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Early childhood intervention critical for children with disabilities

Opinion & Analysis
AS I entered the Sibanda homestead in Funyana village, Silobela, Mbuya Sibanda was patiently picking short pieces of copper wire for her grandson, Ignatius Sibanda (16), which he had just dropped and placing them within his reach.

AS I entered the Sibanda homestead in Funyana village, Silobela, Mbuya Sibanda was patiently picking short pieces of copper wire for her grandson, Ignatius Sibanda (16), which he had just dropped and placing them within his reach.


Ignatius, who is sitting oddly facing the back of his wheelchair — which has a sack cloth as the back cover – is busy piecing together the copper wires to make a car toy.

As I watch, he then begins to fit in the wheels made of empty shoe polish containers to the wire toy.

Mbuya Sibanda then starts cheering and applauding her grandson for his invention and creativity.

This arouses Ignatius, who responds by lifting his legs and lights up his face with a warm giggle — showing immense excitement.

Ignatius, who has cerebral palsy, also makes light tubes, which the homestead uses as their form of lighting. This is despite Ignatius never having been to school.

“My son uses his legs to make copper wire car toys and lights. We don’t use kerosene lamps or candles,” his mother, Sifelumisa Ncube, said.

Ignatius only started receiving physiotherapy at the age of 11 and this enabled his lower limbs to function.

Although he has shown such great skills, his disability and lack of an adequate support system to nurture children with disabilities, will see his talent going down the drain.

Poverty and disability are Siamese twins — inseparable. Research has indicated that poverty increases the likelihood of disability and it may also be a consequence of disability.

Nevertheless, despite Silobela district being rich in gold deposits, it is among the poorest areas in the country.

The World Health Organisation 2012 discussion paper on Early Childhood Development explained that pregnant women living in poverty experience poor health, restricted diet and exposure to toxins and environmental pollutants, all of which have a direct effect on foetal development.

In this case many women prefer untrained village midwives, when giving birth, due to the high costs of hospital fees.

As such, many face complications when giving birth resulting in death, lifelong damages or disability for both the mother and child. “Most pregnant women in this community cannot afford the hospital fees. It is beyond their reach and as such, they prefer untrained village midwives when giving birth, which can result in complications that can lead to disability,” the rehabilitation technician at Silobela District Hospital, who asked not to be named said.

The officer advised that chemicals used to separate impurities from the gold mineral also affect pregnant women, if mistakenly inhaled.

Diseases have also been a major cause of disability. The 2013 Living Conditions among Persons with Disability Survey reveals that a large portion of individuals with disability acquire them as children.

So far, statistics at Silobela district hospital show that they have screened over 700 children with various impairments. The 2012 World Health Organisation Early Childhood Development discussion paper notes that children with disabilities face a lot of barriers that hinder their development.

These include inaccessible environments, inadequate services, inadequate legislation and policies and negative attitudes. Early identification and early physiotherapy intervention are central for the development and functionality of children born with disabilities.

However, in a developing country like Zimbabwe and in a remote community such as Silobela, children with disabilities are deprived of their rights to health care, education, social inclusion, protection from violence, abuse and neglect.

For Ncube, she noticed at six months that her son was not making any movements and developing, unlike children of his age, but it was 11 years later when Ignatius begun his physiotherapy sessions at Silobela hospital.

Due to poverty and the high cost of caring for a disabled child, most families in the area cannot afford to make constant visits to Silobela hospital, which is more than 10km away from their homestead with a child with a disability strapped on their backs.

This is cumbersome, with the burden of care left to the mother, who in turn has to care of other children and partake in other household chores.

WHO highlights that despite being vulnerable to developmental risks, children with disabilities are often overlooked in mainstream programmes and services designed to ensure child development.

Further, they don’t receive the specific support required to meet their sights and needs.

“Physiotherapy demands commitment as it takes time to begin to see notable changes or improvements on a child,” the medical rehabilitation expert added.

As such, if children with developmental delay or disabilities and their families are not provided with timely and appropriate early interventions, support and protection, their difficulties can become severe often leading to lifetime consequences, increased poverty and profound exclusion.

For children with disabilities in Kwekwe district, it was discovered that about 95%of them were out of school and not receiving medical care.

The 2012 WHO discussion paper on Early Childhood Development and Disability explains that early childhood is a period from prenatal development up to eight years.

It is a crucial phase of every child but for children who experience disability, it is a vital time to ensure access to interventions, which can help them reach their full potential.

Stephen Hawkings, a mathematics professor at the University of Cambridge, despite having motor neurone disease all his life, this didn’t prevent him from having a prominent career.

In his foreword in the 2011 World Disability Report, Professor Hawkings said, “Disability need not be an obstacle to success”. Motor neurone disease also known as Amyotrophic Lateral Sclerosis (ADL) occurs when specialist nerve cells in the brain and spinal cord called motor neurones stop working properly.

Back home, Leonard Cheshire Disability Zimbabwe (LCDZ), a disabled people’s organisation, has introduced programmes aimed at empowering children with disabilities, enabling them to reach their full potential.

The organisation is targeting children with disabilities of all ages and has designed programmes that meet the needs of their various disabilities.

At Silobela district hospital, the organisation provides assistive devices such as wheelchairs, medical support that is physiotherapy sessions, which are beyond the reach of many in this community.

Greaterman Chivandire, LCDZ director,said his organisation is motivated to assist such disadvantaged and underprivileged children with disabilities to reach their full potential and live an independent life with dignity.

“We also facilitate access to education and livelihoods through the goat keeping and poultry projects. Parents and caregivers are also reached with awareness to ensure family support and that families remain intact despite disability,” Chivandire said.

Ignatius, who was dependent in all activities of daily living (ADL) since birth, through physiotherapy is now able to communicate his needs, has improved physical functionality and mobility.

Ncube has benefited from the goat-keeping project, and of the two goats she and her household were given, they now have 11.

“I am able to buy Ignatius food and blankets. In times of droughts, we are able to sell these goats to buy farming inputs and use some of the money to travel to the hospital,” she said.

Ncube is relieved that her son not only can help himself and communicate his needs now, but is displaying exceptional talent. “I can travel and do all my chores without worrying about Ignatius. We communicate using home taught sign language,” Ncube said.

The WHO report on Early Childhood Development and Disability shares the need to have well-coordinated and sustainable responses from a range of stakeholders at all levels to ensure that the rights and needs of children with disabilities and their families are met.

 Sally Nyakanyanga is an independent journalist, communications and development specialist focusing on health, disability, human rights, gender and climate change.