Saturday, March 30, 2013

Small & Simple Projects

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This is an adult education class on beauty salon skills. We had a project that helped this program.
Humanitarian services provides resources for 2 types of projects. The major projects involve wheelchairs, vision help, water, newborn resuscitation, and small farm projects. These projects are large, both in terms of money and in time and effort to develop, implement and monitor. These projects must be individually requested, usually in the Fall when  the Church’s humanitarian budget for the following year is planned.
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Church Leader takes us to visit a possible project
For the second type of projects, each humanitarian couple is allowed a certain amount of money every year to use for local projects that meet specific community needs. As long as the couple follows the general guidelines, they are free to search for any opportunity to help the local area.
And that search often is aided by members of the Church who know of needs in their community. Below are 2 sisters in our branch who took us to many different schools, nursing homes and jardins that could benefit from humanitarian projects. Several projects were the result of this help.
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Briefly, the general guidelines are:
1. The project is done with a non-profit partner. It can be a government agency or a NGO (non-government agency). We don’t work directly with individuals, though we enjoy meeting the individuals that the partner serves.
2. The purpose of the project is to help the partner become more self sufficient to serve the community, and/or the people served by the partner in the community are better able to care for themselves.
3. The cost per beneficiary is to be $20 or less.
4. Generally, day to day or consumable costs are not provided in the project.
One important principle we always need to keep in mind is the value of each individual. Truly, ‘the worth of souls is great in the sight of God.’ (D&C 18:10) Though we work with partners, spend lots of money, walk to the partner’s office to discuss the project and do all the myriad of chores required for each project, the most important part is each person that is blessed by our work.
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When a couple finds a need that fits the guidelines and they feel this is a project to do, they write up an application on the internet-based program of the Church whose acronym is “CHaS.” Here we describe the project, its purpose and objectives, and develop a budget. We then send it to the European area welfare specialist (another missionary couple) who then takes it to the bi-monthly approval meeting. If they feel it follows the guidelines, they approve the project and the couple can then start the project (usually that means spending money!!)
Below, are some of the smaller, area projects that we have done. We have enjoyed this part of our work very much. It gets you right down in the community!
Here is a map of Cape Verde so you can see where these different projects are.
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(Map courtesy of Wikipedia.com)
Educational Equipment for the Blind
Praia, Santiago
Partner: ADEVIC - Association of the Visually Handicapped of Cape Verde, approved in October, 2012.
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These are the key people in this organization, of which 3 of the 5 are blind themselves.
This is a national organization, but our project was to help the school for the blind that they administer in Praia. They serve people of all ages, from 10-12 years old to 70. The school is a day class and they provide transportation to get the students to and from class.
Basically, you can’t buy any blind equipment in Cape Verde. We generally ask the partner organization to find a vendor for their requests. However, with many of the leadership blind themselves, it was hard for them to do the internet searches. We finally decided we needed to take that role if we wanted to submit this project. We also thank Elizabeth who did research for us on where to purchase the equipment that was needed and how much it would cost.
The first order was for Perkins Braille Writers. We found a company in England that had a good price on refurbished writers and participated in a program where equipment for the blind is shipped free of charge. Shipping can be very expensive, so this was a great help. We able to purchase 5 refurbished machines for the price of 1 new one. They were happy with that!
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Some Braille writers in use.
The next piece of the order was for Braille punch writers (pautas in Portuguese) and speaking calculators. The English company, for some reason, didn’t stock Portuguese speaking calculators. They also didn’t have the requested size of the punch writers. So, we ordered them from a Company in Portugal and as miracles would happen, a member of the church here was going to Lisbon on Church business and he brought all the calculators and pautas to Mindelo in his suitcase – for free! We then carried them in our suitcase to Praia.
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Here is a student trying out the new Portuguese speaking calculators.
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Students feeling out the new pautas!
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The teachers, blind themselves, are trying out pautas also.
The final piece of the project was ordering again from our English source some Braille writing paper and some math Cubarithm’s. Below is a picture of one. They hadn’t yet arrived when we visited last and so do not have a picture of our delivery. But this is what we ordered!!

