January- 1955. P H Y S I O T H E R A P Y Page Five An O u tl ine of the History of th e National Council for th e Care of Cripples in South Africa. B y P H Y L L I S L E A C H . r ORD N UFFIE LD in 1937 made a gift to South Africa \ j of £100,000 to stimulate the interest o f provincial and Union Government departments as well as public and m-ivate bodies into the realisation o f the urgent needs of the cripples in this country. So after an initial survey by his representatives, it was realized that such a large sum of money had to be judiciously directed into the right channels, and wisely spent, and that a co-ordinating and advisory body was required. At that time there was only a small active Cripple Care Association in the Cape and a voluntary body in the Free State, and the Johannesburg Committees o f the Hope Homes in the Transvaal. The Cripple Care Association o f the Cape Province agreed to call a conference o f interested bodies, persons and depart ments in Cape Town in 1939 which resulted in the birth of the National Council for the Care of Cripples in South Africa, in Bloemfontein in September o f that year. The following are the aims and the objects o f the Council: 1. To ensure a national service for cripples. 2 To co-ordinate and correlate the work of the different Associations, departments and institutions engaged or intersted in this work. 3 To encourage associations already undertaking the care o f cripples and assist in forming new associations when and where necessary. 4. To formulate policies and to promote and support measures for the early discovery and the prompt and efficient treatment o f children and others who might become cripples. To promote schemes, for the treatment, education, training and employment and general welfare o f cripples. To be the official channel for communication in matters o f general policy between constituent bodies, the Government and Provincial authorities. To act as an advisory body on all matters appertaining to the care of cripples. To co-operate with the international organisations whose aims are similar to those o f the Council, and, if deemed advisable, to affiliate with such organisations. Generally to concern itself with all matters and questions relating to the care o f cripples, and the prevention o f cripples throughout the Union, South-West Africa, Basutoland, Bechuanaland Protectorate and Swaziland. When Council was created there were only 3 orthopaedic surgeons in the Union. There were no nurses trained in orthopaedics and scarcely any qualified orthopaedic tech nicians. How different things are to-day! There are now well on 50 qualified orthopaedic surgeons while a number are still 6. 7. 8 9. For the relief of Osteoarthritis Recent reports suggest that increased use is being made o f local ultra-violet irradiation in rheumatic diseases, and in the words o f one writer “It is unusual for a patient suffering from osteoarthritis to fail to obtain relief from a course o f local ultra-violet irradiations follow ed by suitable exercises.” Power ful doses are necessary and the use o f the Kromayer lamp is therefore indicated. Full d eta ils o f this equ ipm ent can be o b ta in ed f r o m : THE B R I T I S H GE NERAL ELE CT RI C CO. L TD . Magnet House, Corner of Loveday and Anderson Streets, Johannesburg. Branches at Durban, Cape Town, Natal. Agents for HANOVIA OF ENG LAND. M 2 1 3 / 6 1 