Quality systems at Life Rehabilitation meet international standards Only ISO 9001:2008 certificated rehabilitation network in

Michelle de Kock (left), the rehabilitation standards manager who spearheaded the quest for ISO 9001 certification for Life Rehabilitation, with Dr Nilesh Patel, general business manager healthcare services, who has executive responsibility for Life Rehabilitation amongst other businesses, and Dr Dena van den Bergh, general manager national healthcare functions at Life Healthcare, whose executive responsibilities include, amongst others, quality in the Life Healthcare group.

Although Life Rehabilitation units were separate ISO 9001:2008 certification, performance with regards to the focus included in the Life Healthcare Group ISO making it the only certificated networked areas of the business, namely slips multi-site certification, achieved in 2007, a group of rehabilitation units in the country. and falls and medication errors. decision was taken in 2009 to embark on The following components of the n Enhancements to the established a separate certification for the business, quality system were developed and patient satisfaction tools to ensure with an emphasis on specific rehabilitation implemented: effective measurement of satisfaction processes and customer needs. n Rehabilitation specific work procedures with the rehabilitation process. The formal certification process to address areas that are unique and n A measurement and monitoring conducted by PricewaterhouseCoopers different to the acute care business. system for the above mentioned (PwC) commenced in July 2009 with an These work procedures are reviewed items. initial readiness audit. The PwC review and updated on an ongoing basis This certification underpins Life was finalised in October following three to ensure they continue to meet the Rehabilitation’s commitment and ability final audits at individual unit and head needs of the business. to provide its patients with world class office levels. n A rehabilitation specific scorecard, rehabilitation services. Life Rehabilitation has now achieved detailing rehabilitation specific

Page 3 Page 5 Page 11 Unique pulmonary New insights into TBI There is life after ISSUE 12 rehabilitation in SA rehabilitation amputation autumn 2010 2 growing the service Specialised paediatric rehabilitation New now offered The inordinately high incidence of road traffic accidents in South orthopaedic Africa contributes significantly to neurological injuries in children. This, together with near-drownings, violence, accidental injuries, rehabilitation certain medical conditions and, to a lesser degree, birth trauma, result in many children being affected with varying types and service degrees of neurological challenges. Life Rehabilitation’s new ortho­ impairment and disability. paedic rehabilitation programme, In the enriched environment created initially offered at Life Riverfield through paediatric rehabilitation, the child Lodge and now also at the five is stimulated to successively achieve age other units, is structured to ad- appropriate skills. Dedicated and intensive inpatient rehabilitation of children also serves dress orthopaedic dysfunction to provide a supportive and informative disability. It facilitates optimal environment for parents and other family independence for patients with members, who usually struggle to come complex orthopaedic rehabilita- to terms with the trauma that paediatric tion needs, includ­ing post hip or disability brings about. knee replacement surgery and multiple orthopaedic trauma, all “Life Rehabilitation’s specialised paediatric Benefits of paediatric rehabilitation programme has been developed to help The benefits of Life Rehabilitation’s of which could potentially result restore these children to their fullest physical, programme include the following: in significant disability. The pro- mental, emotional, social, scholastic (and n Prevention of prolonged stay in an gramme is focused on providing eventually vocational) potential possible, inappropriate, acute hospital environment. time limited, outcomes based thereby improving their quality of life. n On-site rehabilitation service offered by a Success in this restoration also results in inter­vention early in the recovery comprehensively trained, interdisciplinary reduced healthcare costs and burden of process; thereby ensuring that team of medical, nursing and therapy care in the long term,” says Nina Strydom, all medical, physical and psy- professionals who address all issues rehabilitation standards manager at Life without overlap. chosocial needs are addressed Rehabilitation. n Improved outcomes achieved over a timeously. To meet the huge need for this specialised shorter period of time. The service includes stabili- service, the first paediatric rehabilitation unit n Child and family centered, outcomes sation of medical co-morbidities; in KwaZulu-Natal opened at Life Entabeni driven rehabilitation. Hospital in Durban in 2009. The unit can patient and family education on n Simulation of a home environment where accommodate 10 children, as does the the correct post-surgery exer- the child has the opportunity to practice second paediatric rehabilitation unit, which tasks with increasing confidence. cises and movement, returning to has just opened at Life New Kensington n Focused and appropriate caregiver daily activity without compromis- Clinic in . training by all team members. ing physical limitations; recom­ Children (under 12 years) who would men­dation on home adaptations benefit from rehabilitation include those Paediatric rehabilitation programme with acquired neurological conditions, for and assistive devices to ensure Life Rehabilitation’s paediatric programme accessibility and safety in the example traumatic brain injury, spinal cord is focused on providing time limited, cost discharge environment; ad- injury or Guillan Barré syndrome, as well as effective and outcomes based intervention children with cerebral palsy who have limited early in the recovery process; thereby dressing psychosocial needs access to appropriate therapy resources, and ensuring that all medical, physical and of adjustment and coping; and children with degenerative conditions, such psychosocial needs are addressed timeously training of caregivers, if required. as muscular dystrophy. for an optimal outcome. The holistic, Patients also have the opportuni- A number of factors necessitate a interdisciplinary programme includes both ty to practice tasks in a simulated different approach to the rehabilitation of individual and group sessions. In addition home environment. children compared to that of adults.One such to medical care, individually targeted The programme offers factor is brain maturity, with a child’s brain intervention is developed for each child, still in the process of growing and developing based on a variety of standardised and numerous benefits, such as through an active process of learning and internationally recognised assessments, pre­venting prolonged stay in acquiring new skills. The occurrence of brain which cover functioning across the spectrum an inappropriate, acute facility, injury resulting from illness or injury can of functional areas. Interdisciplinary team significantly decreasing the risk severely affect a child’s ability to achieve meetings are held regularly to assess the of complications post-operatively milestones as would normally be the case. child’s progress and, based on this, to and greatly improving patient Research evidence indicates that starting determine whether any adaptations should rehabilitation as early as possible is important be made to the programme that has been outcomes in shorter periods. in optimising recovery of brain function and developed for that specific child. reducing the level of short and long term 3 growing the service new in-patient pulmonary rehabilitation programme