The top of the cubes have Braille dots for numbers. And you arrange the cubes for whatever arithmetic problems you want to solve.
CASA DA CRIANÇA
Mindelo, São Vicente
Project was approved in November 2011.
Casa da Criança is a kindergarten serving many children ages 3-5. It is a public school, and like other public schools, it is difficult to maintain the facilities. The roof over the entrance way leaked terribly. The classrooms needed paint as well as the outside play area.
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Here is one of the classrooms that needed to be painted. Aren’t the kids cute!! All kindergartens (Jardins, in Portuguese) wear a gingham Bata for a uniform, both boys and girls. Each Jardim chooses its own color.
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Here is a freshly painted room. The rooms looked much nicer and much cleaner and a better place to be.
Then the entrance way. The problem was the concrete roof that had cracked and was letting water in.
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Here they are applying the sealing primer after making the needed repairs.
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   Here is the finished product.
   Looks MUCH better.
    And the rain stayed outside!




Finally the play court:
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The bright red, high gloss paint that resists dirt was made twice as high as it was previously. The children do enjoy playing

Another small part of the project was to have a hygiene lesson given by some nursing students to the children followed by giving them an individualized hygiene kit.
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Here ‘Flecha’ learns why  it is important to wash your hands, take a bath and brush your teeth from his friend (and I don’t remember her name!).
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Handing out hygiene kits
We had a little money left over in the project and asked the director of the school what she needed. What was most important was to put a water box on top of another school so they could have water at the school! Unfortunately, the cost was too much for our budget. But we agreed this was a very important need. So we applied for some more money through a supplemental request which was granted. I won’t add that picture. It is just a building with a big, concrete box on top.
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And if you want a hug, go to a Jardim!!
Mosteiros Special Education Workshop
Mosteiros, Fogo
Project was approved in October, 2012. We are waiting for one more piece to pay for so we can close the project.
Special Education is just beginning to be implemented in Cape Verde. In the past, the students that didn’t progress in their schooling dropped out, perhaps after only getting to the 3rd year. Basically, you keep repeating a grade until you pass or you get too old and are dropped from the school system. And if you have a problem like being blind or deaf or other type of handicap, you often just didn’t go to school. The next 3 projects we describe were with different Special Education programs.
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Here is a view of Mosteiros as we are climbing up the steep hill. The light lime green building is the pensão where we stay when we go to Mosteiros. We usually  eat our meals there too and the cook does fish wonderfully well! The building across the street, a brownish one with rounded corners is the Cámara, the local government building.
Mosteiros is on the opposite end of Fogo from the main city of São Filipe. If you don’t have a car, you have to take the hiace which only leaves from São Filipe around noon. And if you want to go back to São Filipe, the hiace leaves at 6:00 a.m. (yes, that is morning!!) One morning as we were leaving Mosteiros, we had to leave the hotel before anyone woke up and we left without paying!! We did take care of it, but we are careful now to pay for our hotel the night before.
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And a view from sea level!
The Mosteiros school district asked if we would finance a Special Education workshop that would instruct teachers on visual aids that would help those students learn. And the workshop would include a hands-on session for the teachers to make some of the teaching aids. The hope was that then they could go back to their school, teach the other teachers, and make more aids as they needed them.
30 teachers gathered at the end of November. The assessment of the school district: better than they had ever hoped!
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First the boring part with a general meeting with all the teachers.
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Then the instruction!!
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And now the fun part!!!
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Here are some of the projects. Although we supplied many materials, you can see the normal Cape Verdean way of recycling common household items like empty yogurt cups, egg cartons, cups, cardboard boxes, etc.
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And, finally, part of the pay off for us:
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We visited a school in Relva  which had sent a teacher to the conference. She came home and made an alphabet matching game for EVERY student in her class (the plastic bags that each students has on their desk)! Our goal of helping our partners to be better able to serve their people was clearly met!
Sal Sepcial Education
Espargos, Sal
Project was approved in December, 2012. Because the final workshop will be in the Fall, 2013, we won’t actually close the project.
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On Sal, the Special Education Director is also the only Special Education teacher on the island!! She has a classroom in a school in Espargos, and the children rotate through her class from the other regular classes. She needed help with upgrading her room with windows that would keep the dust and rain out to protect the equipment, a repaired and repainted floor to make the room look and function better and a new printer and computer network. She also wanted to better serve the needs of deaf students with a workshop for teachers, families and friends on Portuguese sign language. Also, as part of the project, she will be conducting a general special education workshop next Fall. She has been a wonderful partner, always answering our emails quickly and coordinating all the work in her classroom.
Installing windows
New aluminum windows are being installed!
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Participants in the sign language class. Our partner reported that after the week long course, one teacher began really communicating with the deaf student in her class.
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A larger view of the class. The young woman in the front right wanted to take the class so she could ‘talk’ to her friend.
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We spent an hour one day in her class and enjoyed doing some math activities with the children. You can see the nice, clean window in the top right.
Note: An interesting part of this project is the ‘long distance’ factor. We only visited Sal twice: once discover the need and once during the project when no work was currently being done. All applications, requests, discussion, payment of vendors etc. was done online. We have to have a very high level of trust in our partners to do these types of projects. She actually reimbursed us $25 that we had overpaid on one bill. We would never have known, if she hadn’t been honest!
São Filipe Special Education
São Filipe, Fogo
Project approved April 2012.
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Red Cross President, Special Ed Coordinator and Artist with daughter
This was actually our first Special Education project. We learned about the challenges of Special Education in Cape Verde from the local Red Cross president, who is also the coordinator for Special Education in São Filipe as well as a Spec. Ed teacher and very accomplished artist. Here is a piece he was working on in his home.
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His request was for equipment and learning games.
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I enjoyed the visit to the Special Ed Recourse room. Here a deaf student is trying to teach me to ‘say’ my name in sign language. It’s as hard to learn as Portuguese!
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Here is a special program that was presented to handicapped people using the projector, laptop and other equipment from the project.
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A teacher is using one of the new educational games to help this student understand math.
A final piece (with money that hadn’t been used on the major part of the project), was to put in a secure door to protect the equipment from theft. The resource program moved to another school and while in general it was safer, the director felt it better to add a secure door.
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The fabricator and the door he welded together!
As you can see, one major emphasis we have had in our Area Initiatives is education. Certainly an essential key to helping the people of Cape Verde become more self-sufficient is adequate education. They have made great strides in the past few years. We hope the small projects we have been privileged to participate in have helped!

