Offering O&P services in the United States has its challenges. It can be easy, however, to forget there are some obstacles most U.S. practitioners never have to face that are a daily reality for anyone providing care in less resourced countries—including unavailability of basic components, spotty communications technology and even the lack of electricity in some locations, and systemic poverty.
But perhaps in learning more about the methods the men and women working to meet the needs for O&P care in these areas are using, we can gain perspectives about not only how to support their work, but also how to think creatively to meet our own challenges.
This issue’s first feature, “Nine Years Since the Colombian Peace Process Began: Amputations, Landmines, and NGOs,” provides examples of how several organizations in Colombia are helping people injured by decades-long conflicts between guerrillas, paramilitary factions, cartels, and the government. Because one of the challenges practitioners there face is patients’ socioeconomic status and lack of opportunity, the approach is often comprehensive rehabilitation focusing on providing a usable prosthesis and also educational or employment training so that patients can transition to active societal participation. Another challenge is location, as many patients live in rural areas, and that there are no prosthetic manufacturers in Colombia, so components must be brought in. One organization addresses this through a mobile model, partnering with local municipal governments and staged visits.
As various organizations seek to address the O&P needs in Colombia, founders, staff, and volunteers work to ensure that their approach is sustainable and first, does no harm. “Toxic Charity—When Doing Good Does Harm,” tackles the uncomfortable reality that well-meaning acts of humanitarianism can actually result in dependency rather than empowerment. And when offering O&P services in less resourced countries, there is a delicate balance—providing a device will nearly always do some good, but without a plan for long-term follow-up, will it do the most good?
Finally, in this month’s Perspective, Jeff Erenstone challenges the profession to think creatively about how to translate a tool used by others in the medical arena, telehealth, to address the shortage of O&P providers to care for the estimated 85 percent of people globally who need assistive devices but do not have access to them.
I hope you enjoy this issue focused on the international perspective of O&P care.
Happy reading.
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