Pulmonary rehabilitation is increasingly recognised as an important part of the comprehensive management of patients with severe symptomatic lung disease, especially chronic obstructive pulmonary disease (COPD). The Life Rehabilitation units based the only major disease with an increase in potential possible,” says Michelle. “Major at Life Riverfield Lodge in Nietgedacht its death rate. In 1990, the WHO ranked objectives are to control, alleviate and, northwest of Johannesburg, Life Entabeni COPD 12th in terms of the burden of if possible, reverse the symptoms and Hospital in Durban, Life New Kensington disease on the economy, but estimates pathophysiological processes leading Clinic in Johannesburg, Life Eugene that by 2020, it will rank fifth as the impact to respiratory impairment, as well as to Marais Hospital in Pretoria, Life Pasteur of COPD on the economy becomes improve the quality of the patient’s life and Hospital in and Life St significantly bigger. to attempt to prolong it. Outcomes of such Dominic’s Hospital in East London are “Before admission, each referred a pulmonary rehabilitation programme offering a unique, structured inpatient patient is fully assessed to establish include an increase in exercise endurance pulmonary rehabilitation programme. the potential benefits of pulmonary and exercise work capacity; changes in “It is the only dedicated pulmonary rehabilitation. Our structured pulmonary biochemical muscle enzymes; a significant service offered within acute rehabilitation rehabilitation programme runs over a 10 reduction of dyspnoea; an improved units in South Africa on an inpatient basis. day period and the interdisciplinary team quality of life and reduced health related Until now, such rehabilitation was done members – a rehabilitation doctor, nurses, costs,” she explains. on an outpatient basis over a long period physiotherapist, occupational therapist, of time,” says rehabilitation standards dietician, psychologist and social worker manager, Michelle de Kock. – focus on physiological, psychological Patients who would benefit from and social aspects, incorporating pulmonary rehabilitation include COPD individual, group and family sessions. patients with acute exacerbations, COPD Medical as well as therapy staff involved patients about to undergo surgery or have all undergone specialised skills having had surgery, patients who have training in pulmonary rehabilitation. On had multiple re-admissions to hospital, discharge, appropriate referrals are made especially to ICU, with pulmonary and resources are provided. A follow-up problems, and patients who are in the assessment is done to ensure that the early to moderate stages (stages 1 to 4) of person is maintaining an improved health respiratory failure. status.” COPD is currently the fourth biggest “The goal of pulmonary rehabilitation cause of death worldwide, according to is to restore patients to the fullest medical, the World Health Organisation (WHO), and mental, emotional, social, and vocational Rehabilitation capacity expanded

Life Rehabilitation continues to expand its facilities to provide even greater access to this much needed specialist service. Life Rehabilitation opened its first 28 bed unit in 1999 and has since grown significantly to six rehabilitation units, with a total of 201 beds, almost 50 percent of all private acute rehabilitation beds in South Africa. New dedicated paediatric units speech and physiotherapists involved in The 16 bed adult unit at Life St At Life Entabeni Hospital in Durban, the paediatric rehabilitation are trained Dominic’s Hospital in East London was the first paediatric rehabilitation unit in in neurodevelopmental therapy (NDT), recently granted a licence for a further KwaZulu-Natal opened in August last year ensuring that internationally recognised 12 beds. This will bring its total number with 10 beds, with a second 10 bed unit NDT techniques are applied and integrated of beds to 28 and enable it to serve the having opened at Life New Kensington into the paediatric service. Border/Kei community even better. The Clinic in Johannesburg this year. A licence unit at Life Pasteur Hospital will also be for 10 acute rehabilitation beds has also Expansion of adult units expanded by a further 13 beds, bringing been granted to Life Claremont Hospital in Life Rehabilitation’s adult facilities its capacity to 40 beds. . The need for acute paediatric are also being expanded to meet the Furthermore, Life Claremont Hospital rehabilitation is widespread and these new demand. The capacity at Life Entabeni has been granted a licence to establish a units focus on children under 12 years was increased from 26 to 40 beds in Life Rehabilitation unit with 40 adult beds. with neurological disability. Occupational, 2009. 4 training and development LIFE PASTEUR THERAPISTS INVOLVED IN Dysphagia management UNIVERSITY TRAINING PROGRAMMES in Adults

A two day training workshop on dysphagia management in adults, organised by Life Rehabilitation and presented by Dr Mershen Pillay, speech-language therapist and audiologist, was attended by therapists from across the Eastern Cape. The event was held at Life St Dominic’s rehabilitation unit last year. Dr Pillay is the author of many current dysphagia manuals and has a wealth of clinical experience and theoretical knowledge on the Back, from left to right: Life Pasteur rehabilitation unit’s Elma Heyns, Christolene Saaiman assessment and management of this and Corina Botha, Corlia Van Vuuren from the University of the , and Heleen Van Wyk (front), from Life Pasteur, who presented at the workshops. challenging patient population. In addition to sharing information on the Therapists from Life Rehabilitation Vuuren, a lecturer at the University of the latest technology for managing these units are often invited to participate at Free State. It focused on the practical patients, he also adapted the theory teaching level in various courses offered techniques for facilitating function in and techniques for use in less affluent by tertiary educational institutions spinal cord injury patients. settings, such as rural environments across the country, reflecting the level of n The management of stroke and government hospitals. expertise and skills in the business. – a practical approach workshop Therapists were required to revisit In 2009, therapists from Life was held as a follow up on a more their anatomy and physiology know­ Pasteur Hospital’s rehabilitation unit, theoretical workshop presented in 2008. ledge in detail and were challenged in conjunction with the Physiotherapy Physiotherapist Heleen van Wyk, and to apply their own knowledge and Department from the University of the occupational therapists Elma Heyns experience in practical applications. Free State, presented two workshops: and Corina Botha, all from Life Pasteur’s The Life St Dominics rehabilitation n Attended by 40 professionals rehabilitation unit, together with Corlia team took advantage of the oppor­tu­ from across the Free State, The Janse van Vuuren from the University nity to network with their peers from management of spinal cord injuries of the Free State, did presentations other hospitals and rehabilitation – a practical approach workshop in and supervised practical sessions. The centres in the area, with the aim of Kimberley was presented by two of the course content focused mainly on gait developing a provincial protocol for the rehabilitation unit’s physiotherapists, retraining, functional cognition, upper dysphagia management – a project Heleen van Wyk and Christolene limb management, as well as the impact that is currently underway. Saaiman, together with Corlia Janse van of HIV on stroke.

