The Association’s therapy-related services are packaged and delivered through the Hambisela programme. Therapy is the primary healthcare tool for the management of cerebral palsy and so Hambisela is a critical element of the Association’s services. Hambisela is an isiXhosa word which means “make progress”, and is used in the context of making progress towards excellence in therapy for cerebral palsy. The objective of Hambisela is to improve the level and intensity of therapeutically-correct ongoing care received by individuals affected by cerebral palsy in the broad community.
The Hambisela programme of the Cerebral Palsy Association (Eastern Cape) was in 2012 the recipient of the Discovery Foundation Excellence Award. The award was made in recognition of the Hambisela programme, and to enable the Association to further implement the Hambisela programme in the Eastern Cape.
Watch the Hambisela programme video produced as part of the Discovery Foundation Excellence Award programme.
What Hambisela does
As specific needs in the communities were identified, specific projects within the Hambisela programme emerged:
A: Hambisela Care Centre Project
A great number of children, teenagers and adults with CP are attending day care centres, or are living in residential centres. Most of these centres are run on a very small budget and can therefore not afford to appoint therapists. Many of the managers and caregivers have very little or no experience in dealing with CP. Furthermore many of these centres do not have the correct positioning equipment (or the knowledge on how to use them) in place for their residents/attendees for effective postural management.
The Hambisela Care Centre Program was developed to integrate Hambisela caregiver training with other development support interventions, to address some of the challenges faced by these care centres.
The following aspects are part of this model:
GAP analysis – the objective of this analysis is to assist the care centres to achieve sustainability by enabling them to register with the Department of Social Development and thus receive continued funding. It is also helpful in planning where the priorities in intervention for each centre should lie and furthermore assists management in their future planning for their centre as well as ensuring that they meet the necessary requirements set out in the Children’s Act.
Individualized care programmes – after initial screening of clients at these centres the information gained was used to develop individualized care programmes. These programmes included provision of therapeutic equipment and adjusting each device according to the individual’s needs; dividing the clients into stimulation groups and assisting the staff in developing sustainable daily programmes
Training of the caregivers – based on the Hambisela training programme, staff received extensive training as well as opportunities to implement the positioning and stimulation programmes under the guidance of the Association’s therapists
Liaison with therapists working in Dept of Health as well as other NGO’s to ensure sustainability after completion of the specific project at the centre.
B: Hambisela Healthcare Centre Project
The Hambisela Healthcare Centre project is focused on in-depth training of therapists and health care workers, to develop their specialized knowledge on cerebral palsy and skills for the management of the condition. The overall objective is to establish an effective and well-managed cerebral palsy management programme within the community healthcare structures throughout the Eastern Cape.
The latest development is called Hambisela-Usana and is focused on early identification and intervention. In collaboration with one of the local tertiary hospitals, infants with high risk birth histories are screened using the General Movements Assessment, and those identified as at risk for cerebral palsy and other developmental disabilities are referred to appropriate early intervention services.
C: Hambisela Research
The Association acknowledged the need for community-based interventions with a good evidence-based approach. We are currently busy with one study, and planning a second one.
The first study (currently ongoing) focuses on the impact of the Hambisela parent / caregiver training programme on functional outcomes in the children with cerebral palsy as well as looking at parent outcomes.
The second study (in planning) focuses on developing a scalable model for early identification and intervention for infants at risk of developing cerebral palsy. We realise the importance of early identification and hence early intervention to assist with these children’s’ development whilst the brain plasticity is at its greatest.