Humanity & Inclusion (Handicap International) lance un appel à consultation pour une formation de formateurs dans le domaine de la Réadaptation et du diagnostic du handicap, pour les camps sahraouis, en Algérie عودة إلى الفرص

Organization: Humanity & Inclusion (the new name of Handicap International)

Program: Algeria

Country: Sahrawi camps, Tindouf. Algeria

Indicative Dates: 21^stMarch to 19^th April, 2018

General context:

Humanity & Inclusion (formerly Handicap International) is an independent and impartial humanitarian aid organization working in contexts of poverty and exclusion, conflict and disaster. We work with people with disabilities and vulnerable populations, taking action and testifying to their situation in order to respond to their basic needs, improve their quality of life and promote respect for their dignity and fundamental rights. Since its founding in 1982, Humanity & Inclusion (HI) has worked in 59 countries around the world.

As an expert in the field of inclusion of vulnerable population, especially persons with disabilities and the elderly, HI has been present in Algeria since 1998. In 2015, after the floods that hit the five Saharawi refugee camps in October, HI helped the humanitarian response by providing emergency rehabilitation of the infrastructure of special education centers and centers for children with disabilities. As a result of this intervention, it was possible to strengthen, in 2016, the long-term work of the health entities through specific training and accompanying actions to provide care for children with disabilities.

In the same year, HI’s intervention was aimed at improving access to quality rehabilitation for children, adults and older people with disabilities living in the Bujdour, Ausserd and Smara camps. In addition to physiotherapeutic care aimed at increasing the individual’s functional capacity, occupational therapy training received by rehabilitation specialists has made it possible to strengthen the autonomy of children and adults with disabilities in activities of daily living.

Specific context

In this context, persons with disabilities are among the most vulnerable. In 2015, the Ministry of Social Affairs recorded a total of 2.929 vulnerable persons, identified according to the following criteria: 1) paralyzed and bedridden persons; 2) wheelchair and paralyzed elderly persons; 3) single/isolated elderly persons; 4) persons with intellectual or visual disabilities.

Given the restrictive definition of disability that was used, these statistics exclude a large number of persons with disabilities. The World Health Organization estimates that the proportion of persons with disabilities, including older people, in a given population is 15%. Based on these estimates, it is calculated that more than 13.500 persons with disabilities live in the camps.

In addition to the basic services available in the camps, the Sahrawi Ministry of Public Health is mobilizing to meet the physical and functional rehabilitation needs of persons with disabilities, with the support of non-governmental organizations and academia. On a national level, the Rabuni Rehabilitation Centre offers physical therapy services provided by a Saharawi professional trained in Cuba and his assistant, a service of orthotic and prosthetic equipment according to international standards, with the support of the ICRC. At the regional level (in the district or “wilaya”), there is the following: A rehabilitation center in Bolle (near Bujdour), financed and managed by the Italian association Rio de Oro Onlus, which provides physiotherapy services, especially for children with disabilities, and has the capacity to accommodate them for periods ranging from 1 to 3 weeks (some are sent to Italy during the summer for specialized care); a rehabilitation center in Smara, in the regional hospital, run by a Saharawi physiotherapist trained in Cuba, financially supported by the Italian NGO Rio de Oro Onlus:arehabilitation center in Ausserd, in the regional hospital, run by a nurse trained in physiotherapy thanks to specific training courses of various associations, currently closed for remodeling purposes;an early detection and care center for persons with disabilities in Dakhla, inaugurated in October 2016, which receives technical and financial support from the Spanish NGO Alma Esperanza and a rehabilitation center in Laayun, managed by a local physiotherapist trained in Cuba and built with the support of the NGO Oxfam.

Justification

Early detection of disability is essential to ensure the prompt and appropriate treatment of children aged 0-5 years and thus increase the chances of improving or ending disability. According to the survey conducted by HI in 2016, disability appears at this age in 88% of cases in Sahrawi camps. However, health authorities and rehabilitation professionals interviewed confirm the current fragility of the health system, especially in child health clinics. Beyond theoretical knowledge about different types of disabilities and their causes, health professionals also need guidance on how to inform the family. Concerned about parents’ reactions, professionals often prefer not to share the diagnosis with the family.

More generally, doctors, nurses, midwives and pediatricians are not fully familiar with rehabilitation services and their complementarity with health care for persons with disabilities. As a result, they still provide very little guidance to their patients who might benefit, even though the rehabilitation centers are mostly located on the grounds of the Wilayas regional hospital site (this is the case in Smara, Ausserd, Laayun and Rabuni, while Bolle – near Bujdour – is also located next to a hospital).

As a result, and after more in-depth exchanges with the Director of the Nursing Personnel Center and the Ministry of Public Health, it was decided to develop a training module that will be integrated into the curricula. In the school there are twooptions of studies:

1. A 3 years course to obtain the title of Nurse. After completing it, there are two specializations possible either in pediatrics or in midwives. Both specializations requite a 2 years length additional course.
2. For students with a university background who are interested in becoming midwifes, there is the possibility to study a 3 years course where thefirst year is centered in nursing and the other two in midwifing.

