prosthetic & orthotic services in post-earthquake haiti
DESCRIPTION
The 7.0 magnitude earthquake which struck Haiti on January 12 of 2010 created the challenge of providing prosthetic and orthotic care to a severely marginalized population that was already lacking in adequate services.TRANSCRIPT
Prosthetic & Orthotic Services in Post-Earthquake Haiti
Dave Ritchie, Amanda Barizo
Nathaniel Wheeler, Edward Phinney
Our intention for this presentation is a proposition,
that although the magnitude of the necessity alone is
no guarantee of an appropriate response, the
Prosthetics and Orthotics professional community, by
virtue of our core principles, disciplines and ethics, and
broad scope of practice, is innately suitable for the
providing of sustainable rehabilitation services and
strategies to the Haitian people. The contingent P&O
enterprises already in place and others yet to be
deployed we consider to be categorically appropriate
to the character and spirit of the engaging discussions
that are so desperately needed in this hour.
• OverviewHaiti, Jan. 12 earthquake, immediate effects, P&O response
• Current P&O practicesSurvey, fabrication trends, training programs
• Challenges, Further NeedsSustainability, standardization, ISPO Code of Conduct,
volunteering
• Acknowledgements/Q&A
P&O Services in Post-Earthquake Haiti
The Republic of Haiti
République d'Haïti
Repiblik Ayiti
Pre-Earthquake P&O: Needs Assessment
• 800,000 disabled (GoH, 1983)
• Total disabled people in need of P&O services: 50,000
(WHO 0.5% of ~10 million pop.)
• Number of trained personnel needed:
67 (Cat I/II), 300 (Cat III)
(WHO/ISPO, Guidelines for Training Personnel in Developing Countries in P&O services)
Pre-Earthquake P&O Services
Healing Hands for Haiti, PaP
St. Vincents Hospital, PaP
Advantage Program, Les Cayes
Center for Eucharistic Heart, Cap
Haitien(Eitel, 2010)
The Earthquake
P&O Post-Earthquake
• 2000-4000 amputations (HI), 4000-6000 amputees (GoH)• The need for orthotic services is far greater.
The P&O Response
• Donations
• Parachute Services
• Patient-transport Programs
• Rotational Short-term Projects
• Long-term Projects
I. Donations• Monetary
• Componentry
• New or gently used
prostheses
• Fabrication materials
• Equipment
• In Conclusion• Prosthetic & Orthotic
Component Clearinghouse
(P.O.C.C)
MedShare International
c/o P.O.C.C.
3240 Clifton Springs Road
Decatur, GA 30034
II. Parachute Services
• Discouraged by ISPO
• Neglect in-country services and capacity buildingof Haitians.
• Often leave problems in their wake(Kistenberg, 2010)
III. Patient-transport Programs
Highly discouraged by ISPO
• Componentry may not be appropriate for the
patient’s home country
• Traveling to a foreign country can be disorienting for the patient
• Upon return, patient may be left with a sense of
abandonment
(Kistenberg, 2010)
IV. Rotational Short-term Missions
Rotational short-term missions
Length of stay and objectives of the P&O clinic
should be considered
V. Long-termProjects
• Adhere to international standards
• Implement training programs
• Offer integration programs and psychosocial support
Current P&O Practices
Current P&O Practices
Post-Earthquake P&O Services
•Healing Hands for Haiti with Handicap
International
• Hanger Prosthetics Clinic
• Hopital Albert Schweitzer
• Mission of Hope
• Hopital Sacre Coeur
• BRAC Brace and Limb Center
• Haiti Hospital Appeal
Question #1: What are the most common injuries
and pathologies you have treated?
Fabrication Trends
Question #2: Of your P&O clients, what is the
percentage of those injured by the January
earthquake?
Question #3: What fabrication
methods are most commonly
practiced at your facility (i.e.
Lamination, Polypro sockets,
donated parts, ICRC kits)?
Question #4: Approximately how many
patients have you fitted for a device?
Question #5: What was the follow up
frequency?
TrainingQuestion #6: Is there a training program currently
implemented at your facility?
Proposal of Education in Prosthetics and
Orthotics for Haiti
Question #7: Can you give a brief
description about your facility?
Challenges
Further Needs
Overwhelming enthusiasm for providing LE prosthetic
devices, but orthotic care is far more needed.
• Pediatric orthotics
• Traumatic and chronic disease orthotic devices
Upper extremity prosthetics
(Ingersoll, 2010)
Sustainability • Education, materials
Coordination • Geographical• Technical• Governmental
Information gaps (pre-quake, new injuries)
Ethical considerations of P&O groups• Publicity, previous experience in undeveloped
nations, cultural sensitivity(Stanfield, 2010)
Challenges
“The sheer quantity of humanitarian assistance efforts in Haiti is heartwarming and inspiring. But it is also alarmingly inconsistent, with examples ranging from well thought out and appropriate relief work to the infamous charitable group that allegedly kidnapped the children.”