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. ) Page Six P H Y S I O T H E R A P Y January, 1955. in t r a i n i n g ; s o m e 40 n u r se s h a v e been p r o v i d e d wi th o r t h o p a e d i c t r a i n i n g in th e U-mon a n d s o m e h a v e been s e n t o v e r s e a s , a n d a s we all k n o w , t e c h n i c i a n s a r e n o w very m u c h o n th e j o b . T h e C o u n c i l pl ays t h e m a j o r role in c o - o r d i n a t i n g t h e o r t h o p a e d i c se rvices in t h e U n i o n a n d S o u t h Wes t A f r i c a w hi ch i n cl u de s t h e m a t t e r o f p e r s o n n e l a n d th e ph y sic al , p s y c h o l o g ic a l a n d e c o n o m i c r e h a b i l i t a t i o n o f t h e h a n d i c a p p e d — a n d t h e h a b i t a t i o n o f c h i l d r e n . T h e N a t i o n a l C o u n c i l h a s h elp ed t o i n t r o d u c e o r su b s i d i z e a l m o s t ever y a s p e c t o f o r t h o p a e d i c w o r k . It h a s p r o v i d e d b u r s a r i e s for p o s t g r a d u a t e s t u d i e s in m a n y b r a n c h e s , i n c l u d i n g o n e f o r a p h y s i o t h e r a p i s t . T h e C o u n c i l b r o u g h t sist er t u t o r s f r o m o v e r s e a s to tr ai n n u r s e s in o r t h o p a e d i c w o r k . T h e r e a r e a fairly full r a n g e o f o r t h o p a e d i c services in all o u r cities a n d la r ge r t o w n s , a n d C o u n c i l w i t h its local C r i p p l e C a r e A s s o c i a t i o n s h a s s u c ce ed ed in o r g a n i s i n g a n d s u b s i d i z i n g c e r t a i n a s p e c t s o f cli ni cal se rvices wh ich a r e n o w e x t e n d i n g i n t o th e l u r a l d i s t r i c t s : t h e first o n e w as o p e n e d at W o l m a r a n s t a d in t h e S o u t h e r n T r a n s v a a l in 1950— o t h e r s h a v e f o llo w ed b o t h in t h e T r a n s v a a l a n d o t h e r P ro vi nc es. It is t h e e a r n e s t a i m o f t h e N a t i o n a l C o u n c i l t o link up th e s e c e n t r e s in a v e r i t a b l e n e t w o r k t h a t s p r e a d s t h r o u g h t h e l eng th a n d b r e a d t h o f t h e l a n d w h e r e n e e d e d so t h a t ever y di sa b le d m a n , w o m a n o r child w h o c a n be h elp ed t h r o u g h o r t h o p a e d i c s m a y receive t h e benefit o f thi s s p e ci al i sed m e d i c a l t r e a t m e n t . T h e te n d e n c y fo r th e fo o t to dro p (th e in a b ility to r a ise (h e fr o n t o f (h e fo o t a t w ill) is o ff s e t by th e c o n tr a c tio n o f th e s p r in g s , th u s a s s is t in g s ta ir -c lim b in g — th e la tt e r is p r a c tised a s a fo r m o f e x e r c is e in th e p h y sio th e r a p y d e p a r tm en t. T h e N a t i o n a l C o u n c i l is e a g e r for ever y p e r s o n suff ering f r o m a p h y si c a l h a n d i c a p t o be r e h a b i l i t a t e d if t h a t is n o t b e y o n d h u m a n skill so t h a t h e — o r sh e— b e c o m e s i n d e p e n d e n t a n d en jo y s his o r h er r i g h tf u l p l a c e in soc iety a n d is a n as se t to t h e sta te. T h e N a t i o n a l C o u n c i l a c t s as a s o u r c e o f i n f o r m a t i o n o n all k i n d s o f p r o b l e m s , a n d it k e e p s in clo s e t o u c h wit h o v e r s e a s m o v e m e n t s t h a t a r e e n g a g e d in si m i l a r w o r k . N e e d l e s s to say , t h e t e a m o f w o r k e r s , r e q u i r e d t o r e s t o r e t h e c r ip pl e, d