ASFA Physiotherapy & Rehabilitation Centre

Muganza village, Nyaruguru District, Southern Province, Rwanda

Our vision

Established in 2014, our vision remains to provide sustainable inpatient and outpatient physiotherapy treatment and rehabilitation services. Early intervention to facilitate independence and maximise function is key to everything we do to fully realise every patient’s potential. We support and encourage social inclusion of all our patients and their families so they feel valued members of society.  Attiitudes towards people with disabilities are slowly changing as they become more active and skilled members of the community. There is much work to do but by working together, disability or no disablity,  we can Make a Difference

Our main focus is on paediatric care and providing treatment and rehabilitation for children with disabilities and some adult outpatient care. Demand is great and we hope to be able to expand our over-subscribed clinical services once our centre is complete. See Future Hopes for more information.

Small beginnings…

Sr Josephine Nyiranzanwayimama, a member of the Rwandan Franciscan Sisters, had been co-ordinating sewing activities since 2005 in the remote village of Muganza – about four hours south west of Kigali by car.

She took over co-ordinating outpatient services for children with disabilities in 2008 serving a population of approximately 300,000. The needs were, and still are, many and with the support of Margie Salem and donors, in partnership with Global Development Group Australia,  ASFA Centre (Amis de Saint François d’Assise/Friends of St. Francis) opened its doors in January 2014 to provide a multi-purpose hall with guest accommodation, office and a dormitory room where families could overnight before catching the early morning bus to town to receive medical treatment for their children at distant hospitals.

We are often amazed by the distance people travel to get to ASFA, with patients walking up to 20km – or being carried on a stretcher.  We had a wonderful father who walked for six hours carrying his 20-year-old daughter and a mother who held her child on a motorbike journey for five hours. There are many other humbling stories like this.

In July 2014, we joined forces with our local partners to help train two newly qualified Rwandan physiotherapists. Over the course of 10 days, 100 patients were assessed in three rural clinics. This trip confirmed the pressing need to establish a physiotherapy centre in Muganza where we could provide early intervention for disabled children. Highly experienced nurse and physiotherapist Sister Josephy Uwumuremyi moved to Muganza in September 2014 to welcome the first patients at ASFA Physiotherapy and Rehabilitation Centre. We were overwhelmed from day one with the acute demand for such services.  

Diogene Murwashyaka is the Clinical Lead of ASFA Physio and works alongside a small team of one physio assistant, four carers and one part-time practice manager. ASFA treats, on average,  11 paediatric inpatients, 174 paediatric outpatients and a small number of adult outpatients. We see children with developmental delays and disabilities including cerebral palsy, club foot, Down’s Syndrome, genu valgum, autism, developmental delay and many congenital syndromes.  We’re bursting at the seams but we love a challenge and want to do more! Please read on about our Future Hopes below….

 

ASFA Physio is a place where…

The physio team provide full-time treatment and care for a number of paediatric inpatients on a short-term basis
Carers and parents are taught ‘hands on’ tools to help their children develop and achieve their potential
Children and adults are actively involved with their own learning
Parents learn to incorporate the practice of new skills into everyday life
The needs of the whole person are considered including communication, social and physical skills

 We know that, with the right help, people can achieve wonderful things. This message is the foundation of everything we do at ASFA

  Therapeutic Exercise ASFA style!

ASFA is the only centre (we think!) in Rwanda that provides physiotherapy treatment through engaging and fun therapeutic exercise. Focusing on developing gross motor skills such as rolling, sitting, crawling, kneeling, standing and walking, the aim is to facilitate each patient’s normal development and independence.

A stimulating environment is created with toys and therapy equipment and different learning activities are devised to meet the treatment needs of each child. Supporting parents and carers to carry on therapeutic exercise at home is a vital part of what we do in addition to building a supportive network for families of disabled children.

Please read on to learn about a few of our case studies

ASFA Centre’s Projects and Facilities

Inpatient accommodation

For those travelling from remote villages for treatment and medical assistance, ASFA provides accommodation for inpatients and our full time carers.

Sewing courses

Sr Josephine and one full-time trainer, run year-long sewing courses to give young women the chance to learn a skill and, ultimately, the ability to earn a living.

As of April 2018, 10 women had graduated from the programme. Of these, five now own their own sewing machine and work full time, one hires a machine when she has freelance work and four woman work on a freelance basis and use the ASFA machines when needed.

