ASFA Physiotherapy & Rehabilitation Centre
Muganza village, Nyaruguru District, Southern Province, Rwanda
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. Attitudes 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.
Sr Josephine Nyiranzanwayimama, a member of the Rwandan Franciscan sisters, Congrégation des Soeurs Pénitante de Saint François d’Assise, 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 to reach us. 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, the sisters, 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 Josepha 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 Physiotherapy Centre and works alongside a small team of one Physio Assistant and five Therapeutic Assistants (residential carers). To date, ASFA Physio has treated nearly 400 patients and currently has, on average , 10-12 paediatric inpatients and 174 outpatients, the vast majority being paediatric. 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. ASFA Centre provided a home to the physio service for six years but by 2019 was bursting at the seams. Our new dedicated building, located next door to ASFA Centre, was completed in August 2020 so please do read all about our plans in Future Hopes ….
ASFA Physio is a place where…
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
For those travelling from remote villages for treatment and medical assistance, ASFA Physiotherapy provides accommodation for inpatients and full time carers.
As of April 2018, 10 women had graduated from the ASFA Centre sewing programme that gives young women the chance to learn a skill and, ultimately, the ability to earn a living. 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.
The courses started life on the verandah at ASFA Centre but have now moved to a shop on Muganza High Street where the students can sell their products and services more easily. The centre is managed by one of the ASFA graduates.
ASFA Centre grow crops including bananas, avocados, strawberries, beans, cabbages, potatoes, sweet potatoes and the most delicious passion fruit ever known (!) on the projects own land.
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)
ASFA Physio hold monthly safeguarding sessions and weekly reviews. Visiting UK physio’s run CPD sessions accredited by the Rwanda Allied Health Professions Council.
The pig programme was temprarily suspended due to construction of the new physio centre but we hope to restart this soon.
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. At Feb 2018, 11 families have benefitted from the programme with families with disabled children registered at ASFA Physio 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 retired during construction of the new centre but used to lay eggs for ASFA staff and inpatients with excess eggs sold at market to generate income. We hope to re-start our chicken project now that construction has finished.
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. It is also available to inpatient parents and carers who are visiting or enroute to further medical treatment for their child.
Cultivation of fruit and vegetables and basic animal husbandry (pigs and cows) also contribute to the project’s sustainability with excess produce sold at market.
We currently have six dairy cows whose milk is given to ASFA Physio inpatients. Excess milk is sold at market to generate income and any by-products are used as compost to help cultivate crops.
ASFA Centre has a multi-purpose hall that can be hired out for events, with income earned from catering services.
2021 and Future hopes…
Make a Difference 4 Africa completed a dedicated residential physiotherapy centre in August 2020. It is located next to ASFA Centre where disabled children can stay, with their carers, for short-term inpatient treatment and care.
The new building comprises:
- approximately 30 paediatric inpatient beds
- carer accommodation
- 3 dedicated spaces for therapeutic exercise
- 4 consultation rooms
- internal bathrooms
- toilets (inside/outside)
- separate outpatients department
- waiting/reception area
- garden and car parking
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.
If you would like to support this vital work please do get in touch to find out more or if you are able, please kindly consider make a donation.
Kate & Diogene
Hydraulic hospital beds
Shoes & specialist Piedro walking boots
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
- 2,500 school lunches (2016)
- 1 school library with four bookcases (2017)
- 1 washroom building for girls with sick bay, shower and toilets (2017)
- 1 large retaining wall (2017)
- 8 new toilets (2017)
- Connection of mains electricity to classrooms (2014)
- Delivery of Book Aid International books from Kigali (2017, 2019)
- Over a 1,000 health insurance cards (2018, 2019, 2020)
- 3 lightening rods (2018)
- 243 lunch plates (2016)
- 1,200 pencils
- 10 footballs and some bouncy balls
- 1 sewage pump system (2015)
- 14 in-classroom library corners with books (2015)
- 860 school uniforms (2016, 2018)
- 200 items of sports kit from National Tennis Association
- 300 sharpeners (2016)
- 300 erasers (2016)
- Teacher training resources (2015)
- TV (2017)
- 1 mobile science lab (2016)
- 1 black/white photocopier (2010)
- printer toner cartridges (2014)
- 2 laptops (2015)
- 2 iPads (2015)
- Repointing brick walls in classrooms (2015)
- Numeracy, science & literacy resources (2015)
- 1 projector and screen (2015)
- 4 mobile phones (2015)
- 2 SmartClassrooms ( March 2020)
- SmartClassroom 100 chairs and 20 tables (Sept 2020)
- 2 library book cases (Dec 2020)
- Teaching resouces ( March 2021)
- Colour photocopier (March 2021)
Be part of our life-changing projects and Make a Difference today
UK registered charity number: 1127976