e p e n d e n t u p o n his c o n d i t i o n , is t h e o r t h o p a e d i c s u r g e o n , t h e o r t h o p a e d i c a n d ge n e r a l n u r se s , the p h y s i o t h e r a p i s t , t h e o c c u p a t i o n a l t h e r a p i s t , of t e n th e p sy c h o l o g is t , t h e e d u c a t i o n i s t , t h e so ci al w o r k e r a n d t h e vas t t e a m o f v o l u n t a r y w o r k e r s b e h i n d " C r i p p l e C a r e ” b o t h in p r a c t i c a l w o r k wit h cr i p p l es , in c o m m i t t e e s a n d in fu n d -r ai si n g . N o w th i s m a gn if ic en t s u m c o n t r i b u t e d by L o r d Nuffield w as a l l o c a t e d a n d e a r - m a r k e d o u t t o t h e v a r i o u s p r o v i n c e s a n d h a v i n g h elp ed t o lay a b r o a d f o u n d a t i o n — t h e “ b u i l d i n g " h a d t o go o n a n d se rv ic es i m p l e m e n t e d a n d m a i n t a i n e d . T h e n ew ly f o r m e d N a t i o n a l C o u n c i l c o u l d n o t live o n t h e Nu ffield gi ft — it h a d to de v is e a m e a n s o f g a i n i n g f u n d s t o m a i n t a i n itself a n d t o f u r t h e r t h e w-ork o f “ C r i p p l e C a r e ” in S o u t h Af rica. T o th i s e n d in 1944 its first E a s t e r S t a m p C a m p a i g n w a s l a u n c h e d , o n a sm all scale, a s a tr ial, a n d rai sed th e m o d e s t s u m o f £7,000. It w as a s t a r t — a n d sinc e t h o s e ea rl y d a y s t h e o r g a n i s a t i o n h a s g r o w n ste adi ly a n d stu r d i l y . It is o p e r a t e d by a nu cl eu s o f p a i d s t a ff to e n s u r e c o n t i n u i t y a n d st a bi li ty , b u t this s t a ff ga i n s t h e s u p p o r t o f t h o u s a n d s o f v o l u n t a r y w o r k e r s eve ry y e a r t o c a r r y o u t t h e w i d e s c o p e o f its w o r k . It will m a k e i n t e r e s t i n g r e a d i n g t o n o t e t h a t as e a r l y as M a r c h 1946— t h e S o u t h A f r i c a n S o c i e t y o f P h y s i o t h e r a p i s t s u n a n i m o u s l y a g r e e d at a c o n f e r e n c e in C a p e T o w n to of fer its he lp w it h t h e E a s t e r S t a m p F u n d — a n d c o n v e y e d this de c i s i o n wi th a n ex p r e s s i o n o f g o o d wish es f o r success. Sinc e t h a t t i m e P h y s i o t h e r a p i s t s all o v e r t h e U n i o n ha v e " d o n e t h e i r b i t ” fo r th e E a s t e r S t a m p F u n d , a n d in J o h a n n e s b u r g in p a r t i c u l a r t h e i r c o n t r i b u t i o n o f se rv ic e t o th e E a s t e r S t a m p F u n d h as been o u t s t a n d i n g . T h e N a t i o n a l C o u n c i l on b e h a l f o f all c r i p p l e s in o u r l a n d t a k e s this o p p o r t u n i t y o f t h a n k i n g all P h y s i o t h e r a p i s t s f o r th i s s u p p o r t , in H E L P I N G C R I P P L E S T O H E L P T H E M S E L V E S . ” It will n o t be a m i s s h er e t o o u t l i n e an i n t e r e s t i n g c a s e — let us call h e r M a r g e r y — w h o m a y no t ha v e been a b l e to h a v e re cei ved m o d e r n m e t h o d s o f t r e a t m e n t h a d it no t been f o r t h e e ar ly a n d c o n t i n u i n g ef forts o f t h e N a t i o n a l C o u n c i l f o r t h e C a r e o f Cr i p p l es . M a r g e r y w as s t r i c k e n by illness w h e n sh e w'as in a n o r t h e r n t e r r i t o r y wi th h er h u s b a n d . T h i s h a p p e n e d t w o y e a r s a g o o n N o v e