MEND’s Orthotic and Prosthetic Programme
MEND supports Orthotic and Prosthetic services provided by our partners at their rehabilitation centres in Asia, Africa and the Pacific. Fully-trained local technicians are employed to fit limbs, make special shoes, ankle or knee supports and spinal braces, and other devices.
We source and provide low-cost mobility equipment and other physio aids that are designed to suit special needs and local conditions.
Note: An Orthosis is an assistive device to aid walking or body function,
while a Prosthesis replaces a lost part of the body, like an artificial limb.
In Nepal we have a system that works well in remote areas. The Prosthetician travels each month to assess new patients who need assistive devices. He also fits the amputees with fabricated devices he made for those he measured on the last visit. This saves our centre from paying a lot of patient travel costs for patient and caregiver!
We try to employ former patients who are amputees and especially women who have had club feet or any disability.
- At our Hope Centre in Nepal the manager, Ganga, is a double amputee. She lost both legs as a baby when left unattended next to a kitchen fire. As part of her work today she travels to very remote parts of Nepal and carries out assessment camps for those challenged by disability and extreme poverty and live far from medical care.
- Also at Hope Centre is Indira, who is the physio-aide and originally came as a patient for bi-lateral club feet. Today she walks well and also manages the Hope Centre Hostel ensuring patients are well looked after.
- In Andhra Pradesh, India we help our partner, AGAPE, managed by Asi Babu. He cannot walk from childbirth and has also muscle power in only one arm. Yet he trained to become a teacher in a government school and is a passionate multi-tasker going out of his way to find and help many others with disabilities in the local community. He likes to keep their Facebook page updated for donors>>
MEND aims to ensure each member/patient achieves mobility and then actively participates in community life, in education or trained for employment.
In countries like Nepal, Kenya and India hospitals are poorly equipped and underfunded. Many villagers live far from medical treatment with no money for hospital bills or even transport costs. Caste and tribal apathy are other factors that inhibit services reaching the poorest.
So those with disabilities live isolated and ignored by their community. But MEND knew from the start that given the correct medical care they could be successfully treated at low cost.
MEND’s challenge is to find the resources and money to treat our patients in very remote parts of the world. We assist with medical care, mobility services and also accommodation and transport while under treatment.
We rely totally on the generosity of donors from around the world to fund this vital work for the most needy, many of whom await quality limbs or mobility devices. If you can, please support them!
Common Causes of Loss of Limb or Limb Movement
Those with disabilities are often treated with superstition and disgust in many developing countries where there are few government medical or social welfare programmes. In Hindu countries disability is seen as a curse that is carried over from a past life or deed, as in the word, “karma”.
- Club foot affects 7.5% of births with 80% of these are in developing countries. But it is easily treated with manipulation or plaster casts if babies are seen early. Full correction is achieved when muscles and tendons are supple. Cost of treatment $100-200
- Cooking fires are common in Asia and Africa and often mothers and babies sleep near fires at night with accidents causing severe burns. When left untreated the result is contractures causing loss of movement or loss of limb. Ensuring safer fireplaces in homes is one preventative programme we encourage. Cost of burn treatment $100-200
- Developing countries have poorly maintained infrastructures such as electricity wiring, and so we see many people suffering from burns and loss of limb due to electrocution. Jyothi is a young Indian girl who lost three limbs while seeking free biscuits at a bakery with poor wiring. Cost of three new limbs $400-
- In Kashmir and Afghanistan many accidents and loss of limbs are caused by people stepping on buried mines planted by armies that are meant to protect the citizens! Cost of treatment $189 for one above knee leg.
- In Africa houses are often very close to train lines, with no fencing, posing a particular risk to children, especially loss of limb or life. Read about Angella who, as a baby, was run over by a train, lost both legs and an arm, and survived!
- Driving in India is a dangerous game, where many drivers actually turn their headlights on full beam as they pass you! We see many patients with loss of limb caused by car accidents who struggle ever to claim any insurance from hit and run drivers. Cost of treatment for below knee limb $125
- Malnutrition and Rickets cause bow legs (medical term: Genu varum) when children are very young. If left untreated as they age their bones grow in an arch and the condition becomes more pronounced. It takes painful Alizarov fixators inserted into bones, over many months, to straighten this condition. Cost of fixators $150
MEND’s Early Days
MEND’s first challenge in the early days was to create very low cost prosthetics. Rob used his kiwi ingenuity to craft prosthetic limbs cooked in aluminium molds made from recycled drink cans! Although this roto-molding plastic manufacturing system still needs more development he was able to make aove knee limbs for just $20.
MEND’s Prosthetics Today
We now source top quality, light and well-priced limb components from suppliers such as Proactive Technical Orthopaedics (PTO) in India who have ISO standard factories.
We also recycle quality used prosthetic parts, that have had little use, donated from families of amputees who passed away. We also receive quality components from limb centres in Australia and New Zealand who cannot reuse those parts due to stringent government insurance policies.
Importantly, modern prosthetics are very comfortable and light to wear, with standardised components so that rubber feet, pylons and knee joints are interchangeable. With good mobility amputees can live happy productive lives with dignity in their communities.
Again we rely on donations to purchase the limb parts that change lives!
Our centres carry out health camps in their community and in remote areas and assess anyone with a disability. Amputees (and family and caregivers) are first counseled to create awareness of disability and its treatment, then referred to corrective surgery, fitting of limbs, and follow-up physiotherapy. We also supply funds for accommodation and transportation to hospital.
