186 chapter 23
Keeping clean is very important for persons with reduced feeling, especially if they lack
bladder and bowel control. Take care to bathe daily. Wash and dry the genitals, the butt,
and between the legs as soon as possible each time they get wet or dirty.
If redness, diaper rash, or sores develop, wash more often and keep the sore area dry.
Keep the legs spread open and exposed to the air. When they must be covered, use soft
absorbent cotton cloth. Putting a little vinegar in the rinse water after bathing the child, and
after washing diapers and underclothes, helps prevent skin rash and infection.
For treatment of specific skin infections (fungus, yeast, bacteria) consult a health
worker or a medical book (like Where There Is No Doctor, see Chapter 15).
3. Loss of ability to sense what position the body is in affects a person’s sense of
balance. So does loss of muscle control. The child needs to develop new ways to
sense the position of his body and keep his balance. Start with the child sitting on a
bench, if possible in front of a mirror.
Help the child progress
through these stages:
• both hands on bench
A child with mid-back injury
will balance in this position.
• both hands on knees
• lift one arm sideways,
forward, and back
• After doing this in front
of a mirror, have him do it
without the mirror.
• As the child gains
better balance,
start doing different
movements with
first one and then
both arms, such as
lifting weights or
playing ball.
pillow to avoid
pressure sores
legs
and
feet
apart
mirror—
the bigger
the better
feet flat on floor
Note: Some children may have so much
difficulty with balance that they may
have to start in a wheelchair or a chair
with high back and arm supports.
4. Muscle re-education All muscles that still work need to be as strong as possible
to make up for those that are paralyzed. Most important are muscles around the
shoulders, arms, and stomach.
Weight-lifting is
a good exercise
to strengthen
shoulders.
Disabled village Children
bags full of
sand or stones
Look for ways to make the
exercises useful and fun.