Fondazione Irma Romagnoli will help fund the PAOLO’S HOME KIBERA NAIROBI project with an annual contribution of €5,000.

DURATION: January 2013 to January 2018

TYPE OF INTERVENTION: Physical rehabilitation services and a day center for children with psychological and neuropsychiatric disorders

THE PROBLEM

Kenya is a country in sub-Saharan Africa with a population of nearly 40 million people living on less than $2 a day. Children and adolescents under 15 account for approximately 45% of the population and have a life expectancy at birth of 50 years. In recent years, Kenya has introduced mental health legislation providing for community-based services, but the reality is very different. First, the government allocates only 0.01% of its health budget to mental health. The only available public services are provided by the large Mathare psychiatric hospital in Nairobi and three smaller psychiatric facilities in other regions of the country. In practice, however, these services are accessible only to people who are employed and therefore have health insurance to cover the costs.

Stigma toward people with mental health conditions remains very strong. According to accounts gathered by Cittadinanza Onlus, children with these conditions are kept confined at home and sometimes left to die from deprivation in large, extremely poor families. Other families turn to traditional medicine or local healers, as the belief that children may be possessed by evil spirits remains deeply rooted.

Cittadinanza encountered this situation particularly in Nairobi’s Kibera slum, sadly known as the largest slum in sub-Saharan Africa, with a fluctuating population reaching as many as 2 million people and an extremely high number of street children.

CITTADINANZA’S RESPONSE

In February 2012, through contacts with the Nairobi-based NGO Koinonia and the Italian NGO AMANI, Cittadinanza learned about and visited Paolo’s Home, which provides physiotherapy services for children with physical and mental disabilities living in Kibera. Since January 2013, Cittadinanza has supported the project financially and provided scientific supervision. The center was established in response to an urgent community need: many families of children with these conditions were seeking help from Koinonia staff working with street children in Kibera. It was officially inaugurated on December 10, 2007, and began operating in March 2008 with a full-time physiotherapist, a social worker, and a Koinonia educator responsible for the service.

The physiotherapy center is open by appointment Monday to Friday, from 8 a.m. to 4 p.m. Home visits take place on Tuesdays and Thursdays, while activities at the center are held on Mondays, Wednesdays, and Fridays.

The center currently supports 70 children aged 1–15. The most common diagnoses are cerebral palsy, epilepsy, autism, Down syndrome, neurological conditions resulting from fetal distress during childbirth, and brain injuries caused by meningitis. Most children attending the center also suffer from undernutrition.

The local staff provide the following services free of charge: 

– Physiotherapy sessions, including home visits

– Medication when needed

– Ingredients for preparing a meal for the child and their family

– Support from the social worker

– Community awareness-raising activities

– Individual and group counseling for the children’s families

On July 1, 2013, a day center officially opened alongside the physiotherapy center, initially serving eight children of similar ages with different conditions. They spend the whole day at Paolo’s Home, taking part in physiotherapy, informal education, and play activities. They and their families receive psychological support, and external professionals provide speech therapy. The children also receive three meals a day. Each child has an individualized educational plan, agreed with their family, setting two or three goals in the physical, cognitive, communication, and social domains and reviewed every six months. Two mothers have been involved in preparing meals and caring for the children each day, enabling them to take an active role in their children’s rehabilitation while also gaining an opportunity to improve their financial circumstances. The center’s team also includes two physiotherapists, a psychologist, and a social worker who work across both services, plus a specialist educator and an assistant educator working primarily in the day center. Community mental health promotion and awareness-raising activities also continue.

The goals agreed with staff and the children’s families for 2014 are:

– Include five more children in the day center’s activities, bringing the total to 13

– Expand speech therapy sessions and have the speech therapist train staff and families in basic techniques for providing appropriate stimulation

– Strengthen group therapy activities

– Launch empowerment activities for the families of children attending the center

– Provide ongoing staff training, including input from local and international experts and exchanges of good practices with other professionals in the field

– Purchase new equipment needed for physiotherapy sessions

FUNDING REQUIREMENTS: €25,000 annually

PROJECT STATUS: Underway

CITTADINANZA onlus – via Briolini 48E · 47921 Rimini · tel/fax 0541 412091· info@cittadinanza.org · www.cittadinanza.org