All professionals in one place and family activities: The disruptive model of a therapeutic center for children with disabilities - RED/ACCIÓN

All professionals in one place and family activities: The disruptive model of a therapeutic center for children with disabilities

 Una iniciativa de Dircoms + RED/ACCION

El Granero, located in the Buenos Aires town of Pilar, provides indoor medical consultations and equine therapy, as well as workshops and activities for the family members of individuals with disabilities. Its founders opened it because they observed that therapy spaces are often widely separated and do not take into account family dynamics.

All professionals in one place and family activities: The disruptive model of a therapeutic center for children with disabilities

Intervened by Marisol Echarri.

In 2010, Joaquina was four months old when her parents, Cecilia Fornieles and Mariano Ferreyra, took her to a consultation with a pediatric neurologist. The professional diagnosed her with generalized hypotonia, a neuromuscular disorder in which the transmission of signals from nerve to muscle fails.

Since then, Joaquina and her family have traversed various offices and therapeutic centers. However, along this journey, Fornieles and Ferreyra realized that the path a family with a member with a disability must take is not well-prepared in Argentina. They noticed certain aspects that could be changed. So, they decided to build El Granero, a rehabilitation and equine therapy center to include people with disabilities in society, ensure a family approach to disability, and offer different therapies in one place.

Challenges for families

The couple noticed that one of the main problems was that the rehabilitation centers they frequented were not prepared to accommodate families. "Waiting rooms are complicated. I saw cars in the parking lot occupied by a mother and the kids, jumping or doing homework on the glove compartment when they could be doing it or playing at home," says Ferreyra.

Also, when seeking treatment with professionals with offices in different places, Joaquina's parents spent a lot of time driving her to therapies. But the problem is not only the physical distance between professionals: "Many therapists have correct but diverse views and also different priorities and goals in the rehabilitation process, making interdisciplinary approaches impossible," clarifies Ferreyra.

The possibility of conducting all therapies in the same center provides a unified vision, simplifying logistics and communication among professionals. (Image: courtesy of El Granero. Edited by Marisol Echarri).

The equine therapy center

Equine therapy is a type of therapy that establishes a relationship with a horse to stimulate the muscles and joints of the patient, bringing cognitive, communicative, and personality benefits. The Greeks were the first to talk about the health benefits of horseback riding. The expansion of equine therapy began after World War I when it was used to treat soldiers with sequelae. There are several equine therapy rehabilitation centers worldwide, mainly in the United States and Europe. In Argentina, the Argentine Equine Therapy Network has existed since 2015, where professionals and rehabilitation centers can exchange information.

Fornieles and Ferreyra took Joaquina to equine therapy for the first time when she was two years old. There, they found a more comprehensive therapy with a playful and complete approach that not only worked on strength but also connected with her environment. "She started speaking, standing, eating better, and making better eye contact. We never imagined that the treatment would encompass all of that," recalls Ferreyra.

However, the problem with the center they attended was that therapies could be suspended due to weather conditions. So, in 2014, Fornieles and Ferreyra thought about starting an equine therapy center tailored to their needs and listening to what families with children with disabilities needed.

She traveled to Spain and Colombia to meet with other equine therapy centers and thus be able to create one that was professional and of high quality. They considered it crucial that this new space be self-sustainable: depending on donations makes it difficult to survive in times of instability. Thus, El Granero was conceived as a professionally managed rehabilitation center, run as a business.

"There is no manual for the equine therapy center; you assemble it based on your resources and vision," explains Ferreyra. He also highlights the help of Elena Cataldi from the Azul Equine Therapy Foundation in Salta, one of the pioneers of the practice in Argentina.

Cecilia Fornieles is the founder and director of the center. She studied Economics, holds a diploma in Inclusive Education, and received training in equine therapy with Edith Gross Naschert, a global reference in equine therapy. (Image: courtesy of El Granero. Edited by Marisol Echarri).

