1. In the last 12 years, Adarsh Charitable Trust (ACT) has gained considerable experience in providing rehabilitation assistance to children with special needs by way of comprehensive measures, starting from identification of such children, evaluating the precise nature and extent of the problem, remedial intervention including arranging for medical and surgical assistance and provision of assistive devices, apart from training and therapy. Naturally this meant finding sponsors for funding surgery and procurement of assistive devices, apart from getting medical practitioners and therapists of different disciplines to get involved in such a project. Finding that Bharat Petroleum Corporation Ltd (BPCL) and Indian Academy of Pediatrics (IAP), Cochin Chapter were willing to associate with the project, ACT decided to venture into 4 Panchayats around its Rehabilitation Centre and to start such a project. The primary intention of the project is to extend rehabilitation assistance to those children, who are not even able to attend a special school or any Rehabilitation Centre due to lack of facilities and also lack of awareness. ACT’s experience shows that the major factors militating against proper and timely Rehabilitation measures are:

1. Lack of awareness about the nature of the problem of disability in children as well as of what can be done about it
2. Lack of confidence that remedial measures are possible, to reduce the extent of the disability, even if is not possible in many cases to overcome the problem fully.
3. For proper rehabilitation measures to be initiated, a scientific assessment of the nature and extent of the problem for each child by competent personnel- medical professionals and therapists and trainers.
4. Comprehensive rehabilitation must include adequate medical treatment, even surgical assistance, where necessary.

These are the basic principles underlying the Project which was undertaken.

2. In the first phase it was decided to cover 4 panchayats namely Chottanikkara, Vadavucode/Puthencruz, Thiruvamkulam and Thiruvaniyoor. The implementing agency naturally was ACT with financial help from Bharat Petroleum Corporation Ltd (BPCL) Kochi Refinery and National Rural Health Mission (NRHM) Ernakulam unit. A Disability Screening Camp held on 14^th March 2010 at Amabalamugal Medical Aid Society (AMAS), was the first step of this ambitious project.

3. During the preliminary discussion with authorities of BPCL-KR and Indian Academy of Pediatrics (IAP) on the 4^th of February 2010, it was decided to organize such a comprehensive medical camp for the children from the selected Panchayats with the objective of identifying all the children of age from 0 to 20, with special stress on children below the age of 10. Considering that this was a very novel and ambitious project, the preliminary discussion was initiated at the highest level of these organisations. SShri.E.Nandakumar Executive Director, George Thomas, Senior Manager (Public Relations), BPCL-KR, K. Neelakantan, Chairman, PR.Mahadevan, Secretary General, S.Aswin, Executive Secretary from ACT and Dr.Sachidananda Kamath, Medical Superintend of Welcare Hospital for IAP and NRHM represented these organizations. Prior to that, a preliminary survey had been carried out. The discussion was based on the results of this survey, which was done in the Chottanikkara Panchayat by ACT. In the meeting, it was also decided that prior to the medical camp,

1. A similar survey should be completed in all the 4 selected Panchayats to assess the extent of disability in children.
2. Based on the results, the number of experts to be associated with the medical camp, from different disciplines like Pediatrics, Neonatology, Neurology, Orthopedics, Ophthalmology, ENT specialist etc. should be arrived at.
3. The survey would be done with the help of Child Development Project Officers (Mulanthuruthy & Vadavucode/Puthencruz), ICDS Supervisors, Anganwaadi Teachers and helpers.

Such a survey was started in the last week of January under the aegis of the Community Based Rehabilitation (CBR) team of ACT, headed by Shri Aswin. The efforts of Ms. Oyena Chinnu Joy, Co-ordinator of CBR of ACT deserve special mention. Several staff of ACT, who do not form part of the CBR team also assisted by visiting Anganwaadis and collecting and collating the details.

4. The details of the survey are as follows:

i.                     Number of children in each Panchayat:

ii.                   Number of children based on the disability

CP-Cerebral Palsy OH-Orthopedic Handicap ASD-Autism Spectrum Disorders MR-Mental Retardation LD-Learning Disorders HI-Hearing Impairment VI-Visual Impairment

Dr.M. Beena, District Collector inaugurated the camp, attended also by Shri. E.Nandakumar, Executive Director, BPCL-KR,  Dr.K.V. Beena,  District Programme Manager, NRHM, Dr.Tony Mampilly President,, IAP , Cochin chapter, Shri.K.P.Padmakumar, Vice Chairman, ACT, Shri.George Thomas, Senior Manager (Public Relation), BPCL-KR, President of Puthencruz Panchayat et al.  At the camp, which went on from 0930 hrs till 1600 hrs , a total of 86 children turned up.

5. A detailed analysis of the figures collected at the camp reveals the following picture:

i.                     Distribution of children based on  Panchayat, Disability and Sex:

6. Implementation.

 For implementing the project, the following steps have been initiated:

i.                     Started on 2^nd June 2010. A team of a Physiotherapist, a Special Educator and a

 Teacher has been formed exclusively to implement the programme. In addition to them, a Coordinator has also been appointed to coordinate and monitor the implementation of the programme.

ii.                    Out of the 86 children who attended the camp, 34 children are undergoing regular training programme either at Adarsh or some other special school in their area. From the remaining, around 30 children have been selected for the Home Based Rehabilitation (HBR) programme. The special HBR team visits their homes and administers training and /or therapy according to the physical and/or functional problems of each child. The programme of the visit of the team has been drawn up in such a manner as to ensure at least 1 visit to each child in a week to start with. After the initial assessment children who need more care will be visited more often.  From ACT, a van has been released exclusively for the use of this team for the team from 1000 hrs to 16 hours.

iii.                 From out of the 8 children mentioned in Annexure II, 5 children have already been operated on by surgeons (1 General, 2 ENT, 1 Orthopaedic and 1 Neuro). The surgery for the other 3 will be conducted during July. BPCL has agreed to reimburse the expenses for the surgery.

iv.                 Assistive devices will be supplied soon to all the children mentioned in Annexure III. A total sum of Rs.61000 is available for this purpose.

v.                   A separate provision is available, of Rs.35000, for supply of hearing aids to 7 children. The final screening of the children who need this help will start on the 6^th of July and the equipment (Hearing Aids) also supplied to those who need by mid July.

vi.                 Screening of 20 children for checking acuity of vision has also been planned during July 2010.

7. It may thus be seen that not only has the follow up of the programme by ACT been quick but also the number of children getting benefitted quite significant. It is hoped that with the activities of ACT through their HBR programme, quite clearly visible in their vicinity, more parents will be motivated to bring forward their children for one of these programmes. ACT is very confident that this ambitious project will be a forerunner for many such projects, covering more areas in Ernakulam District. Adarsh is grateful to the various agencies who have assisted them in this efforts and hopes that similar help will be forthcoming in the similar ventures.

S.Aswinkumar

Executive Secretary

 & 

Head Projects &

Developments                                               KUREEKKAD

                                                                         10-07-2010