m b e r 1st. S h e w as t r e a t e d by a local d o c t o r f o r fib rositis . a n d la te r f o r a n e r v o u s b r e a k d o w n unt il in d u e c o u r s e t h e d o c t o r d i a g n o s e d h er t r o u b l e a s P o l i o m y e l it i s a n d s h e w as f o r t h w i t h c a r r i e d in a st r e t c h e r to a p l a n e a n d flown t o a l ar ge h o s p i t a l in S o u t h A f r i c a w h e r e sh e w as p la ce d in th e fe ver w a r d . W h e n t h e fever di ed d o w n s h e w as co n f i n e d to h e r bed, c o m p l e t e l y flat o n h e r ba ck . P h y s i o t h e r a p y was e m p l o y e d a t this st a g e t o w hi ch she r e s p o n d e d very well in d ee d , a n d h er c o - o p e r a t i o n a n d r es u lt s g a i n e d f o r h e r t h e title o f t h a t h o s p i t a l ’s " s t a r p a t i e n t . ” T h e o r t h o p a e d i c su r g e o n u n d e r w h o s e c a r e she wa s, p r e d i c t e d t h a t d e s p i te t h e s e r i o u s n e s s o f t he a t t a c k , s h e w o u l d m a k e a v er y g o o d re co v er y. M a r g e r y is a p e r s o n o f c o u r a g e a n d d e t e r m i n a t i o n a n d sh e m u s t be given c r e d i t f o r h e r p e r s e v e r a n c e : sh e p u t ev er y o u n c e o f h e r s e l f in to thi s i m p o r t a n t m a t t e r o f tr y in g t o get well so t h a t s h e g av e t h e fullest c o - o p e r a t i o n to th e 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. ) January, 1955. P H Y S I O T H E R A P Y Page Seven A L E T T E R T O T H E E D I T O R . A p r o p o s o f t h e p r e c e d i n g a r t i c l e — I, as y o u r S o c i e t y ’s P r e s i d e n t , w o u l d like to u r g e ever y p h y s i o t h e r a p i s t in S o u t h A f r i c a to c a r r y o u t o u r P h y s i o t h e r a p y C o n f e r e n c e r e s o l u t i o n o f 1946 t o lend ever y a s s i s t a n c e to t h e E a s t e r S t a m p F u n d , h o w a n d w h e r e v e r p os s i b l e d u r i n g its a n n u a l c a m p a i g n , w h i c h lasts f o r se v era l wee ks , f r o m M a r c h 1st e a c h year. F o r t h e benefit o f t h o s e m e m b e r s not re si d e n t in J o h a n n e s b u r g t h e f o l lo w in g w as t h e p r o c e d u r e we a d o p t e d h er e: W e c o n v e n e d a t a b l e at a p r o m i n e n t s h o p c o r n e r a n d a t T a t t e r s a l s , f o r th e 2 we eks . P h y s i o t h e r a p i s t s in p r i v a t e pr a c t i c e sold E a s t e r S t a m p s in t h e i r t r e a t m e n t r o o m s , a n d t h o s e e m p l o y e d in ho sp i t al s , in J o h a n n e s b u r g a n d t h e Reef, also di d t h e i r fa ir sh a re . 1 h a v e a l w a y s been very p r o u d o f t h e a m o u n t t h u s co ll ec te d f o r th i s w o r t h y c a u s e a n d I t h a n k t h e S o u t h e r n T r a n s v a a l b r a n c h m e m b e r s a n d t h e U n i v e r s t i y P h y s i o t h e r a p y s t u d e n t s f o r s u p p o r t i n g m e so loyally, a n d h e l p i n g m e w it h t h e E a s t e r S t a m p C a m p a i g n , as th ey a lw ay s h a v e d o n e . I w a n t , al s o t o t h a n k all t h o s e p h y s i o t h e r a p i s t s , t h r o u g h o u t t h e U n i o n , w h o h a v e h o n o u r e d o u r C o n f e r e n c e r e s o l u t i o n . 