less fortunate

On my last day of rural prac (abroad), i had the opportunity to visit a Community rehab centre for children with special needs. I went for home visits which is normally done once a week. As i was chatting to the staff members, i gathered that they visit each patients once a year (mainly CP kids). I had the opportunity to see one of the most severe CP patients. Pt is 8 y.o female. When i arrived, her carer was carrying her in her arms like a little infant. The rehab centres' staffs were talking to her carer and did a rather informal subjective examination (which only includes, have you been doing the exercises with the pt, and anything significant happened in the past yr). One thing that struck my patient immediately was that the exercises that were given last yr might not be appropriate this year and needs some progression or alterations. I asked the carer if the patient has been sitting much. Her carer said that, she will be carrying the pt most of the time and letting her sit on her lap, and if that is not the case, she will be lying down on the bed. When i had a look at the pts back, she had obvious spine deformity due to positioning. Quickly I suggested that she has to be sitting +++ with support (custom made seats specially for CP kids) to at least prevent the worsening of the deformity. I talked to the rehab centres' staff and her carer and they said that it is difficult to get these type of chairs in this town and it's hard to convince the patients parents to invest their money on these equipments. I was quite frustrated with that and i insisted on proper positioning for this patient. I was thinking on the spot on how to improvise. The patient has a younger brother who is approximately 5, I asked the carer if the brother has a little feeding baby chair or play chair. Her carer took it out from the storage room and we fit the patient on it. Because she is so kyphotic and scoliotic, we took a towel and tied it around the patient to provide her with some trunk support. The chair comes with a tray in which the patient can rest her hand and play with some toys while sitting. I don't know how well the 'special chair' will work in improving or maintaining her condition but it is always better than just lying down or being carried by her carer. It is really interesting to see how healthcare systems work differently in areas out of Australia, kids with special needs in this area is less fortunate and it is really sad to see.