We support the Katalemwa Cheshire Home in Kampala, Uganda who have an excellent and active prosthetics unit. At our outreach centre in Masaka, 150 kms away, we employ Robert Lujoba as the physiotherapist who now has a lot of experience with amputees. Through this collaboration we get incredible services for our children and youth with disabilities at our outreach centre in Masaka District.
Rob, our MEND Director always carries loads of donated supplies when travelling overseas, such as 20 kgs of limb parts from New Zealand and Australia to Nyabondo Rehabilitation Centre in South West Kenya. We have also sent them a supply of new PTO (Proactive Technical Orthopaedics) limb parts from India in 2015. We are now trying to gain tax exemption for further orders for prosthetic parts from the Kenya Revenue Service who have no problem charging taxes on items donated to disabled persons!.
In Kenya we also work with Shepherds of Life (SOL) who work with 8000 poor and disadvantaged Samburu kids and youth. SOL is based in Meru and the Rift Valley. They send amputees to a government workshop run at a local hospital and also give them recycled parts we collect from New Zealand and Australia. We have discovered a real need across all of Africa for low cost quality prosthetic parts.
The prosthetic parts we buy from PTO in India are best quality at a low price. We recently visited the company to view the whole manufacturing process. Their AK (Above Knee) Kit costs US$189 with all parts including Sach foot, pylon and 4 axis knee joint. Four pivot points of the bars in the knee joint give fluidity to walking compared to a single axis knee joint.
A BK (Below Knee) Kit costs just US$60, which puts walking quality within our budget and poorer amputee’s budget. The parts are made under ISO standards.
We helped set up Hope Centre in Kashmir many years ago. Directed by Sami Wani, the team of 29 staff conduct health assessment camps in very remote mountainous areas. They now manage 4 outreach centres around the Kashmir Valley and have 4 Prostheticians. They are expanding a new Limb and Orthotic Workshop in the Anantnag District which MEND funds both staff salaries and rent of premises to carry out that Physiotherapy Programme.
We learnt that the new Vanuatu Amputee Association was fitting recycled limbs without a trained technician. So we are currently creating a plan to help them employ a qualified technician to travel to Vanuatu and train a local team. Diabetes caused by poverty and a poor western diet of high sugar levels has led to high cases of amputations on this small group of islands. It is the 4th highest in the world now! There are apparently 5400 amputees currently needing help.
We have connected with an Afghanistani banker in Sydney, Australia who wants to help the many amputees there. The majority of these injuries are caused by mines. A limb centre in Western Australia has generously donated limb parts and some of these will be sent to Afghanistan.
In Nepal we work with a local Prosthetician in Kathamdu who visits each month and fits all our amputees and also supplies and fits orthotics.
ANDHRA PRADESH, INDIA
We send patients needing limbs to an amputee Prosthetician and team who run a busy workshop. Dr Murthy even designs low cost parts himself and invented a laser light that cost $2 and helps keep a patient vertical for measuring limb differences!
How We Work
Early intervention is the key to success with kids and youth for limbs and orthotics. They are growing and stump sizes change quickly so they require constant feedback and monitoring. Fitting limbs is never a one stop shop! It is a lifelong process that needs money every 6 months or so to make adjustments.
Did you know? When one, two, three or four limbs are missing amputees get very hot easily. The surface area of our limbs is actually our body radiator that helps regulate our temperature!
At a recent field camp in Nepal we had an older man ask for a new foot. The flex foot we previously donated was completely broken. The people in this area walk on very rugged mountains, sometimes 3000 ft (1000 m) up and down trails. This terrain puts a tremendous amount of strain on prosthetics. But our task of fitting his new foot is not easy as he needs that limb while we search for a match.
A standard type of foot and limb parts makes our fitting job easier to repair rather than using mixed parts from various sources. This is why it is easier when buying these full kits of essential parts.
Once we have fit the amputee and they are walking well we then raise the necessary funds for later follow-up with skills training or help them set up a small business so they are financially independent. We have micro-loan schemes now in place!
How Donors Change Lives
Angella in Uganda. This very cute girl was run over by a train when she was a small baby. She lost both legs and an arm but she is now walking with new legs. Many thanks to Julie and Marcus from the United Kingdom who very kindly donated $1000NZ for Angella’s future. This is in her own interest-bearing trust account managed by the Katalemwa Cheshire Home in Kampala, Uganda.
Jyoti Rani in India. Jyoti was electrocuted while getting free biscuits at a factory and lost both legs. She is now walking, and living in a clean house with her once rag-picking family in Andhra Pradesh that is nearer her school. Many thanks to Isha in New Zealand who donated $100 to start a bank account for Jyoti. MEND also adds 3500 Indian Rupees (NZ$85) each month to her account from our sustainable milking buffalo venture.
Our milking buffaloes are looked after by our young member, Lok, in Hyderabad. The sale of milk from each buffalo earns NZ$175 per month, plus we get a calf each year that grows into a milker within 18 months. We are depositing NZ$85 each month into Jyoti’s bank account, and when she is 18 she can buy some buffaloes or start a business to break the poverty cycle.
Kamala Shrestha, who lost three limbs when electrocuted as a 10 year old, has worked hard to become a success in Nepal, at three forms of media. CD album recording, FM radio programme anchor and National TV newsreader!
Rob, our director, arranged for Kamala to travel to Australia with Rotary funds when she was 10 years old, and she was fitted with all three limbs, two arms and one Above Knee (AK) limb, for free by the kind folks at the Applicance and Limb Centre (ALC) Sydney! She still uses those same limbs today with no need for change which shows the quality fitting that was done at the Centre!
Kamala is well known in Nepal and amongst Nepalis around the world through reading the news on National TV, her own radio programme and from making two CD albums to Nyhoo Bajracharya, the top composer in Nepal.