Jon Batzdorff, CPO, Chair of the International Outreach Committee of US-ISPO.
1. Avoid discrimination on the basis of race, religion, nationality or political party.
2. Assistance shall not require any political or religious endorsements or behavior in order to receive benefits
3. Respect the local customs and culture
Code of ConductforProsthetic and
OrthoticAssistance
Non-governmental Humanitarian and Development
ISPO Code of Conduct for Humanitarian
Organizations
ISPO Code of Conduct for Humanitarian
Organizations
4. Encourage and support local capacity for providing P&O services.
5. Avoid creating dependency of the local community on the NGO for future follow up, adjustments, replacements.
6. Materials should be used which can be found or acquired locally.
Code of ConductforProsthetic and
OrthoticNongovernmental Humanitarian and
Development Assistance
7. Avoid overlapping of services
8. Coordinate efforts, planning, and delivering of services with the local community
9. Consider long-term development goals, not simply emergency immediate needs.
(Batzdorf, 2010)
Code of ConductforProsthetic and
OrthoticNongovernmental Humanitarian and
Development Assistance
What Can You Do To Help?
- Research the Organization
- Security
- Residence
- Immunization Shots
- Travel Insurance
- Registration with Embassy
Volunteer Considerations
For more information, please visit our website
http://haitipando.info.nu
Acknowledgements
Dan Blocka & Gord Ruder
Al Ingersoll
Healing Hands for Haiti
Shaun Cleaver
Albert Schweitzer Hospital
Katherine Mackenzie, Diana Cherry
Mission of Hope
Monir Uzzaman
BRAC Brace & Limb Center
Ann Culloo,
CRUDEM & Hospital Sacre Coeur
Vern Hostetler, Hanger Klinik
Reninca Hill, Haiti Hospital Appeal
- The international community has shown overwhelming enthusiasm for providing prosthetic devices, but orthotic care is far more needed.
- Geographical and technical coordination is a constant problem.
Thomas Calvot, HI's disability and emergency advisor
References
Batzdorff, J. (2010) Code of Conduct for Humanitarian Organizations. Retrieved from November 30, 2010 from US-ISPO website:
http://www.usispo.org/code.asp
CDA Collaborative Learning Projects (2010) A Brief Background to Conflict in Haiti. Retrieved November 30, 2010 from CDA website:
http://ww.cdainc.com/cdawww/.../rpp_haiti_brief_background_20100203_Pdf_1_1.pdf
Eitel, S. (2010) Haiti Mission Report. Retrieved November 30, 2010 from One Response web site:
http://oneresponse.info/Disasters/Haiti/disabilities/publicdocuments/Eitel%20Haiti%20Feb-Mar%202010%20Report%20-final%20draft.doc
Groupe de Travail Inclusion, Readaptation et Situation de Handicap (2010) Liste des Services Orthopediques , Appareillage et Readaptation
Haiti.
International Committee of the Red Cross (2010) Polypropylene Technology. Retrieved from the ICRC website:
http://www.icrc.org/eng/assets/files/other/icrc_002_0913.pdf
International Committee of the Red Cross (2010) Prosthetics and Orthotics Manufacturing Guidlines. Retrieved from the ICRC web-site:
http://www.icrc.org/eng/resources/documents/publication/p0868.htm
Rencoret, N., Stoddard, A., Haver, K,. Taylor, G., Harvey, P., (2010) Haiti Earthquake Response Context Analysis. Retrieved November 30
(2010) from ALNAP website: http://www.alnap.org/pool/files/haiti-context-analysis-final.pdf
Rogers, J., Kistenberg, R.,Ingersoll, A,. (2010) Creating a Unified O&P Response to the Haitian Tragedy. Retrieved November 30, 2010 from
American Academy of Orthotists & Prosthetists website: http://www.oandp.org/about/press/
Kistenberg, R. (2010) Prosthetics and Rehabilitation Services for People with Amputations in Haiti – Message from the Chair of US-ISPO.
Retrieved November 30, 2010 from US-ISPO website: http://www.usispo.org/message_haiti.asp
Stanfield, M. (2010) Haiti: The International Response. Retrieved from oandp.com website: http://www.oandp.com/articles/2010-05_02.asp
University of Don Bosco (2010) Proposal of Education in Prosthetics and Orthotics in Haiti. Retrieved November 30, 2010 from Physical
Rehabilitation Programs in Haiti Forum website: http://groups.google.com/group/haitiprp/browse_thread/thread/32ac1844d61883f1?hl=en#
World Health Organization (2005) Guidelines for Training Personnel in Developing Countries for Prosthetics & Orthotic Services. Retrieved
November 30, 2010 from World Health Organization website: http://whqlibdoc.who.int/publications/2005/9241592672.pdf
Questions?