Page 10 P H Y S I O T H E R A P Y D ECEM B ER, 1972 BUTTERWORTH HOSPITAL TRANSKEI S. M. SIGABA, Physiotherapist The Butterworth Hospital is a general hospital which was transferred from the Cape Provincial Administration to the Department o f Health since the 1st April, 1970. The hospital is in a small but fast developing town with all the major industries o f the Transkei and is 62 miles from East London and 74 miles from Umtata. There are 150 beds for Bantu and 30 for Europeans with five European doctors including the superintendent, about ten European nurses, 40 Bantu nurses and two physio­ therapists, a part-time European lady and a full-time male Bantu. Types o f Patients Treated As this is a general hospital, we usually get a cross-section o f patients in this type o f hospital although the numbers are limited. For instance the most common are head injuries due to faction fights, especially with ages o f 20 to 30 years. These cases present themselves in the forms of contusions o f brain, hemiplegias, hemiparesis and a very limited number o f paraparesis. One funny thing to remark about was the response we get from wax treatments in arms o f these patients. This I was taught by a member o f the physiotherapy staff. But most o f them gain some beneficial results. The second most common is the tuberculosis group such as hips, knees, spine and meningitis. I believe this is the most troublesome disease in the Transkei which, I believe, needs some more radical health education. This is more common with children. Then comes the osteitis group. This condition is common in children. These patients stay for a long time in hospital. We rarely get “chest” patients except for lung abscesses and broncho-pneumonias. Funnily enough, even fractures are not so commonly treated by physiotherapy as most doctors here treat them with “K ” nails or P.O.P. and they are sent home. Most o f the out-patients are European and the main conditions treated are sinusitis, torticollis, fibrositis and lumbago. Equipment For a small department we are well equipped with most o f the apparatus found in physiotherapy departments. Supply of Appliances We get our appliances from an orthopaedic workshop in East London. The service from that hospital is slow, therefore one o f the staff has taught a patient how to make some o f the splints, e.g. toe springs from rubber and leather. Some Improvisations Whilst we are waiting we make some splints from plaster o f paris, leather and rubber. A member o f the staff has initiated disability grants for permanently disabled patients and wheelchairs are obtained by the physiotherapists through the local magistrate. An orthopaedic home for such people has been built five miles from Umtata. So one o f the hospital staff negotiated for these patients to be transferred. At the moment we have three, one child, two males, a paraplegic (due to tubercu­ losis spine at D 5 + 6), the other one is an above-knee bilateral amputations due to thrombo-phlebitis. The child is a traumatic paraplegia and she was knocked down by a car. Things I Have Learned 1. In this hospital we keep yellow cards in the wards and surgeries o f local doctors. These requisitions are sent down to the department and we write out a treatment card which we file in our office. We also keep a register which is marked daily and at the end o f the month we total the number o f patients and treatments and these are sent to the administration office. For instance, in 1970, we had about 843 patients and gave 1 043 treatments to these people. 2. Also I learned a lot from Professor R ood’s lectures on brushing and vibrations in neuro-physiotherapy and ice in speech o f head injured patients. This we followed with success. 3. In addition, I have charge of the department and its administration when the physiotherapist in charge, a European lady, is away. We are assisted by a clerk and a porter. REPORT ON THE 1972 PARA-OLYMPICS IN HEIDELBERG BOB WENHAM Chairman, S. Tvl. Paraplegic Games Association Munich, where the Olympics proper have been staged, declined to have the Olympics for Paraplegics and the small and beautiful town o f Heidelberg accepted the responsibility. This was not very astonishing as Heidelberg is well known for the work it has done in the past and is going to do in the future, namely to train handicapped people to become, again, useful members o f society. Large buses, borrowed from the American Army, fetched us from the airport. They had doors at the back and on long ramps the wheelchairs entered the buses without any difficulty, pushed by German soldiers who had been detailed to do all the heavy work for their foreign guests. The same buses took the competitors and escorts from our billets to the sports grounds and back. Our home for the duration o f the Games (10 days) was a brand new Rehabilitation Centre which had all the facilities needed by people in wheel chairs. It has special lifts made for two chairs, one behind the other and enough room for two to three escorts. Meals were taken in a large dining room where 1 000 hungry sportsmen and women could be served within an hour. Escorts helped themselves, com­ petitors were served. There was a large variety o f dishes to( choose from and special requests were always satisfied. The sport took place on the university grounds, where the facilities for all the sports were excellent, a few miles from the Rehabilitation Centre. We had brought a team of 22,11 men and 11 women, the biggest team ever to compete overseas. The classifications o f all competitors were checked by a panel o f experts. Our team suffered six reclassifications, all upgraded, which gave the six unfortunates no chance to get among the medals. However, with the rest o f the team, we achieved to gain 16 Gold, 11 Silver and 14 Bronze medals and another seven in relays. This can be considered an outstanding performance. Twenty-two teams were larger than ours and the three teams who gained more medals, the Americans, Germans and British, had a minimum o f 65 members. In all, 43 nations had sent competitors to these Games. (In 1968 only 26 nations were represented, which shows the tremendous increase in sport from the wheel chair, all over the world.) Our representatives were chosen from old-timers who had covered themselves with glory in the past and did so again. I refer to Margaret Harriman, Ester Hattingh, Serina le Roux, Hannie van der Merwe, Jan van Rensburg, Dame Erasmus, Willy Bosch. Among the newcomers, Riana van der Schyff, Coreen Swanepoel and Marty Schaefer, Mark van der R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) Riet, Willy Kokott and Richard Holmes were outstanding a n d can look forward to compete for their country again if they continue in the same spirit. W e won all our medals in archery, field events, swimming and bowling. I n the races and slalom we just did not exist. Our basket ball team had not been accepted (the organisers allowed us only 22 athletes), our table tennis players were o u t c l a s s e d and we did not take part in fencing and snooker a n d had only one man in the weight lifting competition. Some o f the large teams mentioned above had experts in e a c h field and in each class. The Rehabilitation Centre had a cafe and a couple o f s m a l l e r bars where the Nations sat together in the evenings a n d talked and sang and got to know each other. I heard o f no disagreement or any trouble amongst the teams and politics, fortunately, were never mentioned. We got on just as well with the Czechs and the Yugoslavs as we did with the British or Canadians. The stamina o f the paraplegics has always astonished me and did so again in Heidelberg. After a day’s hard com­ petition they would be up until midnight or even later, but 'were up again at 6.30 a.m. and fresh and ready to face the new day. I must admit, however, that they showed signs o f stress later on, when we were on the road from Heidelberg to Lucerne, Milan, Florence, Rome, Pisa, Rapallo, Nice, Lyon and Paris. This, however, was a matter o f circumstances which could not be avoided. The blame must be put squarely on the shoulders o f the travel agency which provided us with the wrong bus to start with and booked us into hotels totally unsuitable for people in wheel chairs. T oo many steps, lifts that were not large enough, lavatories which could not be entered. We have learned a lesson. The highlight o f the journey was certainly the visit to Mount Pilatus near Lucerne. It was a job to get 11 o f the team in wheel chairs up and down. But to see their faces and to witness their joy made everyone forget the effort that had to be made. And here I must mention the escorts, especially four of them who should have been given the biggest gold medals available for the hard work they had to do all along the road. Mr. Johann Maree, Chairman o f the Free State P.F.A., Mr. Eddy Cummins, Chairman o f the Natal P.G.A., Mr. Jan Botha from the Cape and Mr. Kobus de Jager from the Transvaal. South African Airways had put two nurses at the disposal of the team who flew with us from Johannesburg to Frankfurt and from Paris home again. Their attention to the needs of our team was much appreciated. An official o f S.A.A. also icame along to study ways and means to make air travel and bus excursions for handicapped people as agreeable as possible. It is sincerely hoped that the lessons learned on this long journey are not forgotten. DECEMBER, 1972 A REHABILITATION CENTRE WITH ACCOMM ODATION FOR FAMILIES AGNES W ENHAM , M.C.S.P. . When I accompanied my husband to the Para-Olympics ■n Germany this year I