Thursday, June 18, 2009

Wow, that's a lot of wheelchairs!

Journal Entry from Day 10: Friday May 29

Today we went to the Accra Rehabilitation Center. On our way we got to stop at the OT Department craft store (the OT Department is associated with the psychiatric department of some health care provider, I'm not sure if it's a hospital or clinic or what). Fun times for us! The department reportedly employs the only OT in Accra. It's interesting that it is associated with a psychiatric facility given that psychosocial needs do not really seem to be addressed or even considered here when disabilities are discussed and given OT's psychosocial roots in the US.

Once at the ARC we got to talk with the site manager at some length about what the ARC does, what he would like to see it do, what challenges he faces and how individuals qualify to enter the ARC. The ARC, first and foremost, is a vocational rehabilitation residential center for males only. Entrance into the facility requires substantial paperwork as well as either money of your own or the sponsorship of another individual. Some of the vocations taught there include, woodworking, shoe making, sewing/tailoring, and basketry. The site manager admits that some of these skills are not marketable or profitable in today's society and would like to incorporate more appropriate trades such as tv/radio repair. The trouble is that the ARC is government funded and the government has opted out providing funding for several months. The facility has not been shut down, no fault has been found with the facility, the government just hasn't felt like sending funds apparently. The site manager is barely able to provide food for the residents much less materials for the existing workshops or training and materials for new ones. We were able to tour the facility and talk to a variety of residents, which was as always enjoyable. The facility itself though is confusing. Most of the workshops were dark-- there was lighting, but it was off-- was this because there was no money to pay utility bills? or had no one bothered to turn the lights on? Also most of the workshops were grungy, disorganized and filled with broken machinery or left over materials. The residents didn't seem to have an particular schedule, some were in the workshops working, others were in the workshops sitting, perhaps watching or maybe just waiting for something, others were attending a seminar on fire safety that was being provided by an outside organization and still others were still getting ready for the day or just wondering around the compound (seemingly without much direction). Some workshops had instructors, others didn't seem to. Was this apparent lack of organization a reflection of my lack of understanding of their system? or was there no system? Were people wandering around and sitting around doing nothing because there was nothing to do given the lack of funding to purchase supplies? or did residents just not know what they were expected to go and what to do when they got there? The whole scenario was just really confusing. It was hard to tell the extent to which the financial situation affected the facility's ability to function and how much of what I saw was just how things were done there. I feel like a more apparent daily structure or schedule and some environmental adaptations might be two easy ways to make some vast improvements in the facility that wouldn't require additional funding.

Yesterday we went to Echoing Hills, which is a boarding school for children with various disabilities. It was a much smaller facility than New Horizon school, having only one open air classroom, it seems many of the children that stay there attend school in the community and only the children with the most severe disabilities remain at the center all day and are educated there. In addition to providing basic education at the facility, some residents participate in meal preparation and other facility chores. It is unclear what kind of plans, if any, exist for these residents as they age. Overall long term plans seem to involve the vocational track-- which consists mostly of crafts, or a basic educational track. What is unclear is what supports individuals with disabilities are supposed to make use of to succeed at their vocation once they master the task or what they are meant to do with their basic education as they get older. Additionally the center has a fairly large and mostly unused clinic space, a lot of outdoor space that would be perfect for the construction of an accessible playground, and a wheelchair distribution center. The wheelchair center receives used wheelchairs that have been donated which it refurbishes and then distributes to various communities a particular points throughout the year. They reportedly do some wheelchair fitting when they distribute the chairs.

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