Dept of PM & R is also involved in Training and Orientation about the Disability Management Programme for the PHC Medical Officers. The Rehabilitation Council of India sponsors this programme.
Primary Health Centres Doctors Training
Since 2002 around 70 batches were provided sensitization training to doctors of Primary Health Centres (PHC) on ‘Disability Management’ at the IHRDC. The PHC programme has had a tremendous impact on services to persons with disabilities in Tamil Nadu. The PHC doctors have already identified thousands of persons with disabilities and referred them to educational and rehabilitation programmes.
Vikalang Bandhu Training
The IHRDC in collaboration with the Ministry of Social Justice and Empowerment, Govt. of India, conducted the Vikalang Bandhu Training Programme for parents and family members of persons with disabilities on 15 April 2002. 19 participants, who were the parents of disabled children or family members of disabled adults, were the trainees in the first batch.
Training in Computers for the Visually Impaired
Computer Training for the visually impaired persons also commenced on 2002. Ten visually impaired persons were trained to master the basic skills needed in operating a computer and also trained in MS-Office and Internet.
Apart from the rehabilitation of individual disabled persons, the IHRDC organizes manpower development programmes to address the education, rehabilitation and vocational needs of groups of disabled persons of all categories nder SHG Scheme. In collaboration with the District Administration, Coimbatore, the IHRDC implemented Self-Help Group (SHG) activities for persons with disabilities on June 1, 2003. The Perianaickenpalayam and Karamadai Blocks were covered under this scheme.
Training to Self-Help Groups
Creating of self-employment opportunities is vital for persons with disabilities to make them economically independent. However, individual clients sometimes lack self-motivation due to the difficulty involved in sustaining self-employment avenues. Therefore, providing structured training to persons with disabilities to form self-help groups not only develops confidence in them but also improves their income-generation opportunities. On the basis of discussions with the District Administration, officials from Government of India and Tamil Nadu, experts and disabled clients, the existing SGSY scheme was modified to address the self-employment needs of persons with disabilities.
The IHRDC made an intensive survey in Karamadai and Perianaickenpalayam blocks and identified nearly 800 persons in the age group 14-50 years who can be benefitted by self-help group concepts. Based on the proposed model, the District Rural Development Authority (DRDA) and IHRDC prepared a proposal to benefit 80 self-help groups of persons with disabilities each year in Perianaickenpalayam and Karamadai blocks. The proposal of the DRDA was approved by the Government of India as per their letter dated 11 March 2004. With the preparatory work and orientation of officials, the project was formally launched on June 1, 2004.
The aptitude training and skill training were provided in the IHRDC. The aptitude training was for a period of 7 days.
Assessment for Skill Training
A committee consisting of professionals in visual impairment, hearing impairment, mental retardation and locomotor disabilities, set up by the IHRDC, reviewed the progress of the clients at each step.
Need-based Skill training
After the aptitude training was completed, the disabled people were assisted to identify the trades of their choice. Following this, the trainees were classified into different self-help groups, with a minimum of 5 persons in each group and then given a minimum of 4 weeks intensive skill training in the selected trade to attain mastery over that trade. Depending on the ability of the client, skill training was organized to learn more than one vocational trade. The duration of the skill training too varied. For example, training in bakery needed 3 weeks, tailoring requires 3-4 months, computer training requires 6-9 months and so on. Therefore, the training was fully need-based and the duration depended on the ability level of the client. The DRDA met the cost of training for a period of 4 weeks as per the project. Cost for training beyond 4 weeks for any number of clients was met by the IHRDC, Ramakrishna Mission Vidyalaya.
Need-based vocational activities were provided to the members of SHG in 36 trades and each client was taught a minimum of 5 trades.
Opening Bank Account
After the skill training was over, the IHRDC assisted the clients to form Self-Help Groups and also prepared them for self-employment by opening bank accounts, procuring raw material and creating local work environment.
Cluster Level Centres
Most of the disabled persons do not have adequate facilities in their homes for making the products. The cluster level centre helped them to solve such problems. The members of production oriented SHGs assembled at the cluster level centres and made their products. The raw materials and finished goods were also stored at the centre. The members were also taking their products to markets and customers located in various places.
For the above activities it was proposed to construct 12 cluster level centres during the first year. To monitor the activities of the cluster level centres located at various places a main centre was constructed.
