Below is a short summary describing how each of our projects have been performing between January and March 2022.
A long awaited arrival this quarter has been the oven purchased for the Ganta Centre, Liberia, as well as the router and suction machine we sent on a pallet following a donation from Edinburgh. We have now received positive feedback on these donations towards the efficacy of the workshop, on our journey to making the Ganta Centre a Centre of Excellence. A2D, Benin, is still working on clearance for the machines we have sent them, but in the meantime we have provided funding for the electricity capacity of the workshop to be upgraded to a 3-phase system which will accommodate for the new machinery and any other upgrades made in the future.
Over at St Joseph Kagondo Hospital in Tanzania, Nsengi Magogwa has completed his diabetic foot course, reporting that he will be able to use the skills developed to help protect the feet of his diabetic patients against foot ulcers. He is also continuing to benefit from Spinal Orthotics blended learning course we have funded, and we have also provided funds for a new laptop for the orthopedic department.
Within our new agreement with Fort Portal and Knowledge For Change (K4C), we have also funded repairs to the workshop floor to increase safety and accessibility. It has been a quiet quarter for the mobility network development and training project. However, as we build our understanding of the training needs of prosthetists attached to both the centres receiving our legs and in the wider network, we edge closer to securing some initial SCOPE courses with Human Study e.V which we hope to be a model we can use lots more in the future and offer courses on a much wider basis.
We rescued a total of 1,055 legs so far this year, which comfortably puts us ahead for our target of rescuing 2,800 this year. The big news has been around the UK collection in January, which involved visiting 10 clinics, 2 suppliers and 2 Men’s Sheds – we managed to collect 655 legs. We asked clinics and suppliers we met ‘why they think recycling is important?’, in front of a camera, and we got some great responses.
Despite doing well so far this year, offers of leg donations in territories outside the UK have decreased, which is surprising considering our efforts to gain more media attention.
This has been a transitional quarter for the leg delivery project, as we evaluate our activities and plan realistic and sustainable ways of distributing our expanding supply of legs and measuring our impact. As we grow and become a more recognisable face in the international P&O industry, our best strategy moving forward is through partnership, and this has been the most exciting outcome of this quarter. We have signed an agreement with K4C and Fort Portal Regional Referral Hospial in Uganda to sustainably improve access to prosthetic rehabilitation, and have kicked things off with a taster delivery of components in suitcases like the good old days, ready for more regular deliveries from Quarter 2.
We have also planned a pilot project for distribution within Tanzania with our friends at Swiss Limbs, that combines the forces of Swiss Limbs’ extensive network, experts, and in country presence with the European components we recycle, removing the burden of expensive importation from international suppliers from the centres and keeping costs low for users, whilst achieving fair distribution across our respective networks of limb centres in Tanzania. We hope to start this in Q2.
In terms of deliveries, we also provided a much needed delivery of prosthetic knees to the OTC in Ghana and celebrated the long awaited arrival of a pallet of 300 legs at Mulago Hospital in Uganda.
Last year we were delighted to receive word of 258 people who had received legs made from donated components over the course of 2021, and more who were able to access repairs and improvements to their prosthesis, and we’re pleased to see these numbers gradually increasing since the pandemic halted prosthetic services and the economic effects forced people with limb loss to reprioritise their health needs, and as we strengthen our relationships and streamline our data management with our partners.
Much of the work this quarter has been part of a big push to collaborate with other organisations which increased visibility for ASNU and their work, and expanded support networks for ASNU members. ASNU has participated in networking 16 events this quarter which has allowed them to develop and strengthen relationships with other organisations.
Jared, Paul and Alex participated in a 4km walk hosted by the Purple Bench Initiative to raise awareness of epilepsy and Alex delivered a talk to the group discussing the links between amputation, trauma and epilepsy. ASNU has established a close knit relationship with Purple Bench Foundation and other organisations ASNU have connected with this quarter including: Cherish Aid Foundation, Temeka Recycling, the Valuable Waste Initiative, Bugulobi Rotary Club and the Kingdom of Busoga.
This quarter ASNU co-hosted the prosthetic fund walk with Crazy Summiters which they estimate included twice as many participants as last year. This event happened in lieu of the quarterly peer support camp i.e. the funds for a peer support camp this quarter were used to host the prosthetic fund walk. ASNU met with a number of communities on the 80km route and Charlotte reports that they are already receiving enquiries from people who became aware of their work as a result of this event. So far the event has raised the equivalent of £2,400 and Charlotte and I have discussed the possible opportunity to host fundraising events like this in the future where the money can be invested directly into ASNU.
ASNU have reported an increased buy in from hospital staff who are making referrals from a number of hospitals and this quarter ASNU have liaised and discussed a referral pathway partnership agreements with 7 hospitals (against the quarterly target of 15), and have secured 4 which exceeds the quarterly target of 3.
Additionally in this quarter, we finalised a partnership agreement with the Federation for Ugandan Amputee Football Associations. Over the next 12 months FUAFA will be aiming to set up a minimum of 4 inclusive amputee football teams as part of the delivery of an 8 district outreach programme which will introduce the sport at a community level.
