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The initiative – known only as Mobile Teams – was set in motion in 2010 by Dr Ritesh Thapa and his German neuro-pediatric mentor, Professor Gunter Gross-Selbeck from the Self-help Group for Cerebral Palsy Nepal.
The initiative began as a means to bring expert rehabilitative services to the doorsteps of disabled children and their family.
Frustrated by an inability to offer rehabilitation to the children with cerebral palsy he saw at his Kathmandu treatment center, Dr Thapa sought drastic change – especially for more remote patients.
Mobile Teams take rehabilitation services directly to places they weren’t previously available.
For the visits, these teams include a doctor, physiotherapist, speech therapist, special educator, occupational therapist, psychologist and local facilitator.
“Studies show that in Nepal, the disabled population is greatly deprived of treatment and rehabilitative measures,” says Dr Thapa.
“The children we saw at the Kathmandu centre were only the tip of the iceberg. Government studies show that more than 40 per cent of people with a disability have never received medical services.
“In my view, the Medical Teams were the natural next step and as the project moved on, only then did I become fully aware of its importance and scope,” he says.
“I could tangibly see how Mobile Teams were making a difference in the lives of so many children, and how it has transformed so many families. It’s been the biggest motivating factor to keep going and to grow the momentum.”
How did the initiative come to life?
Dr Thapa tells us about a Nepalese proverb that gave him strength to see the Mobile Teams come to life.
‘God says: if you dare, I will fulfill it.’
“It was very serendipitous that Professor Gross-Selbeck was an influential member of the Lion’s Club of Dusseldorf, Germany,” Dr Thapa says.
“He pitched the Mobile Teams concept to the club and it was approved. It was initially funded for 3 years with the potential for renewal after a review of the initiative’s performance and outcomes.
“The Mobile Teams initiative has been so successful that – I am told – it is the only initiative in the history of the Lion’s Club of Dusseldorf to have its funding renewed twice.”
Dr Thapa says the Mobile Teams aim was always, ‘not to give fish to the hungry, but to teach the hungry to fish’.
“So, we prioritised using the locally available resources which best suited their environment, using our own knowledge and creativity,” he says.
“For example, wheelchairs are not suitable for most of the mountainous regions of Nepal, and disabled-friendly architecture is a rarity. Specialized wheelchairs are not available. So, we designed improvised assistive devices wherever possible.”
How successful is the Mobile Teams initiative?
Since 2010 when Mobile Teams began, 400 to 500 children are treated each year.
Among these children, 78 per cent have been diagnosed with cerebral palsy. Astoundingly, 32 per cent have seen a doctor for their disability for the first time since participating in the initiative.
More than a third of Nepal is now being serviced by Mobile Teams and survey results show the intervention having positively impacted quality of life for the children concerned.
- More than 400 children have received assistive devices such as walkers, wheel chairs, special/adaptive chairs, tables, orthotics, etc.
- 36 per cent of epileptic children are now seizure free
- 19 parent support groups have been formed across the country
- 18 day care centers have been established nationally and are run by the parent groups. Here, medical and pedagogical aspects of treatment are planned, implemented and regularly revised by the Mobile Teams
- 84 per cent of children seen by Mobile Teams now have a disability card which gives them access to a disability allowance, free education, transportation, customs and tax waivers, and more
- More than 50 seminars, interactive programs and training for health professionals, and 21 school presentations and visits have been held across Nepal by the Mobile Teams.
Dr Thapa has also published 2articles in reputed peer reviewed journals since launching the initiative. These are the only scientific articles on cerebral palsy to have been published from Nepal since 1998.
What’s next for Mobile Teams?
All along, the Mobile Teams initiative has been about bringing rehabilitation services to parts of Nepal where it had not been previously accessible.
In some cases, this has been about empowering local communities to support the children living with cerebral palsy and their families.
Dr Thapa sees this activity kicking up a notch in the future, with a focus on how the internet and video conferencing can make rehabilitation even more accessible.
This future focus is about using Skype to connect specially trained Home Visitors (doctors who also provide a range of therapeutic and rehabilitative services) with parents who can’t regularly take their child to a doctor.
And there are other plans for the initiative’s future, which include:
- expanding the existing service into more districts
- expanding services to treat adults with cerebral palsy
- video conferencing
- hiring more staff
- acquiring more sponsors and donors
- organising more parent groups and day care centers
- building stronger networks
- gaining Government recognition
- publishing more related content
- producing an evidence-based cerebral palsy treatment manual.