We currently have five new students doing the course and we know demand for places is high. Having started life on the verandah at ASFA, the course has now moved to a dedicated space close to the Muganza High Street where the students can sell their products and services more easily.

It costs approximately £80 to buy a sewing machine which allows a graduate to be income generating immediately.

Crops

ASFA grow crops including bananas, avocados, strawberries, beans, cabbages, potatoes, sweet potatoes and the most delicious passion fruit ever known (!) in the surrounding fields.

It costs approximately £5 to buy a selection of seeds for cultivation and sale.

Staff and community education classes

Malnutrition has long been a pressing issue in Rwanda. We run classes on how to sow crops more efficiently and how to cook to maximise nutritional value. We also run child protection classes for ASFA staff.

Continued Professional Development and Safeguarding (Child Protection) courses

Visiting UK physio’s have run annual CPD sessions since 2014.

Safeguarding (child protection) sessions are also held monthly bythe local team and are on the agenda at weekly staff meeting.

Animal husbandry

Farmers are given one pig, commit to pass on the first female offspring from their animal to another local family and agree to provide training for its care. So far, 11 families have benefitted from the programme (as of February 2018) with families with disabled children registered at ASFA being given preference. Farmers who complete the training successfully are often able to provide better nutrition for their families, take out basic health insurance, send their children to school, raise income from produce and often buy further livestock.

Our 50 chickens lay eggs to help feed ASFA staff and inpatients. As with the milk, excess eggs are sold at market to generate income.
It costs approximately £10 to buy a chicken.

Guest accommodation and catering

ASFA has four guest bedrooms with ensuite facilities and full board for visitors. This is an income generating project that is normally rented out to volunteers, NGO workers and local business people.

Cultivation of fruit and vegetables and basic animal husbandry (pigs, cows and chickens) also contribute to the project’s sustainability with any excess produce sold in the local community.
It costs approximately £40 to buy a pig.
In addition to the pig scheme, we currently have six dairy cows whose milk is given to ASFA inpatients. Excess milk is sold at market to generate income and any by-products used as compost used to help cultivate the crops.
It costs approximately £500 to buy a cow.
A multi-purpose hall can be hired out for events, with income earned from catering services.

Future hopes…

Make a Difference 4 Africa wants to build a dedicated residential building at ASFA where disabled children can stay, with their carers, for short-term inpatient treatment.

The current inpatient room is extremely cramped. We want to build a separate building that comprises:

  • approximately 20 paediatric inpatient beds
  • accommodation for carers
  • dedicated space for therapeutic exercise
  • 4 consultation rooms
  • bathing/toilet facilities
  • large kitchen to service the physio and the main building

Already, the lives of many children have improved immeasurably as a result of the intervention and physiotherapy treatment received at ASFA.  With a properly staffed, dedicated facility this number can increase and can help participants become more active and skilled members of their family and broader community. Negative stereotypes of people with disability are changing in Rwanda. We want to work with the inspiring local team to help them deliver this incredible project and then replicate the model in other areas of Rwanda and beyond!

Kate & Diogene

Charlotte

Training

The results

Hydraulic hospital beds

Shoes & specialist Piedro walking boots

Wheelchairs

Medical books

ASFA Physiotherapy Centre in numbers

We shipped (or lugged!) a total of 1,500kg of physiotherapy equipment including…

  • 200 pairs of shoes and specialist Piedro walking boots
  • 200 pairs of socks
  • 70 medical books (in collaboration with Book Aid International)
  • 60 walking sticks and metal crutches
  • 40 pairs of arm/leg gaiters
  • 35 metal walking frames
  • 20 postural wedges and supports
  • 22 boxes of Plaster of Paris
  • 15 postural management chairs
  • 20 wheelchairs
  • 10 hydraulic hospital beds
  • 2 hydraulic physiotherapy treatment couches
  • 10 leather helmets
  • 10 standing frames
  • 7 plastic floor mats
  • 4 toilet and washing chairs
  • 4 pushchairs
  • 4 bean bags
  • 2 wooden climbing frames for muscle development
  • 2 sleeping management systems
  • 2 full-sized physiotherapy couches
  • 1 interferential therapy machine
  • 1 filing cabinet

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UK registered charity number: 1127976