There are seven medical rehabilitation centres in Ukraine, but Chernihiv has the only social rehabilitaion centre, that is, a child is prepared for involvement in life.
Victor and I had visited the Centre in April when it was empty and cheerless, plumbing and wires lead nowhere and voices echoed. The change was like a Phoenix rising from the ashes. Fully-equipped, pretty curtains, polished floors, laughter and activity--the heavy grey clouds of snow outside could not compete with the sunshine inside. We toured the rooms with the three founding doctors Pasechnik, Yakubova and Zenchenko.
In the computer room we met Vadim, seven years, with his crutches leaning close to the keyboard. He fell down in the nursery and separated his left hip epiphysis. Four other children were playing computer games.
In the physical therapy room we met Sasha born in Chernihiv on the day after the Chernobyl accident. He was receiving a massage as he had difficulty walking due to Duchenne muscle dystrophy. In the next cubicle was Kostya, ten years, born in September 1985. He has cerebral palsy and was being encouraged to talk.
In the hydrotherapy bath was another Sasha, 13 years, who had the epilepsy syndrome since the Chernobyl accident and was now left with the chronic fatigue syndrome.
In the corridor on a wooden horse was baby Yaroslav born 21/1/96 who was a breech presentation and had a brachial plexus C5-6 causing a paralysed right arm which was now almost better. The mother enthused about the Centre's care.
In the gymnasium were seven children and a physiotherapist assisting each in turn with their arm and leg strengthening exercises. Misha, eight years, had cerebral spastic paralysis and was much improved. Oksana, 12 years, is a weak and pale child with headaches classified as due to radiation and was doing her best with the exercises.
In the therapeutic ball bin cavorted two boys with cerebral palsy, yet they twisted and turned as they played in the coloured balls giving themselves exercise and a micro-massage.
We entered a small room, seated at a wall table against the mirror was a lady psychologist observing Marina, six years, playing with an early learning toy but she could not sit still for longer than a few seconds and was rapidly running about the room in a disorganized and agitated way while her anxious mother looked on. In the sewing room four boys and one girl were seated at Singer sewing machines which were very popular because children can see the result of their efforts immediately and their achievement raises their self-esteem, teaching them at the same time coordination and precision. The mother Anya was radiated when twelve years old and her now five year old daughter had a brain aneurysm and psychological problems behaving one moment rationally and the next moment foolishly. The father left his family when he found his daughter was abnormal. All the children loved their teacher who herself had a child with cerebral palsy. Two children proudly presented Victor and me with the results of their morning's work--a pin cushion and a napkin. We left quietly.
Then we passed through the well-equipped but empty TV room to the The English Room. Here the intellectual development of a child was studied and they were educated to integrate socially and encouraged to exhibit their craft work to raise their self esteem and play with musical toys and even learn English. Katya, four and one half years, was psychologically disturbed, had poor hearing, was backward in speech and unable to express herself, yet she could draw well.
In the Electromyography room, still waiting for electrodes before it could be used, was a boy, twelve years, having electrophoresis for a displaced hip epiphysis. This room would become the future EEG room and which was expected to arrive on the next container shipment we're sending from Minneapolis/St. Paul this coming week.
There was a bright and cheerful room for the giving of injections and receiving medicines. While a child was squeezing the noisy nose of the clown on the wall, the injection was given before the child knew it had happened.
Dr. Zenchenko demonstrated the new blood pressure machine and cuffs--they were for a adults and narrower paediatric cuffs have to be used for accurate measurement.
We returned to Dr. Pasechnik's office to discuss the tour of the Centre.
Thirty-two new patients attend each month and thirty-five children having therapy attend every day. There are many children and more on the way and already too little room. The Center has a second hydrotherapy bath but nowhere to put it. It is hoped that the Centre will expand into part of the Young Children's Nursery opposite, but money is needed for the conversion. The medical staff would like to treat children with diseases before disability develops and they become invalids. Dr. Zenchenko explained the term "invalid." Some children with asthma can adapt to their illness--they are not invalids. Other children with asthma are unable to go to school, the mother must stay at home and she is unable to go to work, so she gets government aid until the child is 16 years--such children are invalids. Some children with cerebral palsy can go to school--the are not invalids, but if the mother must stay at home and receive aid, then the children are invalids. The medical staff want to treat potential invalids.
