Haiti: Day 8

In addition to the O&P center that the mission group supports, they also support a group home named the Bernice Johnson Center which is both home and school for young women with disabilities. There are currently 12 women who live there and a few of them were in need of our services. Most of today was spent finishing the fabrication of an above the knee prosthesis for one of the girls. Of course everything that could have complicated the project happened. We had only one sheet of the correct plastic to finish the project, so everything had to work without a glitch. I put the plastic in the oven and had 3 people ready to assist. Although one of our helpers was deaf and mute, and the other spoke only Creole, I think I did a pretty good job at using my pantomime skills to make sure that everyone knew what they were supposed to do and when they were supposed to do it. The plastic was ready to come out of the oven and be draped on the cast to be vacuum formed for the final and most important part of the prosthesis. We lifted the hot molten sheet off the tray and carefully placed it on the mold. Everyone was doing their task as planned, but for some reason we weren't getting the vacuum that we needed… it was not pulling in the way it should... we started to scramble, and then we figured out what was going wrong and attempted to fix it... it was just about working and then all of a sudden we lost power in the building as the generator broke down. No vacuum at all, and the completion of the project was at stake... we had to think quickly, and start hand molding the plastic to the mold in hopes that it would take enough of a shape to be functional... it wasn't going to be pretty, but it had to work. About an hour and a half later we got power back, and I got to cut the socket retainer off of the model. We were lucky... it pulled in tight enough to provide a stable support for the inner socket and we were able to complete the project successfully and do the final fitting and gait training as our final task before cleaning up and packing our belongings.



During the late afternoon we were treated to cake and soda while the girls from the Bernice Johnson Center provided musical entertainment for us. A few of the girls played instruments and others sang in groups or solo for us to express their appreciation for the help that we are providing to the community. It was a nice closure to a week of very hard work. I have a feeling that I will be seeing many of these people again some day.





One of these pictures shows the completed prosthesis that was mentioned in today's blog. You may notice that we used the top of a water bottle for the valve in the socket. It worked well, is very inexpensive, and able to be repaired or replaced very easily.

Haiti: Day 7

Today we worked all day seeing more patients and completing as much fabrication as we possibly could in order to make sure we have everything completed before wrapping things up tomorrow. Today we took a few more castings of patient's limbs for new prostheses. Since we are limited on both time and supplies, we will be doing a lot of the fabrication of the new prostheses when we get back to Gainesville and then ship them back to Frankel who will fit them to the patients and help them with gait training and follow up care. By the end of the day we were all pretty exhausted and unwound back at the guesthouse.

Haiti: Day 6

The day started out with a line of patients ready to be seen. The entire day was spent fitting people with limbs and braces. The rehab team hosted a post stroke educational session and worked with a number of people who had recently been affected by strokes. They also worked with some of the patients that had been fitted with their first prostheses to provide some initial gait training to them. The day was very challenging as we tried to assemble devices for our patients with limited supplies and limited time, but overall we were very successful today and really appreciated the assistance of Buddy to help us make the impossible happen in a number of cases. We took a few casts for some devices that we will be fabricating on Thursday to be fitted on Friday. We have no idea how many patients will show up tomorrow or what our next challenges will be, but we will all get a good rest tonight to be ready for what will surely be another jam packed work day.



Caroline works with a lady who was just fitted with an AFO to help her walk better after her stroke, while June and Liz teach a boy to walk with crutches and his new HKAFO's.

Haiti: Day 5

Today the therapists from the team went to an outlying village about an hour and a half away from Les Cayes to assist in providing medical care to those who could not easily access the clinic in Les Cayes. Mike and I stayed back at the O&P facility to work on the fabrication of some of the devices that we took castings for on Monday. This was a great hands on experience for Mike to assist me in all aspects of the fabrication process. Our projects were delayed a bit by lack of power for the first few hours of the day and whenever we would blow the fuse by drawing too much power with the equipment. After we got our work done we had a bit of time to explore the local area by 4 wheeler where we drew the attention of a bunch of local children who came running up the hill to see the foreigners.



Later in the evening we had a few guests visit our guesthouse for an evening of entertainment by Mike. Everyone had a good time relaxing and singing along to Jimmy Buffet, Bob Marley, and other favorite island songs.