Nursing manager presents at QuadPara Association workshop

Life Rehabilitation is committed to forging strong Her presentation dealt with various issues of working relationships with disabled associations sexuality in disability and how it is affected by in the community. spinal cord injury, as well the pharmaceutical and This was again demonstrated when when mechanical interventions that are available for the nursing manager at the spinal unit at Life spinal cord injured patients to enhance sexual Riverfield Lodge, Jacquiline Groenewald was function. approached to present at a spinal cord injury and Other speakers presenting at the workshop sexuality workshop, hosted by the QuadPara included Ari Seirlis, national director of the Association of Gauteng South in Johannesburg QuadPara Association of South Africa, and Erik towards the end of last year. Holm, himself a tetraplegic and actor in the local Jacquiline shared her expertise in a talk entitled television shows ‘Binnelanders’ and ‘7de Laan’. Jacquiline Groenewald of Lessons learned on sexuality and disability. Life Riverfield Lodge. 5 training and development

Progress in neurological rehabilitation highlighted at SANRA Congress

With a host of renowned international speakers, the 2009 SANRA (South African Neurological Rehabilitation Association) congress was characterised by the sharing of a wealth of cutting edge research in the field of neurological rehabilitation. Presenters included Professor Steven Smal, professor of neurology and psychology at the University of Chicago, USA; Professor Derick Wade from the Oxford Centre for Enablement, UK; Ms Michele Gerber, physiotherapist and senior IBITA instructor from Switzerland; Dr Leigh Hale, associate dean of research at the Centre of Physiotherapy Research, University Gerlinde Haase demonstrates the use of facilitatory techniques on a of Otago, New Zealand; Dr Ray Wilkinson, clinical reader model to therapists. in language & communication science at the University of Manchester, UK; and Professor Oliver Turnbull, head of the School of Psychology, University of Bangor, Wales, UK. New insights into traumatic Prof Derick Wade was sponsored by Life Rehabilitation. Research papers were also presented by the University of brain injury rehabilitation KwaZulu-Natal, University of the Witwatersrand, University of Cape Town and private rehabilitation company, Rehab-Matters. Therapists learn from internationally Rehabilitation standards manager, Nina Strydom from Life renowned expert Rehabilitation, presented a paper reviewing the Functional Independence Measure (FIM), the primary outcomes measure During November last year, Gerlinde Haase, a German physiotherapist and expert in the field of neurological rehabilitation, conducted an awe-inspiring workshop on the rehabilitation of patients with traumatic brain injuries (TBI). Gerlinde is an internationally renowned therapist, with many accreditations to her name. She is a member and senior instructor for the International Bobath Instructor Training Association (IBITA) and is also a qualified Feldenkrais (movement specialist) practitioner. She has been a lecturer and supervisor for healthcare professionals at Kliniken- Schmieder in Germany where she has been working since 1986. Gerlinde is currently writing a book on ataxia, her particular area of interest within the field neurological disability. Gerlinde presented a fresh approach to treatment, especially of TBI patients in a vegetative state, and how to facilitate function in patients with ataxia. She trained attendees in the implementation of a simple scale which can be used to monitor the progress of a patient with traumatic Prof Derick Wade brain injury, and the therapists found her use of analogies and used in the Life rehabilitation units, with outcomes in Australasia practical examples very enlightening. and the United States. The paper was co-written by Kathy A cornerstone of Gerlinde’s approach is that patients who Wundram, a respected occupational therapist and former acting national manager at Life Rehabilitation. present with TBI need to be treated with infinite patience. The Delegates also used the opportunity to explore exhibitions pace with which therapists treat such patients must be slow by leading rehabilitation associations and businesses, including enough to allow the brain injured patient time to process the Life Rehabilitation, Sanbonani, SANRA, Headway and Stroke information and respond appropriately. She also highlighted Aid. Life Rehabilitation was very proud to introduce their new that the pain experience is learnt at the brainstem level and specialised paediatric, pulmonary and orthopaedic rehabilition that therapists should not cause any pain to the patient as services to delegates at the congress. These new programmes this would result in aggressive behaviour, a symptom often were launched last year. seen in TBI patients. Another interesting teaching was that An inspirational gathering of rehabilitation professionals from maintaining range of movement through passive exercise is across the world, the conference served as a reminder of how far not indicated for patients with TBI, but that therapists should the field of neurological rehabilitation has progressed, as well as rather facilitate activities which would allow active movement a challenge to what can still be achieved in the future. through the range. 6 our business processes Risk Management in Acute Rehabilitation