The Polyclinic No. 2 differs from the Center for Rehabilitation by being a diagnostic clinic and its patients are not invalids. The Centre takes on the medical, psychological and social care of children and many are invalids. The method of the Centre is to make therapy a fun activity through computers, equipment and games. Therapy is never forced upon children. Often children are carried into the center in the arms of their parents and after one month they are walking and achieving.
The aim is that children will forget their disability. Rehabilitation of children is achieved by ensuring that the child is happy.
On admission each child has a registration certificate with the employment status of the parent(s) and the diagnosis. Therapy is for 24 working days per month at a cost of 330 hryvna (1.8 hryvna equals one US dollar). The government only pays for the victims of the Chernobyl accident which is 25% of the children attending the Centre, but many parents are unemployed or single parents and of the 103 children treated so far only the parents of one has paid.
Anglo-American aid is needed without which it could not rehabilitate 32 children each month.
Financial aid has been received and detailed documents are kept recording what is distributed to each child and acknowledged by the parents signature. Also other institutions which receive any excess items must record what is received. These documents were examined by Victor and me and confirmed.
A short history of the Centre of Medical and Social Rehabilitation--"Revival" in Chernihiv is dominated by the quiet-mannered Dr. Vasyl Pasechnik who is its driving force. He observed two other doctors whom he saw were dedicated and showed unusual ability with children, Dr. Anna Yakubova and Dr. Natalya Zenchenko. At the end of 1992 they gathered together and formulated the present program of therapy for handicapped children. In February 1993 Nina Rogerson (Bogdanova) a resident in Bolton, UK, with Richard Robinson from Oxford invited a BBC television crew to make a film in Chernihiv. It was broadcast as "The Forgotten Children of Chernihiv" and was seen in UK, Belgium and Holland. The film revealed that handicapped children were stuffed into buildings and left. The film raised the finances and volunteers to upgrade the offices of a chemical company which was given to the doctors by the Chamber of Commerce, while the Mayor of Chernihiv raised further money for conversion of the building.
The Centre was opened by the Mayor of Chernihiv Vitaliy A. Kosich and the British Ambassador Roy Reeve cutting the tape simultaneously on the 19th June 1996.
One of the benefits, perhaps the only benefit, of closed factories and unemployment is a reduction in pollution to such a level that fish and crab have returned to the rivers. Also, this year the potato harvest has been excellent and in some provinces the wheat harvest has been good. This is attributed to good weather and to less chemical fertilisers being used because they could not be afforded. Only natural fertiliser was used. Message?
After lunch, the tomatoes were deep red and delicious, Victor and I visited the Young Children's Nursery No. 25 next door. There are 75 nurseries in the city of Chernihiv. We entered Matron's office to be greeted by the formidably large Matron and her assistant with crushing bear hugs all around and loud whoops of laughter as we renewed our friendship from April. The Nursery has 158 children in its care from two years to seven years from 7.30 am to 6.0 pm. Matron said that there were more sick children now. 60% of children live with two parents and 40% live with single parents, invariably, the mother. The nursery used to be more crowded but the birth rate is down. Parents like to come to Nursery No. 25 because it is close to the Centre. It costs one hryvna to feed a child each day.
We set off to tour the Nursery, Matron leading the way.
In the first room children with mild cerebral palsy were dancing the Podolochka, the children hold hands encircling a garlanded child, each taking its turn and singing.
In the second room were children with orthopaedic conditions, especially scoliosis. They were quietly sitting at desks, filling in pictures with crayons or modeling with plasticine.
In the third room were children with more severe cerebral palsy, crayonning and modeling very well indeed and they were so polite and attentive. There is much to be learned in Ukraine.
Victor recognised much of the furniture and art supplies sent from Minneapolis, Minnesota. It was explained that a problem which can be solved in America or Europe, remains a problem in Ukraine and 60% of children have prenatal problems exacerbated by the poor nutrition and anaemia of mothers.
Victor is getting tired. --- I think his Tea cells are disrupting. We returned to the Centre and talked about everything for an hour or so.