To ensure that the cluster level centers function smoothly, a coordination committee was formed who met once in 15 days and discussed various matters such as progress, support services, marketing, Govt. welfare schemes, rights of the disabled, etc.
As per the proposal submitted to the Government of India, 80 self-help groups were supposed to be developed in each year of implementation of the project by 31 May 2004. The implementation of the scheme exceeded the target of 80 self-help groups by forming 120 self-help groups.
Disbursement of loans
Meetings were organized pertaining to the disbursement of loans to the Self-Help Group clients and to discuss modalities of loan disbursement and the repayment. Loans were sanctioned on the basis of grading of groups. In year2003, 37 SHG groups covering 160 persons were sanctioned bank loans worth Rs. 9.5 lakhs.
The mentally retarded children have to be trained and educated right from their early age. This unit concentrates on developing the skills of mentally retarded children using the play way method of learning. The children through play therapy learn daily living skills, concept development, social interaction, behavioural modification, reading, writing, play activities with peer groups, and speech training. These efforts are concentrated to prepare the child to get into the general education stream. This unit also gives orientation training to the parents of mentally retarded children.
The play therapy unit provided services to mentally retarded children and children with multiple disorders. This unit is well equipped with various models and toys for teaching and training mentally retarded and learning disabled children. Besides toys, pictures, flash cards and charts are also used. This unit also uses visual stimulants such as TV for the education of the mentally retarded children.
Occupational Therapy is a mode of treatment provided with the use of purposeful activity for individuals who are disabled due to physical injuries or psychological and neurological deficits. Occupational Therapy is a goal-directed activity to promote persons with disabilities into independence in day-to-day functioning. Physiotherapy deals with treating patients with physical modalities like heat, cold and electricity; and various types of Exercise Therapy for accelerating the patient’s recovery from injuries and diseases which have altered his normal way of living. The different electrical modalities used in the unit are Short-Wave Diathermy (SWD), Interferential Therapy (IFT), Electrical Muscle Stimulation (EMS) and Ultra Sound Therapy. Clients with various disorders like musculo-skeletal disorders, nerve disorders, developmental and sensory disorders, cognition and psychomotor disorders, skin disorders and other injuries, mental health disorders, cerebral palsy, polio, arthritis, hemiplegic patients and amputees can make use of the facility.
Every year, generally, weekly twice medical consultation was made available from the Dept of OT & PT. This consultation included patients suffering with Cerebral Palsy, Mental Retardation, Paralysis, Arthritis, Congenital deformities, and also all kinds of Skeletal and Ligament injuries. Total benefited patients varied from year to year, including the adults, children, and aged people.
Swami Vivekananda firmly believed that “the only way of getting our divine nature manifested is by helping others to do the same. If there is inequality in nature, still there must be equal chance for all – or if greater for some and for some less – the weaker should be given more chance than the strong”.
It was in this pretext that Sri Ramakrishna Mission Vidyalaya, Coimbatore, instituted a workshop in 1992 in order to train, and thus employ, the disabled people into different activites involved in the making of a notebook. The idea behind was to bring these masses into the main stream, creatively use their services, and convert all their work into a challenge as well as an opportunity for inner growth, thus bringing much joy and fulfillment to their lives. The workshop was officially inaugurated on 2nd Oct, 1992, on the occasion of Gandhi Jayanti, with the total strength of seven workers. Over the years, several batches of the disabled lot have been trained and assisted for self employment.
Today, the workshop has the total strenght of 24 workers, with R Nagendran, R Ravichandran, C Palanisamy and V Dhandapani as the instructors of various departments. Their proud team of binders consists of G.Sundarajan, R.Selvamani(both visually impaired), K.Jeganathan, P.Moorthy, S.Mariappan, M.Maruthasalam and B.Parthiban (all blind). Crafting, paper-cutting, and pasting of notebooks is done by I. Sirajuthan and P. Dinakaran (both being deaf and dumb). They are assisted by R.Gopal, K.Srinivasan and T.Srinivasan(all suffering from hearing Impairment). Then there is a brigade of trainers as well, who work tirelessly on the thermal press to compress the books, pin them, cover them neatly and also prepare them for dispatch. This team consists of K.Boopathi, R.Parthiban, R.Saravanan and K.Manikandan (all mentally challenged).
