"Each of you should use whatever gift you have received to serve others, as faithful stewards of God’s grace in its various forms. If anyone speaks, they should do so as one who speaks the very words of God. If anyone serves, they should do so with the strength God provides, so that in all things God may be praised through Jesus Christ. To him be the glory and the power for ever and ever. Amen."
1 Peter 4:10-11 (NIV)

Monday, April 23: Macha area patients

John and Chris left about 7:30 Monday morning with Protashow to go to the Macha radio station where patients were told to meet for screening. The radio station announces about our upcoming trip several weeks before we get there to let people know what type of services we provide. John and Chris screened all the patients that were waiting at the radio station to determine who would come back on the bus to the clinic. 

New Day bus at the radio station

Patient walking up to the radio station for screening

After John and Chris screened everyone and people loaded on the bus to head back to the clinic

Meanwhile at the clinic....Amanda, Carolin and I started working to organize and set up patient rooms with casting materials. We started with the clinic basically looking like this...
...and then it got progressively messier as we started seeing patients and working on fabricating. 

Even before John, Chris and Protashow got back to the clinic with patients, we had a few arrive who came on their own. Dennis, who has bilateral drop foot, had came last year but we did not have any AFOs (ankle braces). I made sure we brought a pair for him this year, and Protashow called him to have him come back to be fit this year. Even though it was a year later, I am so glad we were able to fit Dennis with braces that make walking much easier and safer for him. Also, Christopher came for a prosthesis, and I got him casted before the bus got back. His amputation above the knee was last year due to a car accident.

Once the bus returned with all the patients, things got very busy! We split up with Chris and I seeing patients for casting and Carolin seeing patients for repairs. Amanda and Protashow assisted us where needed (mostly Amanda assisting me with castings and Protashow assisting with repairs), and John was seeing all of his eye patients. Monday ended up being 9 ocular patients (2 check-ups and 7 new people), 3 orthotic patients, 6 prosthetic repairs and 6 castings for new prostheses/orthoses. 

All the patients waiting on the porch, which is a nice shaded "waiting room".

John getting his room set up to start seeing patients.

Chris and Carolin working on prosthetic repairs. 

The ladies getting started cooking lunch for the patients. Each year on patient evaluating days and fitting days, we hire these ladies to cook lunch of nshima, beans and cabbage for all the patients.

The older girls from New Day came up on patient days to help with translating, and they also helped people with vision problems with finding eyeglasses. They were such a big help!

My "hope I can figure out how to make this work" face. I brought this shoe specifically for Grey, who is the man who came last year with the severe foot deformity that I fit with a custom shoe. The custom shoe was one that did not work for a patient back home, which worked amazingly well for Grey--turned sideways due to his foot deformity. This shoe is an off-the-shelf option that I brought this year for him, which also worked out well. I'll now know what shoe to order for him each trip. He's been happy with the shoe option we figured out for him since he was unable to wear any type of shoe before.

John evaluating a patient....with his look of focus and compassion. 

Protashow at work. He has seen a few patients for repairs during the year since last trip and got a lot more experience this trip with repairs and patient fittings. 

This is a patient who came for John to make him a prosthetic eye. He had a stroke resulting in weakness on one side of his body. We were also able to fit him with an AFO (ankle brace) to help him in walking and provide him with a walker. 

Amanda getting his walker adjusted in height for him.

Luxon and his dad came for follow up. His prosthesis was still fitting, so he got new supplies and new shoes. "Little" Luxon isn't so little anymore!....he's getting so tall. Chris saw him in 2012 on Prosthetic Promises' first trip when he was not quite 2 years old. 

We also saw Hachompwe and Osia for follow up and new supplies this trip. They have both been long time patients as well. 

Blessford came back this year for a new prosthesis. He was seen last year to lengthen the prosthesis that he had, which was a straight leg prosthesis. We brought a pediatric prosthetic knee specifically for him this year so that he can have a prosthesis with a bending knee now.

I casted Boyce for a new prosthesis. His prosthesis that we made several years ago is no longer fitting.

This is Harrington, who has a right foot deformity, which is causing him to walk on the outside-front part of his foot. I casted him for a custom AFO to correct his foot as much as possible and enable him to wear a shoe. This is another heartbreaking situation where lack of medical care that we are used to in the U.S. is so apparent. He has something going on neurologically, which causes right side upper and lower extremity tone. The diagnosis is not known (they said he "got sick at a young age"), and I'm not sure the availability of medical care to address these symptoms. 

Patient evaluating/casting days are always crazy busy. Monday was a great day filled with lots of people! Tuesday would be another patient evaluating day with patients from Choma.

*Next post-Tuesday, April 24: Choma area patients 

Tuesday, April 24: Choma area patients

Tuesday was an early start again with Chris and John leaving with Protashow to go to Choma to screen patients. We have been blessed with availability to coordinate with the Disabilities Office in Choma for several years now, and they let people know about the services we provide and when we will be coming each trip. 

Chris evaluating a patient's existing prosthesis in Choma to see if it can be repaired.

Rosemary (in the wheelchair) coming to be evaluated.

Waiting outside for