驻四川省人民医院指导并参与地震伤员的康复工作。

20090113: news.sina.com: More than 6000 quake injured urgently need follow-up treatment

Thursday, February 26th, 2009

四川逾6000名地震伤员需康复医疗
2008年1月13日 新浪网

http://news.sina.com.cn/c/2009-01-13/205317036740.shtml

“There are still 6,000 people who need to receive follow-up treatment otherwise hundreds of people will become disabled for the rest of their life.”  One director from Sichuan Provincial Party Committee suggested,“Currently, The priority is to take care of those who injured in the quake.”
This is reported from the tenth Sichuan People’s Political Consultative Conference.

More than 10,000 people have become disabled after the quake. Their follow-up treatment is a fairly serious problem at the moment.  They need more doctors, therapists, psychologists, medicines, medical facilities, and even hospitals. What’s more, lack of medicine has already affected the outcome of treatment.  Some people discharge themselves from hospital ahead of schedule because of the lack of money. An official proposal to support them must be drawn up this year.
[SQR's approx. translation from Chinese to English]

新华网成都1月13日电 (刘大江 吴晓颖)“汶川大地震造成的万余名伤员中,6000多人仍需积极康复医疗,如现在不能及时得到康复医疗,将有数千伤员终身残疾。”民建四川省委有关负责人为此建议,当前应将伤员康复医疗放在首位。

这是记者13日从成都召开的四川省政协第十届二次会议上了解到的。

“5·12”汶川特大地震中因伤致残人员数量庞大,目前有近1万人进入了残疾人员行列,地震伤残人士面临的康复问题尤为突出。现在在康复医疗中存在以下问题:一是医疗康复技术人员不足,专科医师、治疗师匮乏;专业医疗机构、社区康复机构心理康复人才缺乏;二是医疗器材设施未能及时采购,影响部分地震伤员康复医疗效果;三是在伤残人员的后续康复治疗中,2009年的康复费用负担不明确,导致部分伤员因担心医疗自费而提前出院”

20090210: Agreement signed to help those injured in the earthquake

Thursday, February 19th, 2009

港四川签合作协议 助万名地震伤员重新站起来

2009年02月10日  来源:中国新闻网

http://www.chinanews.com.cn/ga/gaynd/news/2009/02-10/1555952.shtml

The Chinese University of Hong Kong (CUHK) signed a cooperation and exchange agreement with Sichuan Provincial Academy of Sciences and Sichuan Provincial People Hospital, in order to enlarge the medical expertise group and help 10 thousand people injured in the quake to recover.

This agreement is expected to promote the Stand-up Project that was set early in Jan by the International Ethnic-Chinese Orthopedics Association. Meanwhile, science research and academic cooperation/ exchange project was also established, including a training program that will provide 1000 certificated medical personnel after 3 years of training.

Cheng Qiming, a lecturer at the Medical College in Chinese University of Hong Kong, stated that there were more than 7000 people injured in the quake that need artificial limbs, and that the Stand-up Project had already provided artificial limbs and physiotherapy to more than 300 of them. He also asserted that fitting artificial limbs is relatively expensive, averaging around 150 thousand RMB per limb. An electric hand costs about 200 thousand RMB. Furthermore, limbs and the required accessories will need constant adjustment and updating. “This is a long-term process; considerable amount of capital is needed.” said Cheng.
Now three rehabilitation doctors from Sichuan are taking training in Hong Kong.

香港中文大学医学院与四川省医学科学院、四川省人民医院今日签署合作交流协议,以扩大专业医疗人员队伍,帮助一万名地震伤员重新站起来。

今日签署的协议将促进川港方面共同为地震伤员展开周详康复治疗,并建立科研、教学的相关交流合作,包括三年内在四川培训一千名医护人员并颁发相应的认证文凭等。

陈启明说,目前需要装义肢的地震伤员超过七千名,自成立至今,“站起来”计划已为近百名病人配上义肢和物理治疗,为超过三百名伤员提供治疗。

陈启明亦指出,安装义肢费用十分昂贵,下肢平均要人民币十五万左右,电子手则需要人民币二十多万。且随着少年儿童不断成长,义肢和配件也需不断调整和更新,“最大的难度在于持续地跟进和调整,这是一个漫长的过程,需要大量资金。”

陈启明认为,目前最重要的是积极落实这三年的培训及发展计划。他透露,目前有三位四川的康复治疗主任正在香港接受培训。

Xinhua: Mixed agony and hope for China quake survivors

Saturday, January 3rd, 2009

Special report by Xinhua writers Wu Chen, Ji Shaoting:

YA’AN, Sichuan, Nov. 9 (Xinhua) – Everyone in the rehabilitation center for May 12 quake survivors in the West China Hospital wants to recover as much as possible through different therapies. Tian Fugang has a bigger dream.

The ceiling of his factory collapsed in the 8.0-magnitude earthquake, which caused nearly 70,000 deaths, and hit his lumbar vertebra. When he woke up from the coma because of the excessive pain, he could no longer feel his legs.

Now, every day, the 22-year-old former technician, who was paralyzed in the devastating quake in southwest Sichuan Province walks with special facility supporting his body for three to four hours, trains on parallel bars for half an hour and has acupuncture therapy for one hour. He has done so for nearly two months.