The management of risks  Inappropriate referrals may be national congresses, presentation of throughout the rehabilitation made to less expensive sub-acute research papers, and internal skills process is important to ensure facilities, resulting in missing development programmes for all optimal patient outcomes the window of opportunity for grades of staff. n and the most cost effective successful rehabilitation. Representation on various rehabilita- n Access to equipment: tion associations. utilisation of funds.  Limited benefits for equipment n Timing of admissions – it is essential may also contribute to unsafe to use the window of opportunity discharges from rehabilitation, to ensure optimal outcomes. This Challenges to risk which could result in complications requires good communication management and further acute hospitalisations. between the treating doctor in the acute hospital environment, the rehabilitation service and the funder. n Discharge process starts upon n Limited benefits for rehabilitation: Management of risk in Life admission, with a family meeting  Lack of funds for acute inpatient Rehabilitation units within the first week of the patient’s rehabilitation often results in admission. patients with neurological disability n Internal risk management: staying in the acute hospital n Employing teams with expert skills.  In 2007, Life Healthcare became setting for longer periods, as n Global fee (inclusive of accom­ the first healthcare company in they are functionally unable to be modation, all therapy and daily South Africa to achieve multi-site discharged home. Paradoxically, doctors visits, and exclusive of ISO 9001:2000 certification. This this may result in a much higher assistive devices, special tests year, Life Rehabilitation became financial burden for the funder. and investigations, medication and the first rehabilitation company Complications of immobility may consumables) offers significant to attain specific ISO 9001:2008 also result, such as pressure savings when compared to the fee- certification. sores, deep vein thromboses, for-service model.  Identification and understanding contractures and chest infections, n Interactive and negotiative funder of risks specific to the acute which compromise the patient’s relationships to ensure effective rehabilitation environment. condition and result in further acute management of resources.  Monitoring of trends with regards care costs. n Patients spending less time in an to patient safety, including slips  Optimal outcomes are not achieved acute hospital environment – once a and falls, medication errors, urinary due to limited time for rehabilitation patient is medically stable and able to tract infections and pressure sores. intervention. participate in a programme of graded  Limited funding can mean that therapy, they should be assessed and patient and family rehabilitation transferred to a rehabilitation unit. expectations sometimes cannot The way forward n Pre-admission screening (at no cost be met, resulting in client dis- to the funder) and initial three day satisfaction. authorisation to allow for discipline  Unsatisfactory discharge planning, n Life Rehabilitation will continue to specific assessments. Should due to lack of resources and time, develop the field of rehabilitation as a a patient be inappropriate for resulting in unsafe discharges specialist discipline. rehabilitation, alternative discharge which may lead to further n We will continue expanding our options will be recommended. complications and readmission to footprint to achieve a national n Measurement of efficiency of acute care settings – for example network, in order to ensure the widest rehabilitation: as a result of fractures caused by possible access to acute rehabilitation  Use of internationally accredited falls, chest infections, or pressure services. and standardised outcomes wounds. n We are committed to the development measures: Functional Independence n Timing of admissions: of specialist rehabilitation products, Measure (FIM) and Functional  Referrals are often not done early such as pulmonary rehabilitation, Assessment Measure (FAM). enough in the recovery process paediatric rehabilitation and  Use of diagnostic specific out­  Not all patients are suited to the orthopaedic rehabilitation. comes measures: Oxfordshire acute rehabilitation environment. n We will continue to explore Stroke Classification, ASIA, and Some may be too acutely ill or opportunities for risk sharing with Ranchos los Amigos. neurologically impaired to benefit funders, including global fee per  Use of numerous discipline specific from rehabilitation, resulting in the admission for certain diagnostic outcomes measures. wasting of funds which may have groups. n Training and development, including been used more beneficially at a accredited internal and external later stage. CPD programmes, representation at Achievers recognised at OTASA congress Life Rehabilitation and Life Esidimeni once again sponsored two prestigious awards in recognition of outstanding performance and service excellence in the field of occupational therapy. These awards were

presented to the winners during the Occupational Therapy Association of South7 Africa (OTASA) Congress earlierour staff, this year.their expertiseOTASA represents and commitment the interests of occupational therapists (OTs) and occupational therapy assistantsAchiever (OTAs) in recognisedSouth Africa. at OTASA congress In 2007offers Lesley, his who skills was anwhere OTA, needed. Lesley is deeply involved in becameempowering the first person in the KwaZulu-Natal youth of his community through involvement to pass inthe sport. Health Professions In his capacity Council as deputy president of the Molweni of South Africa’s (HPCSA) conversion examinationSports to qualify Association, as an OTT. he is a driving force in providing youth with Lesleysporting lives in the skills, rural area advice of and mentorship. Molweni, where“We he are has enormouslybeen involved for privileged to have a person of Lesley’s years incalibre voluntary inwork. our He employ,” has supported says Nina Strydom, rehabilitation the Zimele Care Centre for disabled children.standards In addition, he manager assists at Life Rehabilitation. disabled community members by constructing assistive devices where necessaryOTASA/Life and offering general support Esidimeni Award for best and education. Respectedmental by the health health officials inresearch the From left to right are Letitia Strauss, OTASA congress chairman; Lesley Vezi, winner of the area, he is regularly asked for advice in OTASA Albie Sachs Award, and Kathy Wundram, former acting national rehabilitation manager at Life Rehabilitation. the eventDaleen of someone Casteleijn, from the community an occupational therapist by profession and From left to right are, Letitia Strauss, OTASA congress chairman; Lesley sufferingsenior a stroke occupational or accident. He is therapy lecturer at the University of the Life Rehabilitation once again sponsored the prestigious Albie Sachs qualified in basic life support, and offers Vezi, winner of the OTASA Albie Sachs Award and Kathy Wundram, former Witwatersrand, won the OTASA Life Esidimeni Award for best actingAward. national The award rehabilitation was presented manager to at the Life winner Rehabilitation. during the Occupational his skills where needed. Therapy Association of South Africa (OTASA) congress last year. Lesleyresearch is also deeply in mental involved inhealth. OTASA represents the interests of occupational therapists (OTs) and empowering Daleen the youth is of currentlyhis community in her final year of completing her PhD Firstoccupational OTT therapyreceives assistants OTASA (OTAs) in South Albie Africa. throughentitled: involvement An in sport. outcomes In his measure for occupational therapists in capacity as deputy president of the Sachs Lesley AwardVezi from Life Rehabilitation’s people with disabilities. Molwenimental Sports Association, healthcare he is settings. a Her vision is to establish a research unit at Life Entabeni Hospital in Durban, The award is named after Judge Albie driving forceniche in providingin healthcare youngsters with became the first occupational therapy Sachs, a justice of the Constitutional sporting skills, advice and mentorship. Lesley Vezi from Life Rehabilitation’s unit at Life Entabeni that will exclusively technician (OTT) to receive the OTASA Court, who played a key role in developing “Weinvestigate are enormously evidence privileged to Hospital,Albie Sachs became Award. the first occupationalthe current therapy South African technician constitution. (OTT) have a person of Lesley’s calibre in to receiveThe OTASA the Albieesteemed Sachs Award OTASA was AlbieJudge Sachs Sachs lostAward, his right sponsored arm and the our employ,”and saysoutcomes Sierra Mwangalawa, in by launchedLife Rehabilitation. in 2003. It is awarded bi-annually sight in one eye in a car bomb attack rehabilitationservice practice delivery. manager at the Life to a person who has distinguished himself in Maputo in 1988 and benefitted from Entabeni HospitalSays rehabilitation Dr Gale unit. orIn herself 2007 through Lesley, professional who was excellence an OTA, occupational became therapythe first during person the course in of KwaZulu-Nataland dedication to servingto pass the theneeds Health of Professionshis rehabilitation. Council of South Ure, mental health Africa’s (HPCSA) conversion examination to qualify as an OTT. rehabilitation standards manager The OTASA Albie Sachs Award is awarded bi-annually to New endeavours for former acting at Life Esidimeni: a person whoWelcome has distinguished, doctorhimself or herself! through national rehabilitation manager “Our company’s professional excellence andDr Neels dedication Burger (left) recentlyto serving joined the needs of In July last year, Kathysponsorship Wundram (below), of who was people with disabilities. rehabilitation team at Life Eugene Marais acting national rehabilitationthe OTASA manager, award resigned from Lesley lives in the ruralHospital area inof Pretoria. Molweni, Dr Burger where completed he has his beenLife Rehabilitation. She took an opportunity to work involved for years with voluntaryMBChB degree work. at the He University has supported of Pretoria thevery closely with aacknowledges prominent hand surgeon in private in 1976, whereafter he worked for the Zimele Care centre for disabled children. In addition, he assistspractice, a move thatthe would contribution afford her the flexibility to government until 1988. During this period he spend more time withof occupational her two young sons. disabled community membersworked at by Garankuwa constructing Hospital, Pretoriaassistive West devices Kathy and her team were responsible for the where necessary and offeringHospital generaland Steve Bikosupport Academic and Hospital. education. ongoing managementtherapists of standards in and processes Daleen Casteleijn, winner of the OTASA/Life Respected by the healthAt officials the latter, he in completed the area, two heand is a halfregularly withinasked the service, researchquality assurance, on mental training years of his four year paediatric internship. and development,health.” and marketing. She also Esidimeni Award. for advice in the event ofUnfortunately, someone due from to family the circumstances,community sufferingmade a significant a strokehe was or unable accident. to complete He hisis studiesqualified at that in time. basic life support, andcontribution towards Dr Burger has been in private practice in Les Marais since 1988, and the establishment of has built good working relations with the doctors at Life Eugene Marais a further two units in Hospital. He has a passion for both the elderly and paediatric patients, South Africa. and has over the years built up a practice of loyal patients. She will be sorely Dr Burger is a firm believer in a holistic team approach to missed as a significant rehabilitation, and in theLife importance Wilgeheuwel thereof. His enthusiasm for roleplayer wins in Life gold Rocci award rehabilitation has been demonstrated in the caring way in which he Rehabilitation, as consults with his patients and his willingness to join in unit events. We well as a mentor and In November, Life Wilgeheuwel Hospital, won a gold awardsupport for many ofSays the Glynis: “The presentation showcased the hospital’s are very proud to welcome him to Life Rehabilitation! in the Roodepoort Chamber of Commerce and Industry’stherapists andfacilities aspiring and services and focused on the expansion projects (ROCCI) professional services category. The presentationmanagers. was we’ve undertaken to meet the needs of the community, our made during a gala event in Roodepoort. ongoing training and development programme aimed at The hospital, a member of ROCCI, was nominated by equipping our staff to deliver clinical excellence, and our two members of the public following the excellent treatment corporate social investment initiatives aimed at making life and care they received during their stay in the hospital. Life better for disadvantaged members of our community.” Wilgeheuwel Hospital’s public relations officer, Glynis Krebser, At the award ceremony, two of the judges, namely Sakkie then had to do a presentation to the judges Leon Liebenberg, Stoltz and Elizabeth Malumo, said they had both previously chairman of the South African Institute of Professional received treatment at the hospital’s accident and emergency Accountants and chief adjudicator; Elizabeth Malumo, director unit, and congratulated the hospital for the quality care and of FNB commercial; Sakkie Stoltz, vice president of ROCCI; outstanding service they received. and Chris Koen, chief operating officer of Business Partners.