Liz took the picture of the children peeking in to see what was happening at the outreach clinic.

Haiti: Day 4

Today was our first day at the clinic. We had a constant stream of patients to see all day long. The therapists worked with patients in a large room where they performed evaluations and treatments on people. Those who were in need of orthotic or prosthetic care were sent back to us in a small examination room that was adjacent to the fabrication room. Our first day was a pretty intense case load of both pediatric and adult patients in need of leg prostheses and various orthotic devices ranging in complexity. After evaluating and measuring a number of patients we all worked together to create a Hip Knee Ankle Foot Orthosis (HKAFO) for a patient with paralysis from mid trunk down. After about 5 hours of intense team work between Mike, Frankel, Buddy (Frankel's assistant), and myself, we were able to have the physical therapy team work with the boy to stand up and begin to learn to walk again for the first time since he became paralyzed.

Pictures include a few of the little patients that we were working with today.

Haiti: Day 2 & 3

Our driver picked us up at the guesthouse and promptly shuttled us directly to the airport to catch our flight. Neither Mike nor I speak Creole, so his assistance getting us straightened out at the tiny connecting airport was invaluable. Our flight was pretty smooth and we were greeted by missionaries at the airport in Les Cayes who drove us to the guesthouse that we will be staying at for the entire journey. We had an opportunity to visit the facility that we would be working in, set up a few of our supplies and prepare ourselves for an intense week.

Pictures are of a view of the mountains between Port au Prince and Les Cayes, the local village just down the mountain from the guesthouse we are staying at, and a shot of the fabrication facility that we will be working on over the next week. We also went tarantula hunting at night and found one in the bushes...

Haiti: Day 1

We were supposed to catch a 10:25 flight from Miami to Port Au Prince and then transfer to another flight from PAP to Les Cayes on the South East coast, where the facility is located. Due to complications with rental car returns at the Miami airport, we missed our check in by 7 minutes and got put on the next flight which was 6 hours later. Haiti can be a bit unpredictable and safety for American travelers is always an issue, so this was not a good thing. This setback left us with no way to catch up with our team, and no way to catch the connecting flight. Instead, we spent the first night in PAP at a guesthouse. Despite the obvious hassle, this detour provided us with an opportunity to see a little bit more of Haiti than we thought we would see.

Attached are a few pictures of some of the sights that we saw in Port au Prince.

Humanitarian Rehabilitation Mission Trip to Haiti

A few months ago a colleague of mine invited me to take his place as the sole Orthotics & Prosthetics clinician on a humanitarian rehabilitation mission trip to Haiti. I have always been interested in getting involved in this sort of work, and gladly accepted the offer to join the team. My current intern, Michael Weiss, wanted an immersion experience in O&P and decided to accompany me on the trip to assist. The plan was for us to travel for 10 days with a team of physical and occupational therapists to a small clinical facility that has been established through The Advantage Program which was set up by Lumiere Medical Ministries. The facility houses a small fabrication laboratory that is staffed by Frankel, a local technician who assists in the fabrication and who also helps maintain patient's devices once the visiting teams have left Haiti.

Trip to India

In January I had the opportunity to travel to a number of cities in India to work with a group of professionals who are establishing a new clinical business model for the O&P practitioners of India.



My responsibility was to introduce new technology for practice management as well as identify opportunities to provide continuing education to the students in the O&P schools in India through the Internet. The trip was very productive and educational. Although India is still considered a developing nation by many, I was impressed with the caliber of clinical education that the students were receiving. I was continually thanked by the students for the access to the online journals and other clinical information that they have through our website at www.oandp.com. More than ever, I realized how much of an impact the work that we are doing here in Gainesville is having on the global disabled community. I am working closely with organizations in India and the US to expand the software technology that we created for use in American O&P practices to the many O&P practices that are spread throughout India. The students were in awe of the online educational modules that we created and we are looking forward to expanding access to many of these resources even further. I also had a nice opportunity to visit a few sites and sample a lot of great food. The people were all very friendly and I look forward to returning in the future to monitor the progress of our technology expansion throughout the country.