Wednesday, March 20, 2013

Turbocharged Wheelchair Services

A New Paradigm for Cape Verde

 

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Wheelchair recipient and daughter with Physical Therapist who provided a new type of Wheelchair Service

If water is life, wheelchairs are freedom. From the beginning of LDS Humanitarian Services wheelchairs have been a key offering. We arrived in Cape Verde virtually with our first container of wheelchairs. Working with the Red Cross to distribute those wheelchairs to needy handicapped has been both gratifying and a little troubling. In past postings we have shared a number of experiences meeting those selected to receive wheelchairs. While it has been a privilege to participate in these deliveries, we sometimes wondered if this was always a good thing.

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The Old Way

The guiding concept for these early projects was that almost any wheelchair offered lifestyle improvements and greater freedom than no wheelchair if you were poor and couldn’t get around. Wheelchairs came in different widths and some effort was made to match the width to the person, but it was clearly hit and miss.

As for wheelchair adjustment and maintenance, we offered them a tire patch kit, a basic wrench set, and said good luck.

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After seeing more than a few situations that left us feeling, under the surface, a little unsure how much good we were doing, we were ready for something better.

 

December 2011 – A New Paradigm proposed

In December of 2011 we made contact with John and Marcia, short term wheelchair specialists, as we made plans to create our next wheelchair project. When they floated the idea of a new paradigm for furnishing wheelchairs, we were ready to bite. The new concept, based on World Health Organization guidelines and LDS Charities experience, was this: the wheelchair should be fit to the needs of the recipient, not the reverse. If the wheelchair was not appropriate for the person, don’t give it to them. It is possible to do more harm than good. What a concept.

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Our wheelchair specialists come to Cape Verde

How would we accomplish this change? The first requirement was to partner with organizations that had medical personnel on staff able to learn principles of patient evaluation and wheelchair fitting. We also needed an organization that could store and control the release of the wheelchairs to only those certified to prescribe them and had connections to potential recipients in the community.

