(I type this post with much love to everyone at RTOA. You were all in my thoughts today. I wish you could have been there. You would have asked much better questions!)
After my visit to the landmine museum last Saturday I became interested in seeing what I could learn about Orthotics and Prosthetics in Cambodia. I've grown up around this profession and am the only member of my family not working in the field. I'm proud of the work my father, mother, brother, and other "family" at Ray Tegerstrand's Orthopedic Appliance do on a daily basis. Tiring work with less and less compensation and more and more competition!
Orthotics and Prosthetics is an uncommon job and the work of my family has definitely colored my upbringing in beautiful ways. In fact nothing prepared me better for working with the handicap students in my English classes at Korea Nazarene Univeristy.
Imagine my family's dinner conversations! "Stump" wasn't a taboo topic and neither were jokes about the same. It is amazing how you can joke about something you love and deeply respect. And maybe when you work so much with hurting patients laughter is necessary for survival.
This people's tireless courage and their current struggle meets a part of my personal story when it comes to people with disabilities. Their reality is bleak. With one million active landmines and poor roads filled with masses of motor bikers without helmets it means large numbers of injuries creating disabilities. The need for O&P and related fields is great. (Their is a training school in Phnom Pehn)
After following leads and being disappointed for 2 days in Siem Riep I found, "Physical Rehabilitation Center Siem Riep". I'm grateful to the staff of a Christian NGO coffee shop, Common Grounds, for helping me find what I was seeking. It was literally down the street! The staff member walked me to the NGO, Handicap International. When I saw the display of prostheses in the entree way I smiled ear to ear. This was what I was looking for! Two employees fielded my many questions and gave me the tour of the facilities. It was the same and different from what I've seen at home.
I learned a lot today but here are some are the basics:
The funding for this facility has come from 2 major organization in Europe(I think). In three years this funding is going to end. A big question mark tells the unknown future of the current operation. In three years the government will take over financial responsibility. Handicap International of Cambodia had a budget of1.3 million Euro's in 2006. Today amputees and other patients with disabilities are served at no cost to them. If no more funding comes in and if the government requires people to pay even 50 percent of the costs, it is likely that many many people will go without. Most will likely not be able to pay for transportation to the rehab center let alone pay for needed services. Today practitioners and employee's incomes are subsidised by the NGO. It is likely under government take over that these salaries will compare to the rest of government workers in Cambodia--$50 a month. I can only imagine how complex the issues are with sustainability concerns and hopes the governmental will take on responsibility.
The facility employs three basic practitioners--O&P Technicians, Physical Therapists and social workers. There is also a records department. I assume they don't deal with insurance companies. (Imagine the work you could do if there were no insurance companies to fight with) I was impressed by the organizations holistic approach to care. Education and prevention related to a host of issues including landmine and driving safety have also become major projects for the organization.
Since so many people live out in the provinces there are dorm facilities and a kitchen. Patients are served 3 meals a day. Most stay 7-9 days--casting to fitting.
People with disabilities in Cambodia are as good as sub-human and even if the disability isn't related to one's mental capacity. H.I. is also working to educate the public to change this mindset.
Costs--
Below knee prosthesis: $133
Above knee prosthesis: $182
Ankle foot orthosis: $97
Cosmetic hand replacement: $6
Cosmetic foot replacement: $7
Full rehabilitation process for one person (including care, individual fitting of orthosis or prosthesis,physical therapy, accommodation, food, social services and follow up at home: $180-$250!!!
Most months between 20-30 people are hurt by active landmines. This figure is getting better. June 'only' had 18 casualties!
Below are present day tools and materials and the only photo's I was permitted to take. Notice...no carbon fiber!
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