An Appeal to Prothetists and Orthotists
Howard A. Rusk, M.D. *
Orlando Hector Basilio Gonzales has a long name for an eight year old boy. Long names, however, are not unusual for Chileans. It was in the southern part of Chile which had been devastated by earthquakes that I met Orlando in November 1959. I was visiting a clinic directed by a competent young Chilean physician who had been trained in the United States. Orlando, who is severely disabled from poliomyelitus, was but one of several score of children there. The young doctor turned to me and said, "It's braces and prostheses I need most. What can I do without braces and prostheses?"
He was so right. His appeal reminded me of the same appeal I had heard so many times before throughout the world — in Korea in the last days of the war in 1953; of Sister Joan Margaret at St. Vincent's School in Haiti whose two deaf mute bracemakers have used metal from steel oil drums; of the U.S.-trained physicians in the Philippines, Burma, Nigeria, Bolivia and many other parts of the world.
Throughout the world a network of physicians trained in modern rehabilitation methods is beginning to evolve. In some nations, they number only one, two or three. In no nation, including the United States, is the supply adequate, but the numbers are increasing.
Unfortunately in practically all of the newly developed nations, progress in developing adequate prosthetic and orthotic services has lagged behind the increasing availability of physicians with modern training in rehabilitation.
There are some exceptions. In Korea there are two prosthetic technicians trained in the United States (one is certified by the American Board for Certification) and a number of other competent prosthetists and orthotists trained by U.S. military personnel and Church World Service personnel during and after the Korean conflict. In addition, facilities and individuals in Natal, Southern Rhodesia, the Argentine, Cuba, Haiti, Israel, Korea, Lebanon, Pakistan, Puerto Rico, Thailand, and Venezuela are among the more than 150 foreign subscribers who receive the Orthotic and Prosthetic Appliance Journal published quarterly by the American Orthotics and Prosthetics Association.
At the United Nations pilot demonstration project in rehabilitation at the University of Sao Paulo, Brazil, there is an excellent prosthetics program organized by a Danish expert.
Pilot projects supported by the United Nations and World Veterans Federation are beginning to develop modern services in Viet Nam, Burma, Thailand and Indonesia.
With equipment provided by C.A.R.E. and the International Society for the Rehabilitation of the Disabled (formerly the International Society for the Welfare of Cripples) a new brace shop opened in Bolivia with an orthotist and a physician trained in the United States under a fellowship from the World Rehabilitation Fund. Also, a new prosthetic shop in La Paz will soon be staffed by a prosthetist trained in Puerto Rico and a physician trained at the Kessler Institute for Rehabilitation in New Jersey.
American University in Beirut has just started an amputee rehabilitation program staffed by a physical therapist-prosthetist, husband and wife team. The prosthetist, a Lebanese, was trained at the Institute for the Crippled and Disabled.
In the summer of 1960, a French-speaking Spaniard, who is now in his fourth year of training in prosthetics and orthotics, conducted an eight-week course in basic orthotics at Port-au-Prince for six Haitian trainees. C.A.R.E. has now provided a new orthotics shop for St. Vincent's School in Port-au-Prince where two of his trainees work.
Orthopedic surgeons working in the MEDICO project in Jordan report a Jordanese bracemaker there is making satisfactory orthotic devices.
During the past several years the World Rehabilitation Fund has known of many instances where trained prosthetists and orthotists were available in several nations but general economic conditions within such nations prevented them from being able to import supplies. At such times, the World Rehabilitation Fund has appealed to various groups, usually the Metropolitan Orthopedic Appliance and Limb Manufacturers in New York, for contributions of used braces and prostheses. The response has always been very good.
Through a joint effort of the Committee on the Handicapped, People-to-People Program: Veterans Administration; American National Red Cross. Office of Vocational Rehabilitation and the World Rehabilitation Fund nearly three thousand used but serviceable prostheses were distributed to such nations as Chile, Bolivia, Korea, The Philippines, Indonesia, India, Pakistan and Haiti. One thousand of the prostheses were delivered to Indonesia on the "Hope" ship. The remainder were shipped overseas through the Catholic Relief Services. National Catholic Welfare Conference; C.A.R.E.; and the American-Korean Foundation.
In the spring of 1961, the World Rehabilitation Fund in cooperation with a number of other agencies will conduct a campaign among the prosthetic and orthotic industry to collect used but serviceable orthoses and prostheses. The items contributed will again be distributed to the nations in which there is sufficient trained personnel that these items can be modified and adapted for use. The value of such contributions plus shipping costs will be tax deductible. When the items are delivered to the agency which will use them, appropriate presentation ceremonies will be held with the cooperation of the American Embassies and United States Information Service in those nations to publicize the program as a voluntary effort of the American prosthetic and orthotic industry. With the full cooperation of the industry this can be an extremely significant project, for it will not only bring services to thousands of disabled persons throughout the world, but will re-emphasize throughout the world the value which we in a free society place upon individual worth and human dignity.
Fig. 1, Fig. 2