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Here we are with our team of physical therapists, doctors, and pharmacists from the Ministry of Health planning the training

Second, we needed to train physical therapists and other medical professionals how to assess and fit wheelchairs. These would be the key people to make sure we offered something that would improve their situation, not hurt. We also wanted to train some more mechanical types in how to properly assemble the wheelchairs and maintain and repair them as needed. These people needed to be available to the recipients. We would set up a 3 day course using specialists from the US to prepare clinicians and technicians to perform their critical role in the new paradigm.

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Our short term specialists offered to spend a week with us meeting with potential partners and selecting one or more that would fit the bill. They came to Cape Verde in February of 2012 and together we successfully identified the Ministry of Health as our primary partner. From among others we met with, we selected two to help identify potential recipients. We met with the ministry leaders all the way to the top, and learned that handling wheelchairs in any form would be a whole new ball game for them. Fortunately they had the right puzzle pieces to create the right picture once they learned to put it together. We were very pleased with the potential and excited to be part of a new dispensation for wheelchairs in Cape Verde.

 

A year in the development

Murphy’s law: Anything that can go wrong, will go wrong. Or is it just Cape Verde? We planned six months to get wheelchairs ready to distribute and it took a year.

Educating the parts, especially the head of the pharmacy organization, just took time. Remember this was all new to them. We faced a few disappointments of timing, but the players in time played their parts well. Here is a photo in June when we finally got our contract signed and could place the order for the wheelchairs, walkers, cuff crutches and canes, three months behind schedule.

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The container full of new wheelchairs was shipped from China in September and arrived here in late November. Our partner had forecast one week to get the wheelchairs through customs and into their warehouse. In actuality it took almost two months. The space they planned to use to store these wheelchairs was full of medical materials waiting (and waiting, and waiting) to be disposed of, so they chose to leave the wheelchairs in customs and pay storage fees there.

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During the months the wheelchairs were in manufacture or on the water we were working with a group at the hospital to get ready for the three day training. They would help select the place, the people to be trained, and find potential recipients to also be part of the training. Working around everyone’s year-end schedule, including the arrival of a baby, we set the end of January for our training. It seemed way far off, but with the delay in customs it could not have been any sooner.

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A new wheelchair

Our previous project provided wheelchairs largely suited for indoor use. For this new project we looked at a couple of designs of more rugged outdoor style wheelchairs and decided on the RoughRider. Above is a photo of this chair nearly assembled. It has low profile wheels on the front that handle cobblestone streets, dirt roads with rocks, and generally rough terrain. The rear wheels are bicycle wheels with a standard tire size for replacement.

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It also comes in 5 widths and most come in two depths. The seat cushion can also be sized to provide proper leg clearance in front. All of these options will be used to “fit” the chair to the recipient.

 

Countdown to the change

As our training dates approached we had a list of things to take care of so all would be ready for a smooth course. We thought the list might be of interest:

  • Find the right place for two concurrent training sessions: Answer – our local LDS Chapel
  • Identify the 12 clinicians and 12 technicians: While a Ministry responsibility, we made sure they covered the island, 10 evaluation centers2013-01-15_002
  • Build assessment benches to be used by the clinicians in the 10 evaluation centers. Also a Ministry responsibility, but when they felt a little overwhelmed we stepped in, found the carpenter, got a quote, got him started in mid-December and they were ready before the end of January. Below is what the finished product looked like:

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  • Arrange for a caterer to provide snack breaks and lunch all three days: Answer – a woman with a good reputation near the Chapel
  • Arrange for translators: Answer – two returned missionaries willing to work on a conditional basis (one is the guy in center in photo below) since all four of our trainers had served missions in Brazil

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  • Arrange for 50 wheelchairs of various sizes be delivered by the Ministry to the Chapel: Challenge - getting the working parts of this delivery service working (see 4th photo above)
  • Work with the hospital staff to select and invite 30 potential beneficiaries for the training
  • Order customized t-shirts for the training staff and trainees

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  • Purchase and put together simple tool kits for the clinicians to use in fitting

