Week Nine & Ten

We are now already 10 weeks in Kimilili, we still have one week to go before our vacation!

The last two weeks we mainly worked at Dreamland on the tricycles. We had to improve some things on the first tricycle. We also started building the second tricycle, and this went much faster than the first one. This time we already knew exact how to make all the different parts. We invited the persons for who we are making the tricycles to Dreamland. So they could test it and we could see if all the sizes were fitting. On Monday Emily Rose tested the tricycle; she is a girl of 16 years old and can’t use her legs because of polio. She only comes out of her house when she goes to church on Sunday. With the tricycle she can get out mores, she would like to go to the market. Because she is not fully-grown the tricycle is a bit too big for her, but with some small adaptations it will fit much better. A few days later Geoffrey, a man of 30 years, came to Dreamland to have a test ride in the tricycle. He fitted pretty well in the first tricycle we built; only the steer is a bit too wide, but this is easily to adapt. He already could drive pretty fast!

In the following days we carried on building the tricycles, making it fit better for Emily and Geoffrey and making the drive smoother. Both steers are now smaller. We also changed the frame of the wheelchair. The part where the armrests are- we cut away. Instead of that we placed a diagonal tube, so it wouldn’t be an obstruction during driving. We also made a better brake.

Last Friday at the end of the day we took all our tools to the guesthouse. We had to do a few small things to finish the tricycles so we could bring them to the painter on Saturday. Friday evening and Saturday morning we did the finishing touch and in the afternoon we finally could bring them to the painter! Next Monday they are ready.

Last weekend we went to Kisumu, we stayed at the Sunset Hotel. From our balconies we had a splendid view on Lake Victoria! Like the name of the hotel already says, the sunset was beautiful! We also saw the city Kisumu, which was a nice place. On Sunday we went back to Kimilili by matatu, we were packed with our luggage, six tilapia filet and two blue boxes. We bought the fish for some people in Kimilili and the boxes are for the tricycles, so they can take stuff with them.

Last week, Roel and Marianne arrived. These are two very kind Dutch people. We met them one time in Holland, and they told us some things about Kimilili. They run a foundation for school projects in this area.

Thursday we bought a lamb at the market, he’s called Larilam. Next week we have a barbecue as farewell party and than we are going to eat it. Who’s going to slaughter it, we don’t know yet, but it will probably be Mark. In the next week, the last already, we are going to work on our presentation, manual and report.

Week Eight

Finally we finished the building of the first tricycle. But there is still a big job to do. We thought that we could finish the tricycle on Monday. This was unfortunate but it wasn’t possible, again. But Tuesday in the afternoon the last thing to finish were the brakes. Because we had enough of building we finished the brakes but were not very nice.

We want to test the tricycle, so we took the tricycle to the head office. During the ride we noticeyou hve to be very strong to drive the tricycle and also the stability was not very high. Caspar was driving back and he had to avoid a goat so he drove into a gulley. That was a really test for the tricycle. The frame was not broken, but the wheels didn’t work any more. This was because someone from the village did not do a good job with the spokes of the entire wheel. After this happening we had to buy two new wheels.

Wednesday we tested the tricycle the whole day. We have written a testing protocol. This protocol will be used before improving the first tricycle so we can see what we have to change to the tricycle. And also the testing protocol will also be used after the improving of the tricycle so we can see whether the improvements were good enough. The following points are the main negative points of the testing protocol. The tricycle was not stable enough, the drive is very heavy and the brakes are bad. These are the things we want to change next week. We have also a few other things to do to finalise the tricycle, like installing mudguards, brakes which can be used when the tricycle is standing still and been painting.

So Wednesday till Friday we were busy with the testing protocol. In the same time we wrote a manual for building the tricycle. In the manual we gave a description of every part of the tricycle, the prices and how you get the parts. For example we use a bicycle for the parts. But you have to cut the bicycle to make pieces useful for the tricycle. Finally the manual describes how to fit the parts to each other and how you can fit them together. We hope that IcFEM can use this manual to continue with building of tricycles and to improve them in the future.

Week 7 Working with IcFEM

In this week we started with building of the handbike. Our objective for the handbike is that it’s adaptable to the area of Mount Elgon and also for other area’s in Kenya. The second goal is making the handbike of fewer and cheaper materials as possible. A must is that the materials are available in this area. This makes it possible for the user when something is broken, that they can repair it easily.

We thought that we could finish the handbike in one week, but we didn’t. There where a lot of difficult things. Like the drive is very difficult to make. This part of the handbike takes a lot of time to make. Also with fewer tools, it makes it very hard to make things fast and easy. It means that you have to search for alternatives for some solutions because you don’t have the tools to make it like the way you would like. But the handbike is almost finished. Only the drive needs to be finished. After that the handbike get a painting color to protect them against the weather and for the look. The painting will be done by someone in town.

