Wheels for the world

I am sitting in the middle of the physiotherapy gym engaged in conversation with a man who is telling me about the spinal cord injury he sustained in a car accident a few months ago. The man has limited English and I am not sure about his interpreter either: the answers I am receiving do not seem to be in response to the questions I have asked.

I shuffle sideways in order to avoid the wheelchair heading my way, driven inexpertly between all the mats, chairs, cushions and random bits of metal lying on the floor.

I learn that he had spinal surgery (no other details known) that he is unable to stand or move himself about and is unable to go out because he does not currently have a wheelchair. He tells me that he believes his leg is broken, something he realized himself after going to visit the herbal doctor. This 'revelation' does not appear to have been acted upon.

A few illegal manoeuvres later, my friend is sitting in his new wheelchair, lovingly taped together with duct tape and waiting to see the pastor for the 'evangelism slot' while I embark on a similar kind of conversation with an elderly lady whose registration card reads (name) (age), diagnosis: 'old age'. If it were not Friday, I might have been a bit taken aback but I have just spent a week working with 'details' like this. It appears she was unwell about a year ago and has not stood or walked since. She doesn't know why or what her illness was and has not seen a doctor about it.

Once her new wheelchair has been rattled and hammered into submission and she appears reasonably comfortable, I am washing my hands (under the tap - it is afternoon so the water is running again) when Louanne hands me a couple of crutches, 1 short, 1 tall, and asks me to go outside and reassure the man who is returning them that he should use them. I am so bemused by the request that I forget to laugh at what is really a very comical scenario (once you have accepted the equipment situation).

The man is quite right : the crutches are entirely different sizes, but with one at its shortest and the other at its tallest, I discover they are almost the same size and after checking that this really was the only option, I set about convincing him of this. It is not easy: he would like the holes to match up please...

Leaving him with his original 'set' of crutches, I go back inside to admire the spectacular method a 40 year old man is using to get in and out of his wheelchair. He has been unable to walk since breaking a few bones in a car accident 30 years ago and has perfected this performance: it is incredible but I'm not sure I shall be teaching it back at home.

There is a photo shoot going on so I join in: a 10 year old girl, with significant hypertonicity is being fitted into her first wheelchair - one that has been elaborately (if primitively) custom redesigned for her. This involved sawing off the back, chopping half the side out and joining the ends by screwing in some metal tubes fashioned from zimmer frames. I am impressed.

So what is all this madness about? An American group from 'wheels for the world', a subgroup of the 'Joni and Friends' charity has donated a load of wheelchairs and walking aids and is spending the week with us, fitting them to people who can come to the department for assessment. So the gym is transformed - wheelchairs and walking aids are packed at one end, the workstation takes up the other end, and patients and therapists squeeze into the space that is left in the middle.

People in increasing numbers queue outside to be registered and then, in theory, work their way through wheelchairs/ walking aids, vision and blood pressure check, chat with pastors and then wheelchair training if required. It was a change from the usual laid back atmosphere in the department and gave me opportunities I would never have had otherwise.

Home visits for example! On Thursday there was a lull in the afternoon so the team packed the generator, a bunch of tools and a selection of wheelchairs and sticks into the van and set out for a nearby village where they had heard there were several people needing help but who were unable to travel. I was invited along for the ride.

Most of the village congregated along the side of the main road where we had stopped and people were brought to us from everywhere. So we began our clinic, interspersed with an impromptu gospel message and worship songs. There were also people who couldn't leave their homes so we set out in small groups to visit them at home, bumping a selection of chairs along the dirt tracks in the hope that one will fit when we get there.

If there had been an accommodation officer to appeal to I would have done it on the spot but like so many other things, it doesn't exist and that is all there is to it. It was certainly a variation from my usual community visits!