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  • Purchase clipboards, pens, and make copies of training materials for trainees
  • Purchase paper to print participant certificates
  • Make sure we had keys to the building and that the restrooms and other facilities would be clean and ready to use
  • Work with Church Public Affairs to plan a closing ceremony, provide them with lists of invitees, a program to follow and suggested speakers to invite, with special plaques to recognize the contributing partners
  • Make hotel reservations for the trainers and specialists
  • Make last minute contact with the caterer to verify that all was ready to go

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  • Schedule members to help set up the training and lunch rooms
  • Set up registration/check-in for the participants with all the materials they would receive as part of their trainee package

The change begins

We scheduled the training to begin on Tuesday. Our training staff flew into Praia on Saturday. We met them that night at their hotel and had dinner together to start getting acquainted. Sunday we all attended Church together in the morning then gathered at our place for a spaghetti lunch and a briefing session. That worked wonderfully to preserve a Sabbath atmosphere thanks to Janet.

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The trainers in the midst of setup plan their attack

Monday we started early to set up the chapel for the training and then to begin prepping wheelchairs for the next day. We wanted 12 ready for the clinicians (see below).

Chairs ready to go

Tuesday morning we introduced our translators and had a prayer meeting before starting. We started the training with a group session to welcome everyone and explain a few things about the course and the facility. We are ready to begin.

 

Training with a purpose

The actual training program was the key to this new paradigm. It was pretty clear that no one in Cape Verde has made it a point to evaluate recipients beforehand and consistently adjust the wheelchairs for the best possible fit.

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The training was very much a hands-on experience for all the trainees. The clinicians were asked to spend the whole first day of training in a wheelchair. They had various types of experiences, all insightful. Brian and Brett, the trainers, did pretty well with Portuguese. They had posters up and lots of other visuals. They taught principles then went immediately into the practical stuff.

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The technicians were either in a huddle around a demonstration or working in pairs to assemble and adjust the wheelchairs. Getting the brakes right was a key point. One of the technicians was partially deaf and another was partially handicapped, but that didn’t hold either back. This is the first time we are aware of an effort to put people out in the field where the wheelchair users are, available to adjust, repair, and do basic maintenance on demand.

Here are some additional photos of the fun during the first day of training.

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The real benefits

The final part of the training was where the real benefits were manifest. As the selected potential beneficiaries began to file in, there was no question of their need. Some came in walking on their hands and what was left of their feet. Others were carried in. Still others came in old broken down wheelchairs (see above). They waited patiently until their number was called.

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In the first round with real handicapped, the trainees took their time with close surveillance by their instructors to walk through the steps of the evaluation, asking the right questions, gauging the appropriateness of a wheelchair, understanding their life situation and needs, looking for evidence of existing pressure sores or open wounds, then beginning to measure the width, foot support height, seat depth, and so forth.

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Not everyone in the group of 30 qualified for a wheelchair, and that was a hard conclusion to reach, but a very important one. The instructors were very pleased to see them make honest and difficult assessments and send some away with alternative recommendations but no wheelchair.

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By the end of the third day the now certified clinicians were much more confident and quicker in their assessments. They were read to graduate.

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Celebrating

The final step of the course was a closing ceremony with dignitaries, certificates, refreshments, and time to mix.

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Sister Broderick offering a certificate and beijinhos (cheek kisses) to one of the clinicians

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One of our partners is himself handicapped. Here he recognizes one of the newly trained physical therapists.

Our Church Public Affairs director sent out the invitations and MC’d the event. We thought the Minster of Health was going to attend and say a few words, but on the day of the event we heard that she had changed her mind. Instead the director of the Pharmacy Department represented the Ministry of Health and was our final speaker. Our specialists pointed out they have never seen the top person attend one of these events.

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Our clinicians and instructors standing to be recognized as a group

For the program we invited some of the last beneficiaries in the training and their family members to attend and share some of their feelings. The Church was well represented with the Praia Stake President and several local members attending. The hospital and an association of handicapped were represented.

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A priesthood leader sharing  a Liahona with one of the participants during the refreshment break at the end

Check out this video that one of the trainers made to share with his family.

The training from the point of view of a trainer. Guess which one?

Welcome to a new day in Cape Verde for serving our brothers and sisters with mobility handicaps.

Praia de Barra

The Beach!! Rio de Janeiro is world famous for its beaches and we live 8 miles and 39 bus stops from a point in the miles long beach!! ...