The background: Many parents of children in need with illnesses that affect their mobility or nervous system (diagnoses such as cerebral palsy, spina bifida or trisomy 21) encounter great difficulties when searching for the right treatment in Kyrgyzstan.
There are a number of methods, however these are neither on par with current medicine, nor are they effective and sometimes can even be counter-productive.
Up to date Kyrgyzstan lacks an educational system for physiotherapy. Specialized treatments, such as Bobath therapy or Feldenkrais method, which would be important in aiding affected children, are rarely heard of or not known at all. Those who can afford take their child for treatment outside Kyrgyzstan, whilst the others remain in a seemingly never ending search for help locally.
Though medical specialists from abroad make short-term visits to Kyrgyzstan, where they treat those in need but treatment can’t be continued once they leave.
It becomes obvious where the problem lies: Kyrgyzstan needs its own competent professional personnel. Education, the furthering of education and enhancing competencies is the key for an integrated health care system, not only in the capital, but the entire country. Here Uplift provides an important contribution.
We focus on regular training and furthering of education in theory and practice. The target groups are doctors, therapists as well as paraprofessionals who possess the according education and experience in working with impaired children. The participants come from various facilities across the country and use the knowledge learned here to further the education in their own facilities and networks. An excellent example are specially selected Uplift-mothers, whom we have trained intensively over the last 8 years, so that they are well positioned to participate in further education of this sort.
2016-2017, in cooperation with the state national centre for the protection of mother and child, we conducted a program of further education, in which aspects of the Bobath method were included. The training encompassed four modules in theory and practice, and went for two years. Further units of training are planned in order to revise and expand on the learned knowledge. The training took place in the central children’s hospital in Bishkek, where children from around the country are treated. A total of 16 professionals from all across Kyrgyzstan are successfully participated. The trainers were physiotherapists from Europe, who volunteer for Uplift and were possessing extensive experience in rehabilitation especially with children.
Every participant returns to their facility, be it a hospital, a rehabilitation centre or a children’s home, having gained new knowledge and experiences. They not only bring new knowledge but also a new way of seeing things, leading to a change of perspective. Where the old point of view was focused on the deficits and use isolated treatment, the new attempts centre on recognising the abilities and resources of children and developing them. The focus is on the potential for development on which the individual therapy can be built on.
An additional improvement is that parents, siblings or caretakers are actively involved in the treatment process. Parents are learning new ways of interaction with their child and are experiencing that more can be achieved than expected. Experiencing self-efficacy even under difficult conditions is showing enormous impact. The child is being accepted as a valuable member of its family and their social world, and is breaking up its isolation.
Courage and time are needed to achieve this fundamental change in perspective. The treating specialists, parents and carers jointly go through this process of change in thinking. Sometimes initial concerns are to overcome but immediate results in treatment are generating uplift and provide energy to involved parties to carry on. It is our endeavour to continuously support this approach by providing experience, know-how and encouragement.
In Kyrgyzstan not only physiotherapy but also speech therapy is in need to be developed.
2017-2018 we conducted a nationwide two year logo therapy program with four modules of professional development. The well known therapy of speech impairment is a crucial element for logotherapeutic treatment of children with severe handicaps. The awareness and function of muscular sequences during food intake and breathing, similar to listening and speech comprehension, are fundamental to verbal communication as a complex neurological functional routine. Aspects of the therapy of B.Padovan and C.Morales/J.Brondo and other offers of support to develop communication will be worked on theoretically as well as practically. It is essential to get parents and carers involved as co-therapists, since they are key mediators in the advancement of their children.
2021 12 participants (Uplift staff and specialist from state and non-state rehabilitation institutions) successfully completed the training “Neurorehabilitation of children with special needs. Physiotherapy with ideas from the Feldenkrais method” under the direction of Christine Ingold. 15 participants (Uplift staff and specialist from state and non-state rehabilitation institutions) took part in the further training course “Introduction to Music Therapy. Theoretical and practical principles for the treatment of children and adults with special needs” (3rd module) under the direction of Viola Grandke.
In 2021 we started offering online seminars for health workers and parents on the topic of early childhood development. Seminars were held with a total of 161 participants from all over Kyrgyzstan.
A brochure for parents of premature babies was developed and 200 copies each in Russian and Kyrgyz language were distributed in clinics, birth centers and parent self-help groups.
We are pleased to further improve with this program the treatment of children in need in Kyrgyzstan.