A. Thavimani (Physically Handicapped) arranges the papers from the rim, shapes up the notebooks and gives them the final touches. He is assisted by a team of dedicated workers such as S.Sampath, E.Marimuthu and C.Venkataraman. They also assist other members, as and when required.
The notebooks prepared were sold to educational institutions in Tamil Nadu. More than 90% of the persons working in this unit are disabled. This unit has proved that disabled persons can work on par with normal persons and the quality of the notebooks is in no way inferior to those prepared by normal persons. A summary of note books prepared and sold to various institutions in and around Coimbatore is given below:
Both functional and clinical assessment of persons with visual impairment is done in this clinic. Visual Acuity test and visual field test are conducted under clinical assessment. Visual efficiency of low vision children is developed and their reading preferences are tested under functional assessment. Magnifiers necessary for children are tested and prescribed. Referral services are also made to reputed eye hospitals in Coimbatore.
The low vision clinic of the IHRDC, supported by the Asian Foundation for Prevention of Blindness, was put to optimum use to identify children with visual impairment. Screening camps to identify children with disability in different schools of the Periyanaickenpalayam and Karamadai blocks of the Coimbatore district are being conducted by the staff of IHRDC from time to time. For example in 2003, under phase one, five camps were conducted in which children with visual impairments, hearing loss and cognitive defects were identified and were referred for further action. In all, 2081 children were assessed during the course of these camps of which 69 children were found to be with defective vision, 65 children with hearing defects.
Under second phase, screening programmes were conducted on 6, 13 and 20 of November 2003 at the Panchayat Union Primary Schools of Devaiyampalayam, Naickenpalayam and Govanur respectively and the IHRDC team screened a total of 409 children. The children identified to have difficulties in visual, hearing and learning problems were brought to the centre for further therapy and intervention services.
The third phase screening was conducted on February 26, 2004 at Panchayat Union Primary School, Periya Mathampalayam to screen 95 children. Fourth phase of screening programme was conducted on March 11, 2004 at Panchayat Union Primary School, Pettathapuram in which 100 children were screened. Fifth and concluding phase of screening was conducted on March 18, 2004 at the Panchayat Union Primary School, Selvapuram in which 108 children were screened.
Moreover, every year Vidyalaya students are screened for low vision testing and suitable remedial measures are recommended. For example in 2008-09, 1352 students were screened in Low vision Unit from various institute of Vidyalaya and 74 students were identified having distance vision problem.
- The unit offers early intervention programme to children with visual impairment.
- Orientation about Visual efficiency skills, non-optical devices and optical devices were given to students of physiotherapy and social works of various colleges.
- Note (Money Identification) training is provided.
The IHRDC provides speech therapy to speech impaired students. This unit also has an Audiometer to test the hearing loss of children. By providing speech therapy and also training in Sign Language, the Centre is aiming at promoting total communication system among hearing impaired persons.
This unit provides services to hearing impaired persons suffering from hearing loss of varying intensity. The unit also distributes hearing aids to the hearing impaired patients under various government schemes or under sponsorship from philanthropic minded public.
Many young clients have been able to get admission in Integrated Education Programme after undergoing training at our center. The unit also gave speech training to children with speech, language and hearing problems.
Audiometry Testing for Students
School children and college students in and around our campus are given Audiometry testing, Speech and Hearing disability screening programmes.
Ear Mould Manufacturing Commenced
In July 2003, the IHRDC started manufacturing ear moulds for persons with hearing impairment. The unit manufactures ear moulds for both pocket-held and behind the ear type hearing aids. Apart from the regular need based services to the clients, the centre provided ear moulds to more than 600 children with hearing impairment who were identified through the SSA programme in the 22 blocks of the Coimbatore district.
The Talking Book Production unit produces audio cassettes for textbooks of various classes. These audio-cassettes are then distributed to visually impaired students all over the State on request. This unit has a hi-tech dubbing system, which can produce three duplicate cassettes from the master in less than a minute.
This unit deals with conditions like polio, cerebral palsy, amputees, hemiplegic and paraplegic patients. Orthotic is a mechanical device, which is fitted to any part of the body with the object keeping that part in the maximum possible anatomical and functional position. The different types of orthotic manufactured in this unit are HKAFO, KAFO and AFO. These orthotic are fitted to the patients depending upon their conditions and according to the doctor’s prescription. Prosthesis is to replace the lost part of the body. The different types of prostheses manufactured in this centre are above-knee, below-knee, Syme’s, above-elbow and below-elbow prostheses. Moreover, assistive devices are manufactured with conventional as well as imported prostheses. Special footwear for diabetic, heel-pain and knee-pain patients, known as the Micro Cellular Rubber (MCR) Footwear is also manufactured.