celebrating our achievements

4 8 our staff, their expertise and commitment College instrumental in upholding training standards and expanding programmes

professional development initiatives. She is also responsible for the accredita- One such course, aimed at tion and registration of all nursing and standardising the training of hospitality health sciences programmes. attendants working in Life Rehabilitation Anupa started her career as a general units, was developed by rehabilitation occupational therapist at Kopanong standards manager, Nina Strydom and is Hospital, where she was instrumental now being coordinated and implemented in setting up the first acute psychiatric by both Anupa and Nina. The course is in rehabilitation centre. She was then the process of final accreditation by SAQA appointed to a lecturing post at the as a formal qualification. To date, over 60 University of the Witwatersrand (Wits), hospitality attendants have been trained specialising in neurology, where for six as part of the in-service skills development years she first coordinated the physical programme. rehabilitation aspect of the training Anupa is an occupational therapist before finally serving as deputy head of by profession and also holds a Masters department. Degree in Public Health. She was Although no longer employed by the employed as a consultant to the Life univeristy full time, Anupa continues to College of Leaning in 2007, tasked with coordinate and lecture the Masters course the development of an occupational in Neurosciences in Occupational Therapy therapy technicians course, the first such at Wits. She was nominated for the dean’s Anupa Singh initiative in the country. She taught two Teaching Excellence Award in 2006, and groups of students on the course with was awarded the Health Sciences Mentor The Life College of Learning works hand resounding success – all students who of the Year by the Faculty of Health in hand with Life Rehabilitation in order wrote the Health Professions Council Sciences in 2008. to ensure that training standards and the of South Africa (HPCSA) exam passed, Anupa has presented several courses employment of a highly skilled workforce achieving a 100 percent success rate. relating to neurological rehabilitation and in the rehabilitation units are upheld. Following this achievement, Anupa has delivered several research papers, one The head office support function for joined the Life College of Learning as of which has been published. Life Rehabilitation is committed to the a permanent staff member, tasked Anupa’s passion is for adult ongoing training and skills development with co-ordinating all non nursing and neurological and stroke rehabilitation, of Life Rehabilitation employees. As such, management courses at the college. particularly in the community. Her teaching the rehabilitation standards managers These include courses for occupational and research emphasises an outcomes work closely with the college and therapy assistants and technicians, based treatment approach with an especially with Anupa Singh, who was ancillary healthcare workers, assessors, evidence based foundation. appointed as health sciences manager operating department practitioners, at the college in April 2009, in promoting theatre technicians, emergency and developing training programmes and careworkers and HIV peer educators.