1 c o m m e n d t h e E a s t e r S t a m p F u n d to y o u — be c a u s e 1 h av e been y o u r r e p r e s e n t a t i v e o n t h e N a t i o n a l C o u n c i l f o r t h e C a r e o f C r i p p l e s f o r 1.4 y ea r s, a n d t h e r e f o r e h a v e first h a n d k n o w l e d g e o f t h e vital w o r k b ei n g c a r r i e d o u t by C o u n c i l a n d its C r i p p l e C a r e A s s o c i a t i o n s , in H E L P I N G C R I P P L E S T O H E L P T H E M S E L V E S . Y o u r s tr uly , S U S I E O O S T H U 1 S E N , c / o M r . A. N i c k , P r e s i d e n t : S .A .S .P . P .O . Bo x 6880, J o h a n n e s b u r g . 6 th J a n u a r y , 1955. W h en th e le g is e x te n d e d , and th e to e pu sh ed d o w n w a rd , on to th e flo o r , it b r in g s th e sp r in g in to p la y , s o th a t th is m o v e m e n t n e c e s s ita te s u sin g th e m u sc le s a g a in s t r e s is ta n c e , w ith r e s u lta n t s tr e n g th e n in g . o r t h o p a e d i c s u r g e o n , t h e n u r se s a n d t h e p h y s i o t h e r a p i s t s : t he will t o b e well is h a l f t h e b a t t l e w o n . . M a r g e r y was t r e a t e d by p h y s i o t h e r a p y at t h e h o s p i t a l unt il J u n e , 1954, w h e n sh e t o o k a p o st as a D o c t o r ’s re ce p t i o n i st . H e r righ t leg is a l m o s t as g o o d as ev er it wa s, but her left f oo t h as n o t t h e m o v e m e n t it s h o u l d h a v e : it is still d r o p p e d a n d a l t h o u g h sh e w e a r s no ca l i p er , s h e still c a r r ie s a stick to help h er to k e e p h er b a l a n c e a n d to give h er a c o m f o r t a b l e fe eling o f se cu rit y. S h e will c o n t i n u e wit h p h y s i o t h e r a p y t r e a t m e n t s t wi ce a day. M a r g e r y h a s been to ld t h a t m o v e m e n t will r e t u r n t o t h e d r o p p e d f o o t in t h e c o u r s e o f ti m e, a n d b e c a u s e sh e h a s o b t a i n e d su ch r e w a r d i n g re sul ts so f ar sh e is d e t e r m i n e d t o see t h e t h i n g t h r o u g h t o t h e en d w h e n h er f oo t is as m o b i l e a s sc ience c a n m a k e it. M a r g e r y is m o s t g r a t e fu l f o r t h e help t h a t sh e received f r o m t h e o r t h o p a e d i c sp e ci al ist s w h o a t t e n d e d to her, th e s u r g e o n , t h e n u r se s , t h e p h y s i o t h e r a p i s t a n d t h e t e c h n i ci an s . A s is o f t e n t h e c a s e a p p l i a n c e s a r e m a d e g o o d use of, a n d t h e a c c o m p a n y i n g p h o t o s i l l u s t r a t e t h e use o f a ve ry use ful spri ng. W e in S o u t h A f r i c a o w e a g r e a t d eal t o t h e N a t i o n a l C o u n c i l f o r t h e C a r e o f C r i p p l e s a n d its local C r i p p l e C a r e A s s o c i a t i o n s f o r it is this vast o r g a n i s a t i o n t h a t h as d o n e so m u c h t o h el p b r i n g o r t h o p a e d i c se rvices to its p r e s e n t st a g e a s y o u h a v e a l r e a d y n o t e d . When Ionization is in dicated . . . Im a d y l U n c t io n R o c h e ' is the substance of choice. C o n t a i n i n g 1 % h i s t a m m e - d i h y d r o c h l o r i d e i t will p r o d u c e l o c a l e ff e c ts o n l y a n d w ill n o t c a u s e g e n e r a l v a s o d i l a t i o n . Im ad yl ‘R o c h e ’ is free ly avail ab le a g a in from lU id iu d JfisM JH itw sh Specialists for Physical Medicine Appliances P.O. Box 3 3 7 8 JO H A N N E S B U R G Telephone 2 3 -8 1 0 6 2 3 6 , JEPPE STREET 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. )