In the same time that we worked at the handbike we wrote a manual about how we are making this handbike. We make a description of every part we fit together. With pictures and text we hope that we can give a clear mind about building the handbike.

Next week we will finish the first handbike and completely evaluate the handbike. After that we write our manual and than we will start with building of the second one.

Week Six

Monday the 10th of September we worked at the IcFEM head quarters on our documentation for the wheelchair project. We did some analyse and drew three drafts with our initial ideas. It’s very important to have more ideas for the wheelchair, you can choose the best parts of each of the designs and think of different solutions.

Tuesday morning we and Leonard Wanjala did some field research of the disabled who have a wheelchair. We did some interviews and took some pictures of there wheelchair and completed a moving analyseThe first person we visit was a woman who got a wheelchair from IcFEM five years ago. She was really dependant of here wheelchair. It was nice to talk with her about here application of a wheelchair.

The second person we met was a guy who had a wheelchair, a tricycle and an adaptable car who he could use with his hands. He had a serebral pausy.

It was very useful to talk with him because he knew a lot about wheelchairs and he had also had good ideas for us. In the afternoon we visit Christine, she is spasmatic and has really heavy spasm and she only can lay an is incontinent. We visited her because two years ago two guys from our course did a project for her. They realised a horizontal lay wheelchair for her would give her the opportunity to move. It was good to see that the wheelchair was in a good condition after two years. We also visited some children from the field research of the two guys.

Wednesday we were invited to join the IcFEM staff for the celebration of the launching of the fellowship unit. There were a lot of people. We listened to some speeches and did a lot of praying. It was nice to see some things that IcFEM does in the districts. And we hope the new fellowship unit will be a success like the other fellowship unit the Mission has set up.

Thursday we went with Leonard Wanjala to Bumgoma to visit the Ministry of Health.
We visited their orthopedic workplace and talked about working together with IcFEM because they have a lot in common with IcFEM. In the afternoon we visited the District Hospital of Kimilili. We spoke with the director and the fysiotherapist and saw the workplace and some other departments. We also visited the Rotery Doctors from the Netherland who were based in the Hospital.

Friday we started with building our trycecle and helped Alex with making plaster works.

Trip to Kijabe and Nairobi- Week Five

Tuesday morning we left at 7:00am from Kimilili bus stop to travel to Kijabe. Leonard Wanjala was our company. In Kijabe we want to visit a hospital and an orthopedic workshop.
After a bus trip of 11 hours we arrived in Kijabe, the journey took that long because the rood was very bad and we waited more than 2 hours because of a traffic-jaw. At 18:30 we arrived at the Hospital of Kijabe. We had a dinner and slept in a guesthouse that was part of the hospital. In the morning we visited the orthopedic workshop and got a conducted tour and spoke with the employee’s. It was very nice to see the methodical and the working system, and to see the careful. There was a quality workshop with very good tools and materials.

At noon we left Kijabe by matatu and went to Nairobi. In Nairobi we wanted to do some research for the wheelchair project. After an hour traveling we arrived in Nairobi. We checked in at the YMCA hotel in Nairobi-city and we went for a tour in Nairobi. The next morning Alex Juma joints us. Alex graduated this summer his course orthopedic technology at the University of Nairobi. After breakfast we went to see the orthopedic workshop of the hospital of Nairobi. He is the right person to show use. We went for a tour and saw the work they do there. After the tour we went to the Kenya Medical Training Centre to see the course of Alex and see the educating system and the workplace. They have a lot of materials and developed tools. It’s a high quality workshop.

At noon we went by bus to go to APDK, this is an orthopedic company with a lot of products and cares for disabled people. We saw the orthopedic workshop were they do measuring and plastering and were they make braces and shoes. We went also to their wheelchair factory; it is the biggest in Kenya. They make tricycles and crutches and have a shop were you could buy products. They make crutches from reduced materials. APDK works with a very good system to produce the tricycles, the take care about their product.

At APDK there is also an orthopedic centrum with departments for physiotherapy, occupational therapy, and also a orthopedic workshop.

On Friday we traveled back to Kimilili. It was nice to see another part of Kenya and we also learned a lot of the things we saw in Kijabe and Nairobi.

Next week we’re going to finish the designing of the tricycle and start building it.

Week Four

On Monday we went with the four of us to Dreamland to get further with our handbike project and to help Alex. Alex is making some orthesis for some patients. Marleen and Eelke were assisting Alex en Merel and Caspar were thinking about the design of the handbike. When we were lunching, we were thinking about our internship, about the supervision from IcFEM and our projects. After a discussion with the four of us, we concluded that the supervision was not what we have thought before. We have decided to make an appointment with the director Mister Solomon on Tuesday.

In the morning when we arrived at the Office, there were a couple of patients waiting for us. The patients that we met before at the Fieldresearch. They came this day to Kimilili so we can do the measurements for their orthesis, calipers or corsets. But before we started with the measurements, we had a talk with Solomon, Leonard, Tatwa, Patrick and Matthew about our internship. Solomon told us that we have to make a new program for the remaining weeks of our internship and to set up our goals that we want to reach this internship. He told us also he wanted us visit Nairobi and that we can see the wheelchair factory from APDK. It was a very useful talk.

After the measurements, Caspar and Eelke went to Dreamland with Alex and some patients. In Dreamland they plastered some patients, so we can start with making the orthesis and corsets. Merel and Marleen stayed at the Guesthouse and made the new program and the goals.

On Wednesday we went with Loenard to Kitale Hospital. Once in two months, people who need surgery or treatment went to Kitale Hospital, so they could be booked for surgery or treatment. That was also this day. Leonard was supporting his friend from Kijabe to book all the people for surgery or treatment. Some of the nurses from the Hospital showed us the hospital. We thought it was a very beautiful Hospital, but it was a little bit old and dirty.

On Thursday Caspar and Merel went to Dreamland and Marleen and Eelke stayed at the Office to get further with the handbike report. There was nobody in the workshop of Dreamland, so Caspar and Merel couldn’t do much. After making drawings of the bicycle parts which we can use for the handbike, they went back to the Office to support Marleen and Eelke. At the Office was a guy with a handbike who was training for the Paralympics. We made pictures of his handbike, so we get a clear view of the existing handbikes.

We also give our new program to Patrick and Tatwa.

On Friday we stayed with the four of us at the Office. We have finished a very important part of the analysis of our handbike report.
In the afternoon we had a talk with Patrick and Tatwa about our new program. They were very positive about it. We were going over the whole program, so we could make appointments with the people we need and we know how much money we need for the activities.

It was a nice week, because we have made a new program for our internship. Now we have got a clear view of our remaining weeks and everybody knows what we are gonna do.

Introduction Field Research- Week Three

Field research means searching for people with disabilities in the district around Kimilili. On the 20th and the 21th of August we went to 6 schools were all the disabled people came together. With 3 people (two of us and Leonard or Alex) we were doing diagnose of the people. We write some information down about the patients, like name, age, gender, occupation, status, residence, address, telephone number, medical history, diagnose and treatment. We also make pictures form the patient, one portrait and some pictures of their disabilities. So after that we can make a database of all the patients in the district. We know which problems there are and how we can help. It’s also very handy for Loenard, Jackim and Alex when we are left. It’s also very handy for IcFEM, so they know the problems in the district.

On Monday the 20th we left in the morning to our first school, after 15 minutes driving we arrived. We first had an introduction to the staff of the school. After that we met the patients who already were waiting outside. There were 10 patients with several kinds of disabilities. We split them in two groups and Marleen and Eelke had 5 patients and Merel and Caspar had 5 patients. Some patients we sent to surgery and some we asked to meet with us at DMCC the next week. After we finished the last patient we set off to the second school. It was about a 20 minutes drive. There were around 30 patients with all kind of disabilities and diseases. We didn’t now that we had to make a diagnosis of people with normal diseases, like deaf problem or sightless. It was difficult to say to them that we couldn’t help them. IcFEM can help them but we don’t have the knowledge for those problems. Out of the 30 we made a diagnosis for 15 patients and also some of them had to have first, surgery and afterwards we can help them with prostheses or ortheses.

The last school we visit there were no patients because our visit wasn’t very well arranged. Some people came because they saw our vehicle but they were patients with normal diseases.

The next morning we left early in the morning by matatu and boda boda to go to the first school of the day. Also there were very many people but only a few we could help because of their disabilities. We had the same problem with the second and the third school. At the third school we found two people who wanted a tricycle, so we can help them because of the tricycle project.

On Wednesday we worked out the information of the Monday and Tuesday. We made a database and give it to IcFEM. We also worked on the tricycle document. On Thursday and Friday we went to DMCC to help Alex with some braces and plaster work. We also welded some other stuff and did some regular work.

It was a nice week but we also saw the bad side off the orthopedic work we do. It’s not nice to say to people that we couldn’t help them because we are not doctors. It’s very good for students like us to meet with very disabled people.