New rehabilitation standards manager strengthens national support function

The national rehabilitation support service at head office has been strengthened with the appointment of a third rehabilitation standards manager, Françoise Law. She recently joined rehabilitation standards managers, Nina Strydom, and Michele de Kock, who are ‘old hands’ at Life Rehabilitation. Françoise is a physiotherapist by Françoise Law Nina Strydom Michelle de Kock profession, and has gained extensive clinical and business experience in the public sector, having been instrumental in the establishment of rehabilitation services at the Tshwane Rehabilitation Centre in Pretoria. She also holds a Masters degree in Rehabilitation in which she graduated cum laude. We look forward to her fresh outlook on the service of rehabilitation and we wish her a long and happy career with Life Rehabilitation. 9 community involvement

With World Stroke Day, held annually in October, the World Stroke Organisation (WSO), aims to communicate a unified message to the world: stroke is a preventable and treatable condition, and together we can fight the growing incidence thereof. The 2009 theme was ‘Stroke – what can I do?’ The WSO encourages individuals, groups and governments to take action against stroke, and in this spirit Life Rehabilitation units chose to mark the occasion by launching initiatives which targeted the communities in their areas.

Dietician, Heulen van Rensburg gives nutritional advice to a member of the public during Life Life St Dominic’s St Dominic’s rehabilitation unit’s stroke awareness initiative. The team at Life St Dominic’s rehabilitation unit held a display at Hemmingway’s Mall. Free blood pressure and glucose the unit, which included visitors to the the world looks from a wheelchair, and screening tests were done for the public, hospital as well as staff members from what challenges wheelchair users often and health education sessions were held other wards within the hospital. encounter, for example at restroom doors on stroke prevention, healthy eating habits, and narrow shopping aisles. and recognising the signs and symptoms Life Pasteur The rehabilitation team was over­ of stroke and diabetes. The Life Rehabilitation unit at Life whelmed by the public interest and Pasteur Hospital embarked on a stroke participation in the initiative. Life Eugene Marais awareness and spinal cord injury Life Eugene Marais Hospital held an education campaign at the Mimosa Mall Life New Kensington awareness day in the rehabilitation unit. in Bloemfontein. Approximately 200 members of the public Short sessions were conducted, during Members of the public benefitted benefitted from a joint initiative by Life which information regarding stroke was from free screening assessments and New Kensington Clinic’s rehabilitation unit discussed with the people attending, health education, focusing on healthy and Life Bedford Gardens Hospital. The and information leaflets were distributed. blood pressure, blood glucose and event took place at Life Bedford Gardens Participants’ blood pressure and blood blood cholesterol levels. Shoppers were Hospital in Bedfordview, where therapists glucose were tested and they received a also afforded the opportunity to ’step and nursing staff were on hand to offer card with the results, for future reference. into the ‘shoes’ of spinal cord injury free blood glucose and blood pressure Based on the screening assessments, patients confined to wheelchairs, by screenings, and to talk to the public about a number of participants were advised wheeling themselves around a track set their individual risk factors and give advice to visit their clinic or doctor for a formal up by the rehabilitation staff. This was on preventative measures against stroke. check-up. An estimated 150 people visited done to raise awareness of how different Awareness created for head injury prevention

As part of international head injury awareness day last Pictured at the event were, from left to right: occupational year, hospital management, therapists and administrative therapist Deborah Barrie, therapy manager Sharize staff from Life Riverfield Lodge took to the streets Lategan, physiotherapist Philip Avraam, rehabilitation in Fourways, talking to taxi drivers and handing out admissions consultants Mareli Pottas and Heleen Fouche, pamphlets to create awareness of head injuries and how it hospital manager, Dr Marinda Overbeek, and maintenance can be prevented or minimised in motor vehicle accidents. officer, Dawie Theron. 10 community involvement / outcomes in action Young girl defies odds to walk again Inter-rehabilitation Juanita began to be more responsive to sports event boosts her environment, with basic cognitive patient interaction abilities starting to emerge. After only a few weeks of rehabilita­ The world of acute neurological rehabi­ tion, Juanita had to be discharged liation in South Africa is a relatively due to lack of medical aid funds for small one. It is therefore important for ongoing acute intervention. She was the various organisations offering such placed in a care facility, where nursing services to come together from time to staff could take care of her basic daily time in order to both develop the field needs. She also continued with a less of specialisation and enable patients intensive programme of occupational to socialise with and learn from one and physiotherapy. As her condition another. The annual sports day, hosted continued to improve steadily, motivation by the Netcare rehabilitation unit in was made to the medical aid to autho- Auckland Park, is one such event rise a further rehabilitative stay, in Last year’s sports day, held in order to maximise Juanita’s physical, October, saw a team of 15 patients and functional and cognitive abilities eight staff members members from Life through intensive daily therapy. The New Kensington Clinic’s rehabilitation motivation was successful, and Juanita Juanita Pienaar (above) was ten unit participating. Each patient was was admitted back to Life Eugene years old when she was involved in a greeted with a bag of goodies, before Marais rehabilitation unit in November motorbike accident which left her with being divided into teams for bingo, 2008. The therapists’ main aim at that severe head injuries. wheelchair basketball, wheelchair stage – to get her walking! By then, Juanita was admitted to the Life racing, wheelchair volleyball and both despite significant memory and other Eugene Marais rehabilitation unit wheelchair and standing discus events. cognitive impairments, Juanita was in Pretoria once she was medically The patients were assisted and cheered talking, writing, drawing and playing. stable and able to begin therapy. She on in their efforts by the therapists and Her physical abilities were improving presented with severe spasticity in other staff. daily, although she was left with residual both arms and legs and contractures A Life New Kensington patient, contractures in her left arm. were already starting to form. She was Mr Jeffrey Mnisi, made the unit After a further six weeks of inpatient unresponsive to any stimuli, except proud when he won first prize in the therapy, Juanita walked out of the unit. pain, and was unable to interact with wheelchair discus. Two other patients, She could throw away the nappies she the outside world. With a tracheostomy Mr Shabangu and Mr Tsotetsi received had been reduced to after the accident, in-situ, she could not communicate third prizes in the wheelchair racing she could remember her therapists’ verbally. event and the standing discus event names, she could dress and wash Therapy in the initial stages included respectively. Everyone who attended herself and she could hug her friends external stimuli which could stimulate the sports day took a medal home with and family. Best of all, she could smile – her brain and awaken her senses, them, and the memories of a wonderful a great, big, beaming smile, that proved including music, pictures, smells and day out. the odds can be defied by a young girl photos of her loved ones. Slowly, with an oversize amount of courage!

