UNV doctor saves child from physical disability

DR. DAKSHINAMURTHY TAKIN JUSTINA THROUGH PHYSIOTHERAPY AT HOME
DR. DAKSHINAMURTHY TAKIN JUSTINA THROUGH PHYSIOTHERAPY AT HOME. Photo: Sharon Chalira, UNDP Malawi

Justina Dymon is a four-year old girl who was affected with a condition that cause physical disability in people called Cerebral palsy - spastic quadriplegia. She was diagnosed in October 2012 several months after signs and symptoms of the condition started showing. Ideally, Justina’s should’ve been diagnosed early on but due to lack inadequate doctors in most health centres in Malawi, it took a couple of years for her to get proper attention and treatment.

Highlights

  • A maximum of 65 doctors have been recruited (currently at 44).
  • The CD in Health project has reduced the doctor to patient ratio in Malawi from 1:60,000 to 1:30,000.
  • The project has also reduced the waiting time by patients on doctors 50%
  • UNV medical specialists are involved in mentoring of junior doctors in the four central hospitals including training of specialist doctors at the College of Medicine.

According to Justina’s mother, Rhoda Dymon, her daughter started showing signs unusual physical development when she was only eight months old.

“Even though Justina started sitting down properly, she was failing to crawl. I therefore took her to the hospital where they told me that she was still young and that with time she would start crawling.

“Two months later, we went to another clinic where she was registered for physiotherapy, but I was never told what was affecting my daughter,” said Rhoda.

For one year, Rhoda took her daughter to that clinic for physiotherapy twice every week. Unfortunately, her condition never changed, which made Rhoda to eventually withdraw her daughter from the therapy. In October, 2012, Rhoda took Justina to Kamuzu Central Hospital upon advice from her friend who was surprised that the girl could only crawl at three and a half year old.  

Luckily, owing to the Capacity Development in Health project which ensured the placement of volunteer doctors under the United Nations Volunteer Programme, Justina was diagnosed by a highly qualified medical specialist Dr. Nandhini Dakshinamurthy. The Capacity Development in Health project started as a response to one of the key challenges in providing the Essential Health Package (EHP), which is the high vacancy rates for critical health professionals particularly doctors. The main goal of the project is to strengthen the capacity of the Ministry of Health to deliver quality health services to Malawians, partly through the recruitment of specialist UNV doctors and General Medical Practitioners (GPs) in central and district hospitals.

Implementation of the Capacity Development in Health project started in 2004 through the Southern Africa Capacity Development Initiative with the placement of the first 9 UNV Medical Specialists.  It was further developed and expanded in 2005 following funding from the Global Fund to fight against AIDS, Tuberculosis and Malaria (GFTAM). In 2007 when  the Government of Malawi provided further  funding to UNDP,  thirty (30) UNV General  Practitioners (GPs) and five (5) Anti-Retroviral Therapy  Supervisors were recruited.  Further support from the GFTAM ensured the recruitment of more GPs and Specialist Doctors (SPs) so that by June 2012 75 UNV doctors were working in various referral hospitals across the country.

When Dr. Dakshinamurthy first saw Justina, she was able to sit herself down but was not using the hands for any of the daily activities like feeding. She also had difficulties with speech and at three years old, she could only babble. She also needed a lot of support to make her stand and she was completely failing to stand up on her own.

“When I assessed Justina, I found that she had a good Intelligence Quotient (IQ) and a lot of hidden abilities. I counseled Rhoda that if she could follow the physiotherapy program and advice which I gave her for her child both in the clinic and at home, Justina could become independent in her activities and might also start talking.

“With other colleagues at the Centre for Pediatric Physiotherapy at KCH, I started training Justina to use the hands through play therapy and other therapeutic exercises. We also encouraged her to learn standing and walking using a standing board and a walking frame along with other activities,” said Dr. Dakshinamurthy.

With a few weeks of the physiotherapy, Justina started using her hands to pick, hold and manipulate objects, and feed herself. She also started understanding simple instructions and responding appropriately. For the weeks that followed, Justina was steadily improving and on one Sunday afternoon, a marvelous thing happened.

“It was on Sunday the 3rd march, 2013 in the afternoon when I was chatting with my friends at home and my daughter was playing with her toys when I saw her standing up herself without any help and started walking. 

“I was very surprised, excited and happy to see my daughter making her first walking steps at 3 years and 10 months old,” explains Rhoda while looking at Justina with a smile.

Justina is now able to a stand up without any support. She walks, and uses her hands properly when playing, and eating and she understands properly. She still goes for Physiotherapy twice a week because her back is still not straight when she is walking and she has just started saying a few words like, Mama and Dada. 

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