In the rest of the time, the thing he likes to do most is learning to use his wheelchair.

At first, he learnt different skills from the therapists, including supporting with the back wheels, getting back to the chair after falling down, moving between his wheelchair and bed, and a more difficult one, climbing stairs.

“He always managed to learn them very quickly,” said Ding Mingfu, deputy director of the rehabilitation center.

Now, Tian invented his own skill.

“I can climb a slope, which is as narrow as my wheelchair, and turn around the wheelchair on the top of it,” he said proudly, with a smile on his baby face.

The therapists found he had a talent in sports and suggested he consider to be an athlete. Tian thought it a good idea. That’s why he did a lot of training to improve his physical ability.

Next door, some ten survivors gathered to watch a soap opera. Liu Fang, 13, joined them after finishing her Chinese class upstairs. She laughed together with her wardmates when the heroine of the South Korean comedy was embarrassed by her lover. Her fair cheeks turned pink.

“She never spoke to anybody when she first came to the center two months ago, nor did she smile,” Ding Mingfu said.

The girl could only sit in a wheelchair with a belt holding her in after being paralyzed in one of the aftershocks.
“I’m much better now. I could only sit in the wheelchair for a little while two months ago, but now I can sit for two hours,” Liu said.

The rehabilitation center accepted more than 160 people who had been disabled by the quake, and some 100 people have recovered and left the center.

“Our definition for recovery is the patient’s body function has reached the highest level it can do,” Ding said.
It provided speech, occupational, acupuncture, psychological therapies and physiotherapy, as well as training for using artificial limbs.

“Rehabilitation is important for them to obtain a better life quality over the rest of their life,” Ding said, adding that without proper rehabilitation, the disabled would have a lesser ability to take care of themselves, which would be a greater burden for their families.

Local health authorities have planned a three-level rehabilitation system, composed of three provincial rehabilitation centers, six city centers and community centers.

However, as modern rehabilitation has only developed in China for less than 30 years, in comparison with the 80-year-history of the subject, China lacks professional staff, rehabilitation centers and facilities.

More than 350,000 people in Sichuan alone were injured in the quake, and among them, some 100,000 were hospitalized. Many of them are in need of rehabilitation after leaving hospitals.

However, there are not enough professional doctors, therapists and nurses for rehabilitation in the city-level centers and even no rehabilitation center in the communities, not to mention those who live in the remote mountainous areas. This time, many quake-battered regions were rural areas.

Sichuan has been providing rehabilitation therapies to nearly 6,000 people and the search for injured people who need it in remote areas is still under way, according to local health authorities.

“What we can do now is to try our best to treat every single patient we have here in the center,” Ding said, adding that they not only trained the patients with basic living skills, but also think about ways for them to live on.

Although Liu Fang still could not figure out her future, the doctors have found a job of decorator in east China’s Jiangsu Province for her father.

“At least the family can have a stable income in the future to support her,” Ding said.

The therapists also sent Tian Fugang’s information to local disabled persons’ federation, recommending him to get professional sports training.

“I’m still waiting for the reply,” he said, adding that if there wasn’t a promising future for him, he would break up with his girlfriend, whom he had spent nearly four years with.

Tian, who loved playing football before the disaster, said he would play wheelchair basketball or wheelchair tennis if he was chosen.

“I dreamt to compete at the Paralympics one day,” he said.

(Xinhua reporter Ye Jianping in Chengdu contributes to the story)

Major need for rehab clinics

Saturday, January 3rd, 2009

Translated from Xinhua:

In Sichuan about 7,400 people injured in the quake still need physical therapy, officials said.

So far, 158 amputees received artificial limbs. 341 people are now equipped with assistive devices, officials said. The health department said they plan to set up rehabilitation centers for the injured, but full details have not been unveiled.

Three provincial centers with a total of 300 beds were founded in Chengdu to treat the most seriously injured. Six quake-hit cities have sub-centres and 44 counties have therapy branches for patients. In addition, about 100 rehabilitation experts from all over China are now working in Sichuan. Money has also been spent to help quake victims restart their lives in other ways. For example, in June, The Sichuan Disabled Persons’ Foundation pledged 2 million yuan (293,000 U.S. dollars) annually for three years to help the disabled start their own businesses. The government also announced, in May, that employers would get tax cuts or subsidies if they hired disabled quake victims.

Only 12 of Sichuan’s 623 quake orphans have so far been been legally adopted, state media reported.

According to the Sichuan Department of Civil Affairs, 90 percent of the 600 plus orphans were taken into care by their relatives while the other 60 remain in welfare homes, Xinhua said.

Officials said 623 children became orphans in the quake, but only 12 of them have since been adopted. Other orphans are being fostered by relatives or welfare houses. About 98% of them have been fostered by relatives and 2% of them are living in welfare house.

Relatives have priority in adopting quake orphans according to government regulations, said Zhang Li, deputy director of the department. The adoption process began in late August. In May, it was reported there were about 4,000 orphans, but most were identified by their parents or relatives and taken home, officials said.
“The number is changing all the time as some are taken away and some return from other provinces after free medical care,” Zhang said. “Very few are adopted by strangers.”