The curricula shall be applied to the 3rd year students of nurses, the 4th and 5th years of the specialization and the 3^rd year of the course of Midwives, so that about 15 to 20 students will benefit of  implementation of this new module of early detection. There are a total of 14teachers specialized in different subjects including two midwifes.

In this way, future Saharawi health professionals will be prepared to identify situations of disability and guide the affected persons to pertinent rehabilitation services as appropriate.

Service description:

The mission objective: To contribute to the development of the curriculum and carry out the training 10 to 14 teachers and three students of the last year of midwife specialization of the professional nursing school of Smara.

• Specific objective 1: To address and to train the teachers on the different types of the most common disabilities in the camps and its causes.
• Expected result 1: Teachers are able to identify the different types of disabilities and their causes.
• Expected result 2: Teachers are able to know the causes of these disabilities and thus prevent further complications.
• Expected result 3: Teachers are able to integrate this knowledge acquired both in their practice and in the current curriculum.
  • Specific objective 2: To address and to educate the teachers about the early detection of these types of disabilities.
• Expected result 1: Teachers are able to perform an early diagnostic of the different types of disabilities.
• Expected result 2: Teachers know and can use the pertinent tools for an adequate early detection of disabilities.
• Expected result 3: Teachers are able to integrate this knowledge acquired both in their practice and in the current curriculum.
  • Specific objective 3: To train the teachers about family counseling from a psychosocial approach.
• Expected result 1: The teachers have acquired communication techniques when it comes to inform and guide the family after the detection of a disability.
• Expected result 2: Teachers understand the importance of institutional, educational and social inclusion and are able to communicate itsimportance to the family in adequacy with the context.
• Expected result 3: Teachers are able to integrate this knowledge acquired both in their practice and in the current curriculum.
  • Specific objective 4: To provide guidance and information to the teachers about the rehabilitation services existing in the camps and on the type of services offered related to the different disabilities.
    • Expected result 1: Teachers know the different institutional resources existing in the fields and the type of services offered.
  • Expected result 2: Teachers know and understand the benefits that these services may provide in relation to the various types of disabilities.
  • Expected result 3: Teachers are able to integrate this knowledge acquired both in their practice and in the current curriculum.
    • Specific objective 5: To educate the teachers on techniques of communication and health education with community-based approach to early detection and intervention.
  • Expected result 1: Teachers know and use different educational tools and manage pedagogic tools to transmit it to the students.
  • Expected result 2: Teachers are able to develop and use other educational and communication tools adapted to the context.
  • Expected result 3: Teachers are able to transmit this knowledge to students so that, once graduated, to apply it both in primary care practice and at homeassistance.

Service characteristics:

The main purpose is to provide training to the teachers of the nursing school, who, in addition to understand and integrate the knowledge acquired, shall be able to transmit this knowledge to the students and to integrate the module in its current curriculum. It might be possible to include some students about to graduate as midwives who won’t have the possibility to get benefit of this training in the future.

It is also expected to develop/finalize the elaboration of the curricula together with the teachers and with the support of HI’s technical responsible in order to integrate it in the next years’ school planning.

Indicative agenda:

• 8 to 10 days of distant work for the elaboration of the content of the training, with the support of HI’srehabilitation technical responsible.
• Prior to the start of the mission the consultant will consider any change it might be relevant in the proposed agenda and contractualisation.
• Delivery of 8 days of training. Consulting service will be held in two sessions (5 days + 3 days) for two groups of teachers, that will be divided between morning and afternoon for 2.5 daily hours per group (2.5 hours during the morning to a group and 2.5 hours during the afternoon to the other).
• 1 or 2 days after the consultancy for writing the reports and modification of the curriculaafter having the feedback of the teachers and results of the training.
• Possibility to include a visit to one of the centers of primary health care to better understand the context, the conditions of detection and to understand how health education campaigns are carried out.

Agreements:

All documentation that is used for training should be sent to HI’srehabilitation responsible 3 days prior to the arrival in order to be able to provide the necessary copies.

Develop preliminary exam, final exam and a posttest to be held 1 or 2 months later aiming to monitor the retention of information.

Delivery on paper (to all students) and in digital format (to HI’s rehabilitation responsible) of the content of the training.

Elaboration of a report at the end of each block and a final report of the training including the results of the preliminary exam and final exam (three reports in total), as well as recommendations for the development of sessions of awareness of health professionals from a community-based rehabilitation approach. The final report must be delivered at most 2 weeks after the end of the mission.

Provide to HI’s rehabilitation responsible with some indicators in order to monitor and/or evaluate the retention of the information and the integration of the curricula.

Terms and conditions:

• Rate: Between 300 and 400 €/day,negotiable (flight tickets and visa may be included in an all-included amount or be charged besides the consultancy fees). In all cases, catering is included in the daily consultant fees.Local transportation in the Sahrawi camps may be provided by HI.
• The selected person must have contracted her/his own travel insurance and provide with a proof.