 Without medicines and proper treatment, hemophilia can cause painful bleeding into joints that can leave a child crying in agony as a parent watches on helplessly. In many cases, the bleeds causing the pain will permanently damage the child's knee, ankle, elbow or other joints,
leaving him unable to walk, to play - or eventually to work.
But a life of chronic pain, disability, and dependency is not inevitable. From Cairo to Kuala Lumpur, Dutch physical therapist Piet de Kleijn is giving hope to children and their families by showing that basic, functional exercises can help reduce the effects of joint bleeds. Optimal recovery after each bleeding episode will reduce the frequency and severity of joint bleeds, even if clotting factor concentrates are out of reach.
Better still, his knowledge empowers hemophilia patients and their families to help themselves when doctors and medicines are not available.
Since 1979, Piet has practiced and researched physical therapy in Netherlands hospitals, using it to help children and adults with ailments ranging from asthma to hemophilia. Now a senior physical therapist in the University Medical Center, Van Creveldkliniek teaching hospital in Utrecht, he's one of the WFH's committed volunteers. During his precious spare time, Piet conducts training workshops and helps patients around the world.
A defining moment for Piet was a 1992 trip to India, which showed that helping people with hemophilia means more than just flying into a place, advising patients and then flying out again: "I was very impressed by the medical professionals in Vellore. They were doing the impossible with no money, help, or resources. I then visited Calcutta. The trip showed me that follow up care only existed when I was there. I realized it's important to focus on the knowledge transfer.”
The trip showed me that follow up care only existed when I was there. I realized it's important to focus
on the knowledge transfer.”
Piet proposed that the WFH launch Global Physiotherapy Implementation (GPI), a 10-year plan to develop and establish worldwide basic physical therapy care for people with hemophilia. Piet’s proposal is now reality, and the first “train the trainers” one-week course for physical therapists was just held in Cairo, Egypt, in December 2007.
Says Kathy Mulder, Chair of the WFH Musculoskeletal Committee, “hemophilia is a relatively rare disease, and therefore not all physical therapists are familiar with the important role they can play. The GPI will identify key therapists who can educate other therapists in their regions, ensuring a common approach and consistent level of care around the world.
"It's essential to train local practitioners of physiotherapy in all regions. Having local experts assures continuity and they're more effective operating in the local culture and conditions,” Piet notes. "When you have a bleed in Holland, you go to the fridge, where treatment products are on hand. Boys with hemophilia all participate in some kind of sport and feel at ease in our society. As a physical therapist, you hardly see them. Elsewhere it's a different story."
Spreading that knowledge and implementing physical therapy has become Piet's mission. In addition to field trips, he spreads the word by writing academic papers on the use of objective measurement tools in physical therapy, conducts presentations at medical conferences, and is active in several WFH projects. Piet is not all work and no play, Kathy Mulder is quick to remind people. “Piet is also an avid football fan, a fisherman, and a painter. Not too many people know about the painting, I think, but I have a beautiful watercolor that he painted for me a few years ago.”
Last Updated February 2008 |