Present Prosthetic & Orthotic Facilities
The O & P Unit of the FDMSE is a modest setup capable of producing moderately good quality orthotic and prosthetic devices. Compared to its limited infrastructure, equipment and manpower, the unit has served surprisingly large number of clients and has a good reputation. The unit is housed in a small enclosure measuring 30 ft x 30 ft. The hall is partitioned using aluminium channels fixed with card board and glass panels to create following sections:
- Cabin: To store’s a files, records and intercom connectivity
- Store Room to stock materials. A working bench is fixed here to carry on lamination works, cutting P.P. sheet works, and works related to heat gun machine.
- Machine room contains a shear cutter machine, a drilling machine and a stone grinder.
- POP Section has a small pipe vice and a grinding machine to carry out modification work.
- Thermo Plastic oven: Electric oven machine is place in that room.
- Swing Machine section: Stitching works takes place.
- Workshop: One working bench with one bench vice to carry out appropriate operations takes place.
- Assistive Devices storing place: Finished O & P devices are stored in the cabin.
Activities of Orthotic and Prosthetic Unit
The O & P Unit is rendering its services to variety of clients mainly under following three categories:
I: Services under Sarva Siksha Abhiyan – a Central Govt. Initiative
The Sarva Shiksha Abhiyan (SSA) is a national movement aimed at ‘Education for All’ including the children with disabilities. Ramakrishna Mission Vidyalaya is the nodal agency for implementing the SSA programme in Coimbatore and The Nilgiris districts. In Coimbatore districts the scheme is implemented through 22 blocks and the Nilgiris District has four blocks.
The SSA activities are confined to school going children (up to class XII) providing them variety of facilities. In order to serve the disabled children, the special educators visit all the in-school children to find out the educational needs, aids and appliances required by them etc. They also conduct survey to identify the out of school children and prepare a detailed assessment plan regarding the assistive devices required. Mostly disabled persons need Braille slates, Abacus, Taylor Frame, and Mobility Cane. Requirements of orthotic and Prosthetic devices are passed on to our O & S unit. Mostly orthopedically challenged children need tricycles, wheel chairs, calipers, special shoes, crutches and splints. As per the requirement of each child in the blocks, detailed measurements are made and our team manufactures the items or purchases some complements from reputed agencies and finished products are distributed in the children.
Regular camps are also conducted with assistance from ENT specialists, ophthalmologists, orthotists, psychiatrists, pediatricians and audiologists apart from the village administrative officers, tashildars and revenue inspectors. The children are assessed and details of their requirement is passed on to our O & P Unit.
II: Services under Vazhndhu Kattuvom Project – a State Govt. Initiative
The slogan ‘vazhndhu kattuvom’ embedded in the project name Vazhndhu Kattuvom Project (VKP) has meaning ‘We will grow and show’. The project is mainly designed to benefit disabled people not covered under the SSA Scheme. Whereas the SSA services are restricted only to school children, the VKP is designed to serve all categories. Mode of assessment for both the projects is quite similar in nature. At present prosthetic and orthotic devices are distributed under the VKP scheme in four blocks in Coimbatore district for distributing. The blocks are Kongalnagarm, Gudimangalam, Thondamuthur and Palladam. Plan for extending the services in different districts are underway.
III: Consultancy Services to Individual Paitents
Few patients opt for specifically designed and better orthotic and prosthetic devices otherwise not available under either the SSA or VKP projects. The number is quite small because our unit does not have adequate infrastructure and equipment to serve these patient with high quality stuff.
At a glance statement of services provided by our Orthotic and Prosthetic unit is given below:
Case Study of a Client
Thangaraj, aged 8 years had congenital absence of right lower limb. He has got good muscle power in both limbs. Parents were worried about his mobility. They took him to a number of rehabilitation centres and hospitals, but in vain. Finally he was referred to IHRDC for fitting of prosthesis. He was fitted with a BK prosthesis with suspension system. After fitting the prosthesis the parents were taught about walking, training and wearing techniques so as to assist the child. Now his parents are relieved to a large extent, as the child has become independent in mobility.