The vision of El Granero

The couple based the opening of the center in 2019 on a series of fundamental values. Firstly, the decision to approach disability as a family matter, not just a personal one. Generally, in Argentina, the family member in charge leaves the child with a disability to attend therapies, waits in the car, and picks them up. "You can put your child facing a wall for an hour, but if their family is there encouraging them, they will progress much more than if they are with the best therapist in the world in the best center, but their family doesn't care," says Ferreyra. That's why the place is designed for the family, with a square for siblings to go and workshops for mothers and fathers to come together to share concerns and learn about their children.

"El Granero was the first therapy place she entered without being aware of what I was doing outside. As a mom, you let yourself be accompanied and supported by others who love life as much as you do," said Cecilia. She left the habits of being a Franciscan sister when she decided to adopt Benjamin at the age of two. He had been diagnosed with cerebral palsy.

The family-level approach allows not only for the patients to engage in equine therapy but also for their families to enjoy horseback riding classes. (Image: courtesy of El Granero. Edited by Marisol Echarri).

Secondly, El Granero places great importance on contact with nature. It is located within the Austral Business Park, in Pilar, near Austral University and Austral University Hospital, and has an area of 3,500 square meters. There is a square with trees where families can have picnics and interact.

Finally, El Granero offers all therapies in one place and proposes an interdisciplinary approach. Therefore, different professionals in charge of each patient have meetings to determine how the process should continue.

Walter and Rita are the parents of Emanuel, who has cerebral palsy. "It's a terrifying word," they once said when recounting their testimony. "They told us he needed early stimulation, and he started coming to El Granero. At first, he walked with help and a walker, and after a year, he started walking on his own. We feel that it is our second home," they considered about the center.

The center's operation

Today, El Granero employs 45 people, including health personnel and the communication and administration sector, and welcomes 200 families per month. They also offer various activities, including consultations with professionals. The main one is the neurologist, who refers the patient to other therapies: equine therapy, psychology, psychopedagogy, speech therapy, physiotherapy, occupational therapy, osteopathy, music therapy, and early stimulation.

Additionally, there are horseback riding classes (starting from 3 years old), workshops for teenagers and adults, and internships for advanced health students.

After the inauguration, the organization created the Family Program, which grants scholarships to low-income families without medical coverage from the Pilar area to access treatments and advice from a team that includes doctors and lawyers. The idea is for families to become autonomous. So, they help them with the necessary procedures, for example, obtaining the disability certificate or health insurance to cover therapies. Once that happens, the scholarship is assigned to a new family.

Currently, there are 30 families in the program. Alan and his mother María are one of them. He has non-evolutive chronic encephalopathy, a condition characterized by chronic (long-term) dysfunction of the brain. Both live in General Rodríguez and make a two-hour journey to reach El Granero. María said, "Since Alan went to El Granero, he started walking, and I was able to connect with more people who help me get away from the stress of my daily life."

Although El Granero was initially built with donations from individuals, it is now a self-sustaining business. Additionally, it seeks scholarships for specific projects, such as strengthening the communication area, advertising on social media, and recruiting volunteers or therapists.

El Granero collaborates with healthcare professionals and offers an annual equine therapy training program. (Image: courtesy of El Granero. Edited by Marisol Echarri).

Looking ahead to the future

The motivation to witness their daughter's progress is what drove Fornieles and Ferreyra to build the center. For seven years, they sought to raise funds and materials to construct the indoor track to prevent the suspension of equine therapy classes. They also focused on ensuring the center met high safety standards and employed qualified professionals. They consider this a significant sacrifice, one that, they say, is justified solely by the well-being of their daughter. In this regard, Ferreyra believes that "every NGO generally exists because it has someone like Joaqui, and that is irreplaceable. It is sustained by the power generated by the progress of a loved one with a disability."

This article is part of the Soluciones platform, a collaboration between Río Negro and RED/ACCIÓN.

The original article was published on August 7, 2023.