Did someone say jigsaw?

The school's logo

My favorite part of the trip occurred during the second week when we worked at New Horizon Special School.  The school was founded in the '70s by Salome Francois who had a daughter with special needs and no school would take her.  Mrs. Francois is in her 80's today and still active in the school - she is by any standards a very progressive and amazing lady. The school provides education for kids with disabilities and a sheltered vocational training center for adults with disabilities - and this is in a country that stigmatizes disability!  I was so impressed with this school and their mission!  More info about the school can be found here:  http://www.newhorizon-school-gh.com/about.html

fixing an armrest

We were at the school for two and a half days and focused on adapting equipment and seating/positioning.  This was our time to bring out our inner MacGyver's and let our creativity flow.  We packed kits with all kinds of tools and supplies in anticipation of our work at New Horizon, including foam, 3-in-1 oil, velcro, and lots of duct tape (I would love to know what TSA thought when those bags went through security!).  The school identified some needs that they saw and we also went through each classroom and identified other areas where we thought we could help. We were fortunate to have an OT who specializes in feeding on our team so she led feeding assessments and advised on feeding strategies and equipment, and adapted utensils to make them easier to grasp.

We cleaned up and repaired most of the school's wheelchairs: fixed breaks and fixed and adjusted foot and arm rests.  We didn't know this at the time, but the school was getting ready to ship their wheelchairs out to pay for repairs so they were enormously grateful that the expense was no longer necessary.  Next year the plan is to provide wheelchair repair kits to the school along with some basic training so they will be able to maintain them and make adjustments themselves.  It's all about sustainability:  we can come out and do it for them once a year, but it's even better if they learn to do it themselves!

cutting board for wheelchair seat

It appeared that most of the kids had donated/hand-me-down wheelchairs.For kids who just used them for transport (ie moving long distances but they can walk and aren't in their chairs all the time), the fit of the chair isn't as important as it is for kids that rely on their chairs for daily activities.  We found a few kids who were way too small for the chairs they were using.  Their positioning was incorrect and it affected their ability to engage in daily activities such as eating and writing.  For these kids, we got out the big guns...or more precisely the jig saw.  We cut boards and built new seats with foam and duct tape to elevate them in their wheelchairs, provide better cushioning (to prevent pressure sores), and allow for more trunk stability and better positioning.  It was pretty amazing what we accomplished in such a short amount of time.

my favorite student at New Horizon
with his new pimped-out chair.  Check out
the flashy footrests!

In my classes last year, we talked a lot about the importance of good positioning but it was't until I was able to see bad positioning at New Horizon that I truly understood not only what it looks like, but its importance for daily occupation.  So much of what we did on this trip solidified what we learned in class.  At New Horizon in particular, we were forced to think outside the box, a skill that is important to be a good OT.  We didn't have a textbook to tell us what to do, we assessed what the problem was, looked at what supplies we had available and figured out a way to improve the situation with what we had.  This type of thinking will come in handy in any practice as we (or the client) will not have unlimited funds to purchase the fanciest innovations and interventions.  In many situations we will have to adapt with what we already have.  This experience will serve me well for the rest of OT-school and for my career as an OT.

In addition to adapting equipment, we also conducted a training session for the school's staff on performing correct transfers (ie moving someone to/from a wheelchair to another seat or floor). The staff has do transfers on a daily basis, even multiple times a

Transfer training

day and it is really easy to hurt your back if you don't do it correctly.  The staff was really receptive to the training and even recorded it for future use.  This was yet another situation of learning about transfers in school but not actually understanding the relevance and importance until I experienced in a real setting. I really really really loved my time at New Horizon.  The kids were wonderful, the teachers were wonderful. I learned a lot, they learned a lot. Our services were well received and I feel that our advice will be taken and interventions continued even when we are gone. yay!  I love OT!

One of many inspirational posters throughout the school

Thank you card from the students and staff