Record amount raised for Jean Webber Home

For the past five years, Life Pasteur Hospital’s rehabilitation team, together with the Association for People with Disabilities in the Free Sate, has held an annual fundraiser in aid of the Jean Webber Home for the Disabled. The aim is not only to help the home financially, but also to raise public awareness of people living with disability and the challenges they encounter on a daily basis. The 2009 dinner was the most successful to date, both in terms of funds raised and the number of people and businesses supporting the event. R376 000 was raised from ticket sales to the evening dinner and various donations. The theme for the evening was ‘Back 2 School’, with Life Rehabilitation staff members and their spouses a grand total of 220 enthusiastic ‘pupils’ attending. who attended the dinner were, from left to right: Jacques and Corina (therapy unit manager) Botha, The motivational speaker for the evening was an ex-patient from the Philip and Elma (rehabilitation admissions consultant) Life Rehabilitation unit, Jared McIntyre, who was rendered a tetraplegic Heyns, Michelle van Zyl (rehabilitation doctor) and her husband, Jaco Joubert, and Nelia Fourie (nursing unit following a diving accident. Prizes were awarded to the best dressed manager). Front, left to right, Reinet (occupational couples and individuals, the most spirited table as well as to the most therapist) and Jacobus Kotzé, and Gert Fourie (Nelia’s husband). impressive dancing couple. 11 outcomes in action

Local musicians rally support for disabled colleague

unit a month after his accident. He was diagnosed with an incomplete cervical spinal injury, with incomplete motor and sensory innervation to the muscles of his arms, trunk and lower limbs. He initially required a large amount of assistance with all basic activities of daily living, but after three months of intensive inpatient rehabilitation, André was discharged – able to feed himself independently, participate in self care activities, and even able to take a few steps. South African singer, Mathys Roets, visited André while he was in the rehabilitation unit. Mathys had earlier been involved in a motorbike accident that rendered him a paraplegic and was rehabilitated at the Life Riverfield Lodge rehabilitation André van Dyk (left) and Mathys Roets (centre), pictured with Carina unit. As a disabled person who had ‘been there and gotten the Naudé, enrolled nursing auxiliary and Paula de Beer, rehabilitation T-shirt’, Mathys proved an inspiration not only to André, but to admissions consultant at Life Eugene Marais Hospital’s rehabilitation all the other neurologically impaired patients at the unit. unit. Mathys took his involvement a step further when he organised a music concert with the help of friends in the industry. The André van Dyk, a sound engineer and regular participant in aim of the concert was to raise funds to assist André with his many Afrikaans music shows, was involved in a serious car medical expenses. Over 30 musicians participated in the event accident in May last year. When paramedics arrived on the that was held at the Aula in Pretoria, raising approximately scene, he was deemed to be dead, but a paramedic checked R100 000. Some of the famous names that lent their voices to again and found that André had a very weak pulse – less than make the evening a resounding success included Pieter Koen, 25 beats per minute. He was rushed to hospital, where he was Theuns Jordaan, Snotkop, André Schwartz, Nádine, Hennie declared brain dead, with little chance of survival. However, Smit, Arno Jordaan, Kevin Leo and Steve Hofmeyr. Some of André’s vital signs kept improving, and two weeks later he the funds raised were used to buy a specially adapted sound regained consciousness. board for André, which can be operated using only one hand. André was admitted to the Life Eugene Marais rehabilitation

Having a limb amputated is a traumatic experience. The aim at Life Rehabilitation is to help patients who have suffered an amputation to regain their functional abilities and develop coping strategies in order to adapt to their new challenges. In 2009, the therapy team at the Life Rehabi­ litation unit at Life Pasteur Hospital rehabilitated three patients who initially experienced great loss of function and self identity due to amputations as a result of injuries they suffered whilst on duty. Enrolled in a comprehensive programme of amputee rehabilitation, including physical and functional retraining as well as psychosocial support and counselling, these patients started to rebuild their lives in a safe and supportive environment. Working together with Frans Kleynhans, consultant orthotist and prosthetist, each patient received custom made prosthetic limbs, with the final step in the rehabilitation process teaching them how to use these limbs functionally in their daily lives, on both personal and vocational levels. After spending between Above Jacob Dumzela who underwent shoulder disarticulation amputation of his two and three months in rehabilitation, all three right upper limb following electric shock, and Thys Kooepile, who had a shoulder disarticulation amputation of his right upper limb as well as above knee amputation patients were successfully discharged home and of his right lower limb following electric burns, with their new prosthetic limbs. eventually re-employed in their previous places of Above rigth: Kgotso Rapiletsa, who underwent above knee amputation of the right lower limb following a motor vehicle accident. work. Review Oct 07single pages:Rehab newsletter - Oct 07 10/24/07 12:27 PM Page 8

