As a child, when Mary Natabo was given a quinine injection for malaria, no one knew it was the beginning of her journey to disability. She started having back pains and headaches. But her parents took it as a simple illness until the situation worsened and one of her legs got paralyzed.

At the age of 15, Natabo could not move without the help of clutches. She had a lot of pain and had lost the muscle strength to lift her foot-something that her parents had accepted as normal and were not bothered about seeking medical treatment. It was not until she was 27 years old (in 2006) that Natabo sought medical help at Mbale Masaba Wing Hospital.

"I developed serious pains and the doctors found that I had an ankle and hip dislocation," said Natabo, pulling out her x-ray documents.

"I was operated and screws were inserted in me," she said, painfully pointing at where the screws were fixed.

But after three years, the now 30-year-old primary school teacher in Mubende has not recovered and has to miss classes to seek medical treatment at Comprehensive Rehabilitation Services in Uganda (CoRSU).

"I remained with serious pain. When doctors here [CoRSU] diagnosed me, they found that the hip bone was cut off in the first operation and the screws fixed were not matching the problem," Natabo said.

A month ago, Natabo underwent a second operation. The joint axis correction done at CoRSU was to remove the screws to add staples.

"I am now on trial and error," Natabo says.

Irene Nabalamba, CoRSU's Project Development and Public Relations Manager, says Natabo's case is an issue of 'neglected disability.'

"They [Natabo's parents] were supposed to visit a specialist as early as possible. But they instead took it as a normal disability case," Nabalamba observed.

According to Nabalamba, there are many cases of neglected disabilities where children born with defects are not helped to seek medical attention. This is attributed to the poor referral system -with most people not knowing what to do when children are born with defects.

"Most women don't give birth in hospitals, they go to traditional birth attendants because they are nearer, cheaper and trusted in their communities. When they give birth to a child with a birth defect, the traditional birth attendants, most of whom are not educated, will not tell that there is a problem with the child," Nabalamba said.

"The mother will go back home and bring up their child as normal. By the time they tell that there is a problem, it is too late and that will necessitate surgery which is too painful. Surgery is good, it corrects the defect but if we can avoid it and start the procedure early, the better," she added.

In 1996, people with disabilities decided to start a Children's Orthopaedic Rehabilitation Unit (CoRU) at Mengo Hospital as a way of preventing and reducing consequences of impairment. It started as a small unit but after 10 years, it had overwhelming numbers of patients.

"There was so high demand and the facilities were not enough. We had one small operating theatre. We could not expand. The need was so high and the facility too small," Nabalamba recalls.

"We had to find a way to have a well-established centre that could offer comprehensive rehabilitation services -that is identification of a child with the problem, referral to the hospital, surgery and thereafter rehabilitation," she added.

It is then that CoRU transferred its services from Mengo to a new permanent home in Kisubi, on Entebbe Road, under the name, Comprehensive Rehabilitation Services in Uganda (CoRSU).

With funding from Christoffel Blindenmission (CBM), CoRSU opened its door on March 27 after completion of the construction of the first phase of the hospital with an Out Patient Department, a theatre block with 6 theatres, ward with 64 beds, the rehabilitation hostel with 54 beds and an orthopaedic workshop.

According to Nabalamba, the hospital whose initial focus are children with physical impairment, aims to provide 2,800 surgeries in 2009, increasing this to 4,000 by 2011.

"We don't aim at making profits. We aim at reaching the poorest of the poor," Nabalamba said.

"Surgery is free for children below 18 years. What they pay for is the hospital [accommodation]; when they are admitted, they have to be fed, use water, electricity -which was Shs12,000 per day but has been slashed to Shs 6,000 because of the support from CBM," she added.

According to Nabalamba, the children are provided with surgery, medical and social support, physiotherapy and mobility aids such as wheel chairs, leg/foot braces, etc. The hospital handles defects such as osteomyelitis, club foot, cleft palate/lip, angular bone deformity, post injection paralysis congenital limb deformities, burns and post burn contractures.

Caroline was two years of age when she developed a haematogenous steomyelitis of the left tibia. Following the infection, she lost the whole shaft of the tibia and underwent a bone transplant procedure through which the bone was regenerated after one-year treatment. Two years after beginning treatment, Caroline is happy and playing just like any other child her age. Without treatment, she would probably have lost her leg.