Belize Mission Brings Satisfaction, Adventure

"I was very proud of what we provided. The fit and alignments would pass in any facility in the US. We worked long hours in makeshift, though adequate, conditions. Things were tried and done that I'd never seen in the States, but they worked for us to get the job done. All in all, it was a great experience." --Doug Potter, CPO Potter, from Coeur d'Alene, Idaho, was one of a team of five who traveled to the Central American country of Belize last May to help amputees there. Working under the auspices of Sonrie Ministries/Project Hope Belize were Robbie Jackson, president and executive director; Rob Kistenberg, CP, LP, FAAOP, vice president and director of clinical services, Gainesville, Florida; Stephan Manchurian, CP, Brooklyn, New York; Potter; and Don Pfau, Phoenix, Arizona. Adrian Camara, a bilateral above-knee amputee, is the team's local resident coordinator and technician. The team set up its clinic in Orange Walk Town in a vacant house belonging to Javier Tillett, an amputee patient. For most of the team members, it was their first experience in working in a developing country. In just five working days, the team fabricated 21 limbs for 19 patients. The prostheses included a set of bilateral AK limbs, a set of bilateral BK limbs, nine BK limbs, two upper-extremity limbs, four AK limbs, one Symes prosthesis, and one hip disarticulation prosthesis. This number included three pediatric patients, the first ever to be fit with artificial limbs in Belize. But the numbers tell only part of the story. Advance television and radio publicity brought in amputees from all over the country. In fact, the first day, 16 patients crammed into one truck arriving after traveling for eight hours. Forty-six patients were evaluated, but there were not enough supplies and time to fit everyone, so priorities were set. Creative Thinking Solves Problems During the week, the team met various challenges. For instance, the team ran out of casting plaster, which is not available locally and has to be brought from Mexico. While Adrian Camara spent a day driving to get more plaster, the team used polyurethane foam poured into negative models to make positive models. "It sounds crazy, but it worked," said Don Pfau, a technician. "You should have seen the guys trying to carve it," he laughed. "It was a bit rough, but we made it work." Harley Kaitzen, 11, shows off his new hemipelvectomy prosthesis. The supplies lasted just long enough: "We used the last cup of resin on the last BK limb--we were right down to the wire," Pfau said. Since shipping is a problem, volunteers fill duffle bags with supplies up to whatever weight limit the airline will accept and bring them along. However, in November Jackson rented a small house on the main highway into town, near the bus terminal, and totally wheelchair-accessible. "We are proud to announce we have finally established the first prosthetic clinic ever in Belize, and we now have a semi-permanent home,'" Jackson said. The mission which began December 15 was the first to be held at the new site. Adrian Camara does repairs and follow-up work for patients in between mission trips. "He's a huge help," said Pfau. "He also knows a lot of local people and has connections; he helps us get what we need." On mission trips, Jackson and Kistenberg go in advance of the rest of the team to set up and organize the lab. High-Quality Work in a Low-Tech Setting How good was the quality of the limbs? One bilateral patient, whose limb had been made in New York in 2002, said that his new prosthesis was lighter and more comfortable than his US-made limb. Another patient had a limb made in Guatemala--unused because it was painful and didn't fit properly--and a limb made in Mexico, which was wearable, but very heavy and poorly fitted. The team was able to fit the patient, an athlete who used to run eight miles daily, with a comfortable, lightweight limb. He was eager to return to both work and sports. "Sad to say, another patient who tried to wear his ill-fitting artificial limb made in Mexico--was told by the staff to just get used to it'--ended up with infected wounds and needed another amputation," Jackson said. "He went from a good BK to a very weak AK. He was terribly sad to see other BK patients walking well on Sonrie-made limbs while he struggled with his AK one." Another patient who had been an amputee for 15 years received his first prosthetic leg--much to his joy. Stephan Manucharian, CP, first learned prosthetics in his native country, Armenia, in a World Rehabilitation Fund (WRF) training program. "After the devastating earthquake in Armenia in 1988, several humanitarian groups extended helping hands to Armenia," he recalled. Manucharian stayed with the WRF program for three years and then went to Northwestern University, Chicago, Illinois, to further his prosthetic education. His experiences in Armenia helped him in Belize: "In Armenia, we had to be creative in order to overcome problems with shortages in simple components and materials and to organize production to be efficient," he said. "This enabled me to immediately understand the challenges in Belize and help find solutions." Robbie Jackson, mission director (left) poses with Carl Evelyn, who waited four months for his new leg; and Doug Potter, CPO. Evelyn had worn his old leg for over 20 years. "I was really impressed by the attitude and spirit of this group of guys," said Jackson. "They were strangers to one another when they boarded the airplane for Belize, but soon jelled into a cohesive team, making limbs and treating patients until late into the night. Long hours and an endless stream of patients seemed to energize them, allowing the team to find new solutions to the challenges of doing prosthetics in a rented house on the edge of the Central American jungle." Sightseeing One day of the trip was devoted to seeing more of a beautiful, fascinating country. Jungle-covered ruins and ancient lost cities have fired the imagination for ages--and Belize has over 600 ancient Mayan sites. So, especially interesting to the group was a trip up the New River to the Lamanai Mayan archeological site. "Lamanai" means "submerged crocodile" in Mayan, and the group spotted not-so-submerged crocodiles--some bigger than a dugout fishing canoe also seen on the river. The Reward: Happy Patients Rob Kistenberg, CP, explains to Eric Aban, 8, how the height of his Symes prosthesis must change as he grows. But of course the biggest reward of the trip was the happiness on the part of the patients. In fact, the patients were so delighted to get prostheses that they even hesitated to say, when asked, if there were any problems with the fit, said Pfau. They were afraid that the prostheses would be taken away! Pfau found the work highly rewarding, especially since the patients were so appreciative of the care. As "payment" for services, they often arrived with bags of fresh mangos or homemade breads. "I think we might have gained a few pounds during this mission," Jackson joked. When asked if he would go back, Potter answered emphatically, "Absolutely! I would love to go on another mission with Rob and Robbie to Belize--or anywhere else for that matter. I'm also interested in any other outreach activity." Potter also appreciated the chance to work with the rest of the team: "Interesting people, stories, and experiences." "The most rewarding part of our work in Belize was the appreciation of the patients and smiles on their faces when they took their first steps with newly fitted prostheses," said Manucharian. Said Kistenberg, "The rewards are given to me on the face of every person we help, and their family members too." The mission is increasing its activities to include three trips per year, Kistenberg said. "We therefore need more practitioners, technicians, and component and equipment donations." For more information, contact Rob Kistenberg, robcp@oandp.com

Belize Mission Brings Satisfaction, Adventure

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Belize Mission Brings Satisfaction, Adventure

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