outcomesoutcomes in inaction action Contact Ex-patients raise Contact Fmoneyrom a for wheelchair the physically to disableda tandem us Life Entabeni Hospitalus Four years ago, George Rex could have 148 South Ridge Road, Berea, Durban 4001 been described as an outdoor adrenaline Life EntabeniTel: 031 204Hospital 1300 junkie who actively trained in karate and 148 SouthFax: Ridge031 261 Road, 3439 Berea, enjoyed taking part in scuba-diving, DurbanE-mail 4001: [email protected] Tel: 031 204 1300 abseiling and cycling events in his free Fax: 031Life 261Eugene 6439 Marais Hospital time. At his workplace he lead adventure E-mail:696 5th Avenue, Les Marais, teambuilding courses, including river [email protected] 0084 Tel: 012 334 2504 rafting and rock climbing, which qualified Life EugeneFax: 012 Marais 334 2508 Hospital him as an extremely active man in peak 696 5thE-mail Avenue,: reha Lesb.eugenema Marais, [email protected] physical condition. Pretoria 0084 Life Little Company of Mary However, this picture changed drastically Tel: 012 334 2603 Fax: 08650 George 501 4354 Storrar Drive, Groenkloof, in November 2003 when he had a stroke Pretoria 0181 E-mail: Tel: 012 452 9440 – an artery in his shoulder tore and [email protected] Fax: 012 346 0562 caused an estimated eight emboli to enter George Rex (left) with his fellow cyclist, E-mail: [email protected] Johan Squires after completing the 2007Life New Kensington Clinic Quads4Quadshis brain resulting participants, in a Andrécerebellar Venter in (left)farct. and Jared McIntyre. Pick ‘n Pay Argus Cycle Race. 23 Roberts Avenue, Kensington, After six weeks in ICU, George was Life New Kensington Clinic Johannesburg 2094 27 December 2007 was a day that would himself. He therefore accepted with 23 Roberts Avenue, Kensington, transferred to Life Riverfield Lodge’s was to complete the 2007 Pick ‘n Pay Tel: 011 614 7125 forever change the life of Jared McIntyre. alacrity the chance of accompanying Johannesburg 2001 rehabilitation unit, which became his Argus Cycle Race. What started out on Fax: 011Tel: 614011 3037 614 7125 He and his girlfriend were swimming André and another tetraplegic, Wahl home for the next three months. an exercise bicycle at the rehabilitation E-mail:F ax: 011 614 3037 in a lagoon which, the day before, had Bartmann, on an annual fundraising [email protected]: [email protected] been too“At first,deep I towas reach strapped the bottom, to a wheelchair eventcentr callede, proQuads4Quads,gressed to a whichspinning raises cycle at andto they help had me spent maintain the daymy sittingdiving balancinto e, moneythe for gym people and livingended with with spinal George crossingLife PasteurLife Pasteur Hospital Hospital the mwatery ne c–k without was stiff incident. and my However,arm movements cord theinjury. Argus Participants’ finishing inline the on event a tandem . 53 Pasteur54 Pasteur Drive, DHospitaalpark,rive, Hospital Park, Bloemfontein 9301 unbeknownwere uncoordinated to them, overnight. My weakness currents w as ride theirGeorge quadbikes, developed two wheelers from someone or who Bloemfontein 9301 had drastically reduced the depth of ’side-by-sides’ over a distance of 1 000 Tel: 051Tel: 520051 1230 520 1230 generalised, my balance badly affected could only turn in his bed with support, to Fax: 051 520 1231 the water in the area by washing huge kilometres – from Johannesburg to Fax: 051 520 1231 and my communication very limited. There someone who has completed the Argus, E-mail:E-mail : [email protected] amounts of sea sand up to create a Balito in KwaZulu-Natal. Over the four were numerous challenges and obstacles and is now planning to race in the 94.7 [email protected] sandbank. When Jared dived into the day period, participants spend eight Life Riverfield Lodge during my time in rehabilitation, but with Cycle Challenge. His life reflects the story water that ill-fated morning, his head hours a day in the saddle, averaging 250 Life RiverfieldSouthernw oodsLodge Road, Nietgedacht, wentthe straight guidance into of the the sandbank. therapists Theand 6thsuppo rtkilometres.of one man’s focused determination, and34 SouthernwoodsJohannesburg Road, 2001 Nietgedacht, Tel: 011 460 1970 (or 082 563 4041 when the vertebraeof my finamil hisy, neckwe attempted split in two each and of the these Moneythe unconditional is raised through suppo sponsorshiprt of his family andRandburg 2194 lines are down) 7th shattered into many pieces, severing of the riders by various organisations and Tel: 086 074 8373 at intervals.” One of the seemingly friends who have helped make this Fax: 011 460 1977 his spinal cord and rendering him a individuals. André concluded a contract Fax: 086 532 2330 impossible goals George set for himself journey possible. E-mail: [email protected] complete tetraplegic. with QASA (Quadpara Association of E-mail: Jared began the long road to South Africa), which allowed him to raise [email protected] St Dominic’s Hospital recovery‘In si at cthekness Life Pasteur Hospitaland in fundshealth for a local’ institution in Bloem­ 45 St. Mark’s Road, Southernwood, rehabilitation unit in Bloemfontein. fontein, the Jean Webber Home for the Life StEast Dominic’s London, Hospital5201 45 St. Mark’s Road, Southernwood, He attributes much of his emotional Disabled.Two ofThe the initial patients sponsorship at Life P asteurgoal ’s Tel: 043 743 4303 East London 5201 recovery at this time to the relationships was R250 000, but this target was more Fax: 043 722 3250 rehabilitation unit celebrated happy Tel: 043E-mail 742: reha0723b [email protected] he built with staff and other patients, than doubled when a total of R516 000 events in the last few months. Fax: 043 722 6321 ties forged by shared experiences and was raised a few days prior to the event. Anton Weihman, who suffered a T1 E-mail:Life Rehabilitation challenges to be faced and overcome. A total of 400 riders participated, of [email protected] Office One such relationship was struck with whichspinal three cordwere inju tetraplegicsry in a motor and v threeehicle Oxford Manor, 21 Chaplin Road, another tetraplegic, André Venter, who were accident,paraplegics. mar Approximatelyried Anna-Mar ie370 Life RehabilitationIllovo 2196 had completed his rehabilitation at Life ridersEsterhui finished,zen including in July. all six spinal NationalTel: Office011 219 9620 Pasteur Hospital and returned to his life cord injured paticipants. OxfordF axManor,: 086 21686 Chaplin 0441 Road, Dr Ambrosius Swartbooi, who E-mail: [email protected] an activist for the plight of tetraplegics Says Jared: “It was four days of Illovo 2196 sustained a C6 spinal cord injury in a and paraplegics in South Africa. driving on gravel, road and veld, over Tel: 011 219 9620 motor vehicle accident, got engaged to Fax: 086 686 0441 Jared was inspired by André to railroad crossings, through farmlands, www.rehab.co.za E-mail: look for ways to turn his misfortune traversingSusan rivers, Morgan koppies. We are and tr forestsuly hap ptoy that [email protected] intoAnna-Ma a way rofie makingand Anton a difference on their winedding dacompletey. they 1found 000 kilometreshappiness ofafter immense tragedy . the lives of people less fortunate than fun and life changing adventure”. www.rehab.co.za

Review is published by Life Rehabilitation for distribution to rehabilitation stakeholders. Editor: Marietjie Shelly, communications manager, Life Healthcare • E-mail: [email protected] • Tel: 011 219 9000 Life Healthcare • Oxford Manor, 21 Chaplin Road, Illovo 2196 • Private Bag X13, Northlands 2116