Back to Leh

[pictures to follow, when there is decent internet]

During the time that we were in Kargil, things were developing at the Sonam Norboo Memorial Hospital paediatric rehab unit. Radio announcements had gone out, informing parents in Leh and the surrounding villages that there was a team from Canada at the hospital for the month of July. Some of the changes we had suggested before leaving for Kargil had been put in place, others were still waiting to be done.

Over the next few days, there was a trickle of kids into the unit. One of the children I saw had been followed by the team in previous years. She was now living at a boarding school just south of Leh. I was tasked with making a soft hand splint as she is hemiplegic so requires support to keep one of her hands open. It was a good exercise in designing and fabricating aids from available resources. I found some felt material in the market but this proved to be not stiff enough. I was able to scrounge up a piece of neoprene that did the trick but it would be better if we were able to make the splints from locally available materials, like soft leather, in the future.

Since things have been a little slow at the hospital, Doug, Maureen and I spent some time at REWA Society. REWA is an organization started by a German couple and now run by local Ladakhis. Their goal is to provide physical and occupational therapy services to children in and around Leh. They bring volunteer therapists from Europe for several months at a time, year round. They have set up a pretty well stocked rehab centre and also do trekking outreaches to remote villages. At the time we went, they had several physios on staff but no OT.

One of the tasks REWA required was fabrication of two seating systems for children with Cerebral Palsy. Maureen is an expert in seating and positioning, so she was able to lead us through assessing and measuring the children. We then drew up plans for the seats, hopefully improving on the style they currently use by making ours adjustable for growth. This coming week, I’ll need to find someone who can fabricate metal brackets and will work with the carpenter to actually build the seats. After that, I’ll be with Maureen again to cut and fit the foam that will give the seat the required fit and postural control. That should be a good learning experience.

Armin, one of the physios at REWA, also told us that a kid he has been working with needed some changes to her home environment. Sonam is a 16 year old girl with spina bifida, paralyzed from the waist down. She is a real bright spark, very personable and who loves school. The family bathroom at home is outside, down a very narrow alley at the side of the house. To use the bathroom, her mother has to carry her down this narrow gap. I seriously couldn’t walk down the alley without having to turn sideways so I have to idea how her mother was able to negotiate this path with Sonam on her back. After a look around, we suggested constructing a new, wheelchair accessible bathroom space in the front of the house. With the family, we decided on a spot next a small shed. Next week, we should begin construction. This should be another great learning experience as we will build a wall for the bathroom and roof using traditional Ladakhi materials and construction techniques, plus a few OT suggestions to make it accessible and practical.

I’ve also been able to get more familiar with Leh. It is a difficult town to get around as much of it is made up of a maze of narrow, walled pathways. I feel like I can get from one spot to another without too much difficulty, though it is not easy to know if you are ever going the most direct route from Point A to Point B. The market area is pretty interesting. Lot’s of small shops selling everything to the tourists. My favourite part are the old ladies who sell produce off the side walk along one of the stretches. Their fare changes as new local crops become available. Yesterday, I picked up some carrots and kohlrabi, to try and bump up the intake of veggies. I think it cost about $1.50 for a bag full.

I’ve also managed to get out to see a few of the other attractions. Shanti Stupa is a giant Buddhist monument, built by a Japanese group in the 1980’s. It makes for a good morning trek before breakfast and gives amazing views of the town and Indus Valley. Last weekend, we also toured the Leh Palace. It is in a bit of disrepair right now, but at one time was the tallest building in the world. It is in the process of being restored by a volunteer group. Above the palace is a monastery so we also made the trek up there.