Expanding

Although it is not, as I was told, rainy season, the moment we arrived the monsoons started – thunder, lightning and downpours I have never seen descended on us daily. Since we were in a conference room it didn’t matter to us, except for the breaks which are offered on the hotel’s 15th floor rooftop, next to the pool. The pool would overflow for a while and then everything dries up again. The Malay are very happy about this rain – the draught had reached panic levels. Here, like in Afghanistan, water brings luck. For the most part it is hazy in this otherwise lush tropical paradise. Most of the time we cannot see far from our 13th floor room.

We started on Monday with the management training of people who run either Occupational Therapy services or facilities and who are planning to add wheelchair services to their repertoire. ideally this training is for managers of staff who have just completed the practical training on how to deliver wheelchair services. This is what my colleague T does before I join her.

Through the WHO program people are learning that wheelchair service delivery is more than giving a wheelchair to a person. It includes extensive diagnostic interviews, measurements, wheelchair adaptations & fitting and user training. Few of the 20 participants were actually in management positions (they rarely are in these trainings) and so much of the management content was quite new to them, as was the wheelchair service process.

I have never worked in a middle-income country and I don’t know how they managed to get USAID funding which is usually reserved for low income countries. The difference in attitude is striking: there is no expectation that some outside funder will take care of everything – there isn’t the helplessness (we are poor we cannot help ourselves) that I see so commonly elsewhere. The enthusiasm, the gratitude for this opportunity was striking, and so was the realization that there is money, and that getting it to expand services is possible albeit it difficult.

We divided up the sessions between the three of us and adapted the fixed curriculum to the context. Usually we do this training in a country that has a language and script we do not know. This makes changes nearly impossible as we would need to get translators to make the changes on the slides and the kind of spur of the moment changes I tend to do are not possible. It was a luxury to teach in English and be able to read the slides. It also allows me to put in some leadership content which I can never do in the other settings.

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