Stepping up for DAN

Salaama Alaikum & Hello

My name is Bilan and I am a practicing Occupational Therapist based in the UK. I created this page as I wanted to share a passion project with you all, one borne out of my long-held desire to contribute to the positive development of my home country – Somaliland. Up until now, my support for Somaliland had only gone as far as donating to various social and humanitarian causes. Over time, however, I developed an ever growing feeling of wanting to make a more direct difference. This project marks not only my decision to finally act on this feeling, but also the first of my efforts to try and improve public health services in Somaliland. But I can’t do this alone...

Background & History

Somaliland can be described as an autonomous region located in the north-western area of Somalia. It shares borders with Ethiopia to the west, Djibouti to the north and the semi autonomous region of Puntland to the east. Though not internationally recognised, Somaliland has all the trappings of an independent state. The people of Somaliland take great pride in electing their own government, using their own currency and (in particular) the freedom of having no official presence from Somalia. 

Civil war led to Somaliland breaking away from Somalia in 1991 and, subsequently, declaring its independence. Most of the region’s health, social, economic and political structures have (sadly) been struggling to regain effective function ever since. It is important to acknowledge, however, that some notable improvements have been made in a few of these areas more recently. 

Somaliland’s Health System

Though the government of Somaliland have managed to successfully re-establish a working national health system, it is incredibly limited - at both primary and secondary levels (there are no tertiary services currently in existence). One of the biggest challenges facing Somaliland is the lack of international recognition, restricting Somaliland’s ability to directly access both international funding and support.

Despite these major challenges, some health outcomes have markedly improved in recent years, especially those relating to women and children e.g. maternal, neonatal and child health. As with many other developing countries, what is particularly limited in Somaliland are adequate rehabilitation services – from both an acute as well as a community perspective.

Research has shown that rehabilitation programmes, delivered at the right time, can play a crucial role in reducing (and at times reversing) the negative impact of a wide range of health issues. Proper investment in rehabilitation services have also proven to not only benefit the individual receiving the treatment, but also their wider communities as well. As Somaliland’s population is especially young - with almost half of the population estimated to be < 15 yo - urgent work is needed both top down (government level) as well as bottom up (grassroots) to reduce the prevalence of life limiting disabilities wherever possible.

Field Research: Somaliland 2019

So, with all that being said “what on earth do you think you can do?!” I hear you all say! I too shared those exact sentiments at various points during this journey, especially as I began to realise the sheer scale of the task at hand.  But thankfully, with the support of my nearest and dearest, I realised that anything was possible with the will of Allah (SWT) and hard work. I also told myself (quite literally) “you are an Occupational Therapist with over 7 years experience in acute NHS services, there must be something you can do to help”. So, I travelled to Somaliland during the summer of 2019 to try and gain a working understanding of the public health system over there.

I was fortunate enough to meet with various individuals and organisations during my stay, of which I found most to be both accommodating and very helpful. I began my research with visits to the main public hospital in Somaliland - Hargeisa Group Hospital. I then went on to visit two Non-Governmental Organisations (NGOs) who,  between them, managed the only public rehabilitation services available in the country. Conveniently, all three establishments were located next to each other in the capital of Somaliland, Hargeisa.

Diversity Action Network - Somaliland

I am pleased to share that I have partnered up with a Somali-led NGO called Diversity Action Network (DAN). DAN manages one of the just two available outpatient rehabilitation centres in Somaliland. They also provide outreach services in rural areas along with advocacy support as well. Unfortunately, DAN has been facing serious service sustainability issues after having international funding cut back in 2012. To their credit, the Somaliland Government have since awarded DAN limited funding to help with their basic operational costs. But even with this additional support, DAN has been unable to fully provide the rehabilitation services required by the local population it serves. This is further exacerbated by the difficulties DAN faces in acquiring equipment for their facilities (in particular).

Mission: Stepping up for DAN

This project aims to capacity build DAN’s services via a two-pronged approach; upgrading the facilities at DAN’s rehabilitation centre and then through the provision of staff training. In order to achieve this aim, I worked alongside the staff at DAN to identify all of the essential equipment and products required as well as the staffs' training needs. A particular learning need that was identified was in the assessment and treatment of cognitive deficits. 

Since returning from Somaliland, I have mainly focused on phase 1 of this project; costing the amount needed to purchase all of the essential equipment and products required. At present, the total estimated amount for this is £5,000. Once phase 1 is complete - and the COVID-19 pandemic is under control worldwide - I hope to return to Somaliland for phase 2 of the project; delivering face to face staff training sessions. In the interim, I plan to support the staff remotely via online training sessions. These sessions will help to ensure that each member of staff is able to use current, evidence based and enablement focused practice.

To clarify, I intend to use all of the funds raised exclusively for phase 1 of this project. I plan to self-fund all expenses related to phase 2.

The Costs

Please see below for details on each  piece of equipment, inclusive of how they will benefit service users. I would like to stress that I have worked hard to ensure that all of the below items are cost effective, hygienic and easy to maintain - to ensure they can be used by DAN for many years to come. 

1) Plinth (x1) - Provides service users with a robust surface to complete a variety of  seated and lying exercises - (PURCHASED)

2) Water resistant  pillows (x6) - Provides head support whilst service users complete lying exercises 

3) Positioning wedges (x1 set) - Provides support for the service user and therapy staff when completing a variety of positioning exercises (PURCHASED)

4) Theraband (x5 different strengths per pack - x2) - Improves muscle strength and joint range of movement in both upper and lower limbs (via prescribed exercises) (PURCHASED)

5) Balance disc (x2) - Improves core balance, core strength, gross motor coordination and circulation (PURCHASED)

6) Exercise balls (x3 sizes) - Strengthens core musculature and improves core balance - (PURCHASED)

7) Wrist/Ankle weights (x3) - Promotes the strength of upper and/or lower limbs during exercises (PURCHASED)

8) Gym mat (x2) - Helps to provide a comfortable and shock absorbing surface to complete a variety of floor based exercises -  (PURCHASED)

9) Dumbbell set (various weights - x1 set) - Allows targeted intervention to increase joint range of movement and muscle strength in the upper limbs - (PURCHASED)

10) Gym accessories trolley (x1) - Provides safe and hygienic storage for small  pieces of equipment (SPONSORED BY PRIVATE DONOR)

11) Privacy screens (x1)  - Allows privacy whilst service users complete various exercises (PURCHASED)

12) Infrared lamps (x2) - Infrared (IR) therapy improves wound healing, relieves arthritic pain and increases endorphin levels - (PURCHASED)

13) Suitable uniform for all therapy support staff (x40) - (PURCHASED)

Along with the above equipment, essential consumables will also be purchased to help maintain health and safety standards. All orders will also be exclusively placed with reputable suppliers (used by the NHS). In the unlikely event of any surplus funds, please rest assured that they will be donated to DAN in full (with proof provided). 

Finally, I am pleased to share that all freight related costs will kindly be sponsored as well as organised by Bipsco, a Somali-owned healthcare supplies company based in the UK. Please follow the link below for more information about their products and services:

www.bipsco.com 

How you can Help

I truly believe that this project will not only help to maximise service users' functional independence, but also promote their personal autonomy and ability to engage in society as well - Bi’ithnillah (God willing)! But, as mentioned, I can’t complete this monumental task alone. I humbly ask you all for your generous donations and kind support, together I’m sure we can bring this project to life! May Allah (SWT) reward you all for taking the time to read this page and for any support you feel able to give. Allahumma Aameen.

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