This quarter we visited The Gambia and hosted a series of workshops with the GAA, the Ladies GAA (LGAA) and the Gambian Amputee Football Association (GAMAFA) which included us looking at each organisation’s journey from inception to present day, its existing capacities and what impact it would like to have on the community using an £8000 grant with organisational sustainability being a key theme to our conversations.
During our 4 workshops the Ladies GAA chose to create a project plan for a female amputee only saving circle, starting with two groups of women receiving microfinance training and small business loans. Funding from the L4A Community Partnerships project will provide the initial capital for these small business loans, the LGAA will then use the interest paid on those loans to expand in the future. The LGAA expects that the benefits of this will be seen through increased business activity and household wellbeing.
The LGAA representative committee were keen to share the outcome of the workshops with the rest of the group before Ramadan so Isatou Ndure and Fatou Njie hosted a meeting at the end of March to reassure the group that there is a pending opportunity.
GAMAFA attended 4 workshops during which we co-designed a project which focuses on the continuation of the current amputee football team whilst setting up two new regional teams.
GAMAFA’s ultimate aim is to develop a national league so they have used this project as an opportunity to take the first steps towards this. This quarter we have been in discussion with the head coach at England Amputee Football Association (EAFA) and have reached the stage at which we can introduce EAFA and GAMAFA so the two organisations can begin to strategise how best to develop amputee football in The Gambia.
During the workshops it was agreed that GAMAFA would benefit from 6 months of unrestricted funding to ensure the technical committee could meet on a monthly basis and explore local sponsorship opportunities, something which GAMAFA see as essential for the sustainability of the sport.
The projects discussed will run from August 2022 for a period of two years and myself and representatives from these groups still have to negotiate a partnership agreement.
Although we didn’t make quite the same level of progress towards a solid project plan with the GAA, despite working on some of the partnership development tools together, we were able to move towards an improved relationship with them. This happened organically at the time but making space for it has meant that we are now working together more collaboratively.
During the 7 workshops together we were unable to clearly define the GAAs organisational vision and mission. The executive committee was unable to state clearly what the organisation provides for the amputee community and what impact that may have. Something the GAA identified as a significant barrier to progress was being unable to meet regularly as an executive committee. This was putting a strain on the group dynamic and stunting progress so it was agreed that GAA would receive funds to hold monthly executive meetings to identify some priority areas of org development.
Our second cohort of students have now completed their first set of exams on symes prosthetics and after a much deserved break have moved their focus up the leg to transtibial prosthesis.
Molline, Ophia, Winnie and Judith (from cohort 1) are continuing to thrive in the final weeks of their placements. One wonderful update we received in March was from Ophia explaining that she has been able to bring ischial containment technology to her workshop with the knowledge she gained from her studies, disseminating best practice to her colleagues and impacting their work, as well as solidifying her value as a technician. She also taught a service user how to weed with a prosthetic leg, so that he could continue to work on his farm. We have been updated that discussions are in progress about permanent positions for a number of the ladies at their placement workshops, and we hope that in the next quarter they will all have secured jobs.
Rehabilitation Centre Gambia
The first quarter of the year has seen a lot of work undertaken with the team:
- Supported 41 amputees with the repair of existing or provision of a new prosthesis
- Improved the functioning of the Banjul Rehabilitation Centre through the provision of requested tools, hardware and administrative equipment. For example, manufactured storage cupboards locally, repaired equipment and purchased a printer for the site.
- Helped digitise data collection of prosthesis being manufactured, to help reduce the dependence on paper.
- Undertook workshops with the teams to share ideas about plans over the next two years. With ambitions discussed to expand services upriver, raise awareness on services and improve knowledge of rehabilitation in those with limb difference.
Gambian Peer Support
Over the last quarter, our peer-support team has been busy:
- Provided counselling/peer-support to 26 amputees at hospitals and in the community.
- Sought to expand services to new hospitals and clinics, building relationships with private hospitals in the Greater Banjul Area.
- Attended strategy and planning workshops with the L4A team to collaboratively discuss plans for the future.
- Gave a tour to visiting L4A staff in the UK of sites they’re attending, where they got to learn from nurses and doctors about the benefits of peer-counselling and peer-support.
- Home maintenance team met with 22 clients, either to provide rehabilitation information or maintenance and check prosthesis usage. With 50% of respondents advising they used their prosthesis every day to help with key activities such as going to school, attending work or driving their cars.
- The peer-counselling team sat their first semester exams of the social work diploma. Wish them luck!
Ghana Peer Support
The team in Ghana have been busy doing the following:
- Recruiting and interviewing candidates for our 2nd round of peer-counselling training beginning in April/May.
- Continuing to deliver peer-counselling and peer-support across Accra, with 203 sessions taking place over this time. Clients average overall score for sessions (measuring therapeutic alliance) is 4.7 out of 5, suggesting clients appreciate the service.
- Peer-Support Team engaged in future planning and review workshops, collaboratively discussing the direction they’d like the project to take.
- Organised four community meetings in Accra and at the Orthopaedic Training Centre. Topics covered included stigmatisation and using prosthesis effectively. 66% reporting positively on the benefits of engaging in community meetings and learned something from the sessions.