met Mr. Hans Reinemuth, one o f the organisers o f the brand new Rehabilitation Centre in Heidelberg. It was interesting what he had to say about the Project o f a still newer Centre for the Rehabilitation o f Children and Young Adults to be built in Neckargemund, near Heidelberg (Germany), in the near future. It will serve as a mode} for the housing, upbringing, complete schooling and vocational training o f severely handicapped children. Th6 ~?ousand ° f them on an area o f eight hectares (19 acres). . e Centre will enable the parents o f some children to live ,n ,sm^ l flats or houses as complete families. The father is neiped to find a jo b in the nearby industrial towns whilst the ther is given a chance to work in the Centre if she wishes Page 11 to do more than look after her home. In this way it will be possible to preserve for some children the warmth and the emotional and intelectual stimulation of a life with father, mother, brother and sister. This is expected to enhance the effect o f the thorough rehabilitating measures and varied vocational opportunities offered by the Centre. Facilities for all sports for the disabled are planned together with many other recreational opportunities. I got a glimpse o f what is meant by recreational opportunities at the existing Rehabilitation and Training Centre which served so admirably as “Olympic Village” for the 1,000 wheel-chair competitors from all over the world in August, 1972. There they meant, to mention only one out-door facility, imagina­ tive play corners for children and peaceful green places for walking, resting or quiet meditation for young adults. To discover these places at the Rehabilitation Centre you had to venture well into the back o f the flower garden that stretched along our canteen and invited you to have your cup o f tea on comfortable chairs in the open. Only by follow­ ing, one day, a narrow path through the flowering bushes did I discover that there was a complete little world o f open- air pursuits beyond the bushes along the garden. One green opening followed the next, each ingeniously layed out for the enjoyment o f various forms o f play. Under the trees o f a shaded circle stood a log house. The good-sized door was half closed by planks which lay about outside and inside the house and served for the improvisation o f furniture. Across the little lawn in front o f the house began a mountainous world o f poles and tree trunks. There the children could climb to various platforms. From one of the higher elevations led a wooden bridge into another green opening where everything invited the child to play with sand. Light sand lay thick in the bottom o f a shallow ship or it was contained in higher receptacles for the sand activities o f individual children. A gap between wooden poles led to a winding path between small trees, bushes and groups o f wild flowers just wide enough for two people to amble along. To my delight, the path lead you to several openings on the left and the right varying in size and character. Here people could rest in small or larger groups or all alone. Walking on I began to wonder where the path would eventually lead to. I soon found the end in the form o f a somewhat hidden wooden barrier you could easily go over or under. Beyond the obstacle I found myself near the entrance to the whole centre. Nobody could have guessed what idyllic grounds lay behind just a pole. ABSTRACTS FOR THIRD QUARTER, 1972 Exp. Brain Res., 15, 2, July, 1972: I s h i k a w a , K . , K a w a g u c h i , S., and R o w e , M. J .: Actions o f afferent impulses from muscle receptors on cerebellar Purkyne cells, I : Responses to muscle vibration. Summary: The authors used vibratory muscle stimuli in order to stimulate selectively muscle receptors in three different muscle groups: the anterior tibial group, the triceps surae and the extensor group o f the forearm. Since very little response was obtained at vibration amplitudes o f less than 60. n it was concluded that Group II afferent fibres, rather than Group la, were primarily responsible for modify­ ing the Purkyne cell discharge. The modifying effect in response to vibration was observed to be mediated by both mossy fibre and climbing fibre pathways, and in both cases displayed temporal summation although no tonic effects were observed in response to sustained vibration. Where the response o f the Purkyne cells was mediated by mossy fibres that response was chiefly inhibitory, although sometimes preceded by a brief burst o f excitation. The response mediated by the climbing fibres was excitatory in nature. The area o f the cerebellum which responded, depended upon whether a forelimb or hindlimb group, was being stimulated. S.I-C. P H Y S I O T H E R A P Y R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. )