Rehabilitation nursing in Botswana.

Abstract

As we bumped along the dry, sandy roadin our4x4,I learnedaboutthepatients we were about to visit that morning. Our group consisted of Johnson, a community-basedrehabilitation workeratMogoditshaneRehabilitation Centre; Toitoi, a graduate studentin nursingat the Universityof Botswana; and me. Our first home visit was to see a 4-year-old girl who had femoral tendon releases for contractures due to severe postmeningitis spasticity. Meningoccalmeningitis, an infectious diseaseaffecting childrenin Africaduringthe dry season, is a common cause of neurological disabilities, with an estimated 38,000 new cases reportedthis year alone (International Federation of Red Cross, 2001). When we arrived, all the family members gathered in the yard with the little girl in the center, lying on a blanket carefullyspreadoverthedirt.Her hair was freshly plaited and her skin had been scrubbed so that it sparkled.Her primary caregiver, the grandmother,stood nearby as we examined her incisions. Out of the comer of my eye, I could see a dead goat hanging by its feet from a tree. Toitoiand I discussedwoundhealing,confirmedthat the child was afebrileby feeling her skin, anddiscussedthe typeof range-of-motion exercises we would teach the family. We observed the family interacting with the child and noted she had a place of honor, as evidencedby her meticulousgrooming, nutrition, and care. As we were getting ready to leave, many villagers gathered around,out of curiosityand support,to observeour work.A familymember offered a gift of gratitude, a goat's leg that he placed in front of Johnson to inspect before wrappingit in newspaper. Weleftcarrying the meat as we climbed into our vehicle and drove off to see the next patient. This clinical experience was the first rehabilitation practicum organized for nursing students in the master's degree program at the University of Botswana (UB) in conjunction with the Mogoditshane Rehabilitation Centre (MRC) of the A sculpture in thecourtyard ofMogoditshaneRehabilitation Centre dramatizes thesignificance of mobility and independence for people with disabilities.