Bibek Tamang, 11 months old child resides at Teliya, Chhathar Jorpati-4 with his grandparents and mother. Shanti Tamang, mother of Bibek Tamanag, was just 20 years old when she gave birth to him. Bibek has a history of birth asphyxia and he stayed at Neonatal Intensive Care Unit at Dhankuta Hospital for 5 days after birth. He has difficulty using his upper and lower limbs. He is unable to hold his head properly and cannot sit or stand despite being 11 months of age. The family’s economic condition is very poor so they have not taken him for treatment at any hospital. 

Community Based Rehabilitation Facilitator (CBRF), Pradip Ojha was on a routine home visit on the month of Ashwin when he came across Bibek and his condition. He immediately informed CBR Officer of Karuna Foundation Nepal (KFN), Dhankuta District, Bibek was observed via video call and was suggested to refer for pediatric consultation. However, the family did not show much interest in the beginning. With constant follow up by the CBRF and KFN, the family still did not show interest because of their economic background.

On 28^th of Mangsir 2078 B.S, team from KFN with focal person and CBRF of concerned palika went for a visit to Bibek’s house for assessment. Physiotherapy assessment was done and Bibek was provisionally diagnosed with spastic cerebral palsy. During the assessment, Bibek was drooling constantly and he kept his trunk extended. Some basic physiotherapy interventions were taught to the mother during the visit. The family was counseled for immediate treatment of Bibek and to make a disability identity card since the he is likely to suffer from disability in the future.

A disability card for Bibek was made the next day under category “A”. Bibek will receive a disability allowance every 3 months from now on. He was also taken to BPKIHS for treatment on 7^th Poush where he was diagnosed as Spastic Cerebral Palsy with quadriplegia and was given vitamins. He went for a follow-up to BPKIHS after 2 weeks where his ears were tested. He is asked to come for follow up again at the end of Magh and is recommended to do physiotherapy for some improvement. 

On a recent phone call, Shanti Tamang said “The drooling problem Bibek had has decreased quite a lot after the pediatric consultation and he is also able to sit for some time and hold his head. We are happy to see even this small improvement in him. It gives me hope that maybe he will be able to sit independently at the very least.” She also expressed that she is planning to buy nutritious and healthy food for Bibek after receiving the disability allowance this month.

KFN district team is planning to provide physiotherapy service to Bibek twice a week with the help of concerned CBRF in the coming days.

From this case, we can observe that awareness on itself sometimes might not be enough to convince someone to utilize the services provided. Continuous follow up and consistency is of utmost importance for better utilization of provided services. It was also observed that the involvement of representatives of local government increases the trust mechanism of beneficiaries which will result in speedy service provision as the representatives also experienced the needful condition of the beneficiary.