Regional Visits

Last week I went on a regional visit with a pediatric occupational therapist, speech pathologist and physiotherapist. Each term this team travels to three remote towns to assess new children referred by teachers, doctors etc and to monitor the progress of those children already on the case load. Following the visit a home exercise program is then sent to the parents of these children as well as a program for the therapy assistant whom works with these children at the school. Due to their location it is not possible to treat these children on a weekly basis due to the cost of traveling etc, thus these twice a term visits are the best way to monitor and ensure these children’s gross motor, fine motor and speech skills develop.

The weeks prior to these visits require an enormous degree of organisation by the therapists. They need to contact the local health centers or schools for rooms to assess the children, contact the parents to let them know when the regional visit are occurring and finally a timetable must be made up in order to allow time to travel between each of the towns (roughly 1-2 hours driving between each). Whilst this is a huge undertaking in itself it is made more difficult by the parents.

Whilst many of these children require the therapist intervention a huge degree of the education must be aimed at the parents to ensure they are compliant with bringing their children to the appointments and then following the HEP provided. One major problem in organising these appointments is getting hold of the parents in the first place. A number of the families live in communities and don’t have their own telephone number (instead it is a community one) making it difficult to speak to the parents in person and not just communicate via messages. The next challenge was to see if the parents brought their children to the appointments.

In one town we were booked to see a child with cerebral palsy (hemiplegia). She required measurements to be taken so that an AFO could be made for her foot and we had brought the necessary equipment to make a splint for her hand. Each of these would assist the child to develop her gross and fine motor skills as well as maintaining the joint positions and preventing deformities of the hands/feet as the child grows. Previously the child had been brought to the majority of her appointments by an ‘uncle’, whom we had spoken to on the phone prior to leaving.

When we reached the local health centre the nurse stated that it was unlikely that the child would be brought in as the entire community they were from was out bush looking for a missing person. Sure enough we waited for over an hour but the child wasn’t brought in. This frustrated me as the child required intervention or else it would impact on the quality of their movement and life. Due to the towns location it would be another 5/52 until the child has the opportunity to be seen again as there are no other services provided in the area until then.

Whilst we were waiting I reflected upon the situation and realized that we had done all we could to contact the family, explain what we would be doing in the session and why it had to be done. Unfortunately for us timing wasn’t in our favour due to the missing person. For this family and the community these events take precedence over everything else, which is something we must respect even if we don’t share that belief. As we were waiting the OT and physio explained to me that this was a common occurrence and that there is no point is getting frustrated etc, we just need to ensure that we provide the family with the best options and services for their children.

It was a great experience going on a regional visit, seeing remote towns and communities. Even though we live in the same country there are vast differences in the cultures and belief systems. As a therapist when providing a service to these areas you just have to do the best you can and fit in with these beliefs and value systems. Whilst its frustrating that we didn’t get to see the child, on the next regional visit the team will once again contact the family, organize an appointment and hopefully no situation will arise in the community to prevent the child from being brought in!!