Khethiwe COVID-19 Strategy

Khethiwe provides rehabilitation to children with neurological impairment, mainly Cerebral Palsy. The majority of the children we see are severely affected by their CP, and those children are particularly at risk of contracting the virus. The greater majority of our clients also depend solely on public transport in order to access our services. Khethiwe therefore closed early for client visits

As our children are amongst the most vulnerable in society, we have had to take a long hard look at how we can possibly run Khethiwe’s services over the next 4-6 months. This needs to be done bearing in mind the risk of infection and exposure to our children as well as the further financial pressures on the families.

The majority of our children travel to Khethiwe on public transport. Despite the measure being taken to take Taxi’s safer, we perceive the risk of exposure to the children and their mums to be significant. Before we re-open for clients, there needs to be an acceptable strategy in place which ascribes to the WHO Guidelines.

During the lockdown, we have kept in contact with mothers via whatsApp groups, sms’s for those who don’t have and phone calls for the most isolated.

Following the WHO guidelines:

The WHO Guidelines for Health Workers include the following during the out-break:

  • Ensure that information about the accessibility of COVID-19 health services is disseminated to people with disability and their caregivers.
  • Deliver information in understandable and diverse formats to suit different needs. Do not rely solely on either verbal or written information, and adopt ways to communicate that are understandable to people with intellectual, cognitive and psychosocial impairments.

Khethiwe has been in contact with our families on alternate days since we closed, just before the lockdown. It has not been possible to use Zoom or other video technology due to the high cost of data in South Africa. We have been able to share extensive relevant information via social media, sms and in some cases, calls. We have shared information on the virus, on hygiene and prevention, on social grants and have registered as an organisation who has the potential to distribute food-parcels. We have also been able to dispel myths and correct information at times. We have provided information on accessing emergency services, hotline telephone numbers.
We have done much in the way of encouragement and support, even some counselling as the parents are acutely anxious at this time. We have also provided advice on routines and coping and have been able to pass on numerous resources on home activities. We have sent out advice on positioning the children at home, on keeping up with their home exercises and have also made and shared videos on treatment for the Mums to do at home, using the songs we use at Khethiwe.

Looking to the future

Khethiwe as a small NGO does not have the resources to be entirely home-based. However between those who can come in to Khethiwe without using public transport and those who live in areas where we can see more than two children on a day either at home or at central locations, we do see this as an option in the short term. The would provide some intervention for the majority of the children.
Currently, the support we have already been offering is also in accordance with the WHO guidelines:

  1. Deliver telehealth for people with disability
    Provide telephone consultations, text messaging and video calling for the delivery of health care and psychosocial support for people with disability. This may be for their general health, and include rehabilitation needs.
  2. Communicate frequently with people with disability and their support networks Provide additional targeted information on COVID-19, highlighting information relevant to people with disability and their support networks. This may include information on continuity plans; telehealth and hotline phone numbers; locations of accessible health services; and locations where hand sanitizer or sterilizing equipment can be accessed when their supplies are low, or in situations where they may be required to self-isolate.
     Use a variety of communication platforms such phone calls, text and social media to share information, and convert existing information to accessible formats where necessary.
  3. Reduce potential exposure to COVID-19 during provision of disability services in the community
  • Provide training, and rapidly upskill the disability care workforce regarding infection
  • Ensure that disability caregivers and service providers have access to personal protective equipment including masks, gloves and hand sanitizers; consider increasing orders of these products.
  • Deliver appropriate disability services through home-based consultation or through similar platforms as used in telehealth.
  • Deliver home-based consultations for people with disability, including for their general health needs and, where appropriate, for COVID-19 related needs

Current perspective

In addition to all the measures described above, one of our staff members has created videos of the generic Khethiwe exercises to music with her children which we have been able to distribute to mothers. We have encouraged them to develop a time to do exercises as well on a daily basis.
Khethiwe has shared several ideas for making masks on these forums as well as advice on their use and the government stipulations. We have obtained 3 layered re-usable cloth masks for each of our mothers and children (those who can tolerate them!), and certified hand sanitiser, 1 bottle per household, which we will distribute to the mothers for their own use.

Model for Covid Outreach

Khethiwe will see clients who are able to get in on Mondays, and Thursdays. On Tuesdays and Wednesdays we will visit children at home or at local point close to their homes. The visits will be to do therapy and re-enforce home programs. All visits will be done using personal protective measures, masks and hand sanitisers. Children will not be seen if either they or the rehab staff have any signs of a respiratory tract infection, or have a history of direct exposure to the virus. This is bearing in mind that we potentially all have indirect exposure to the virus.

Once the Outreach Centres re-open we will drop off masks and hand sanitiser but not work with the learners. As the preparation has essentially already been done, we are in a position to leave tasks for the staff to do for at least two months and to extend that if necessary. As these learners come from different areas, we feel the risk of exposing us and therefore our more frail clients would be too great. If we work with the learners. We presume we are only talking about a few months here.

At a Level 2 stage we will recommence Outreach visits, and still add home visits to the visits.
Horse riding will not commence at all during the outbreak, the risks are just too great with volunteers coming from different areas. Once we reach Level 1 we will review the whole process of client visits as the whole ethos of Khethiwe is based around contact with other families and getting out with their children to the Khethiwe home environment.
At each stage we will review what we are doing and how we are doing it.
May God bless and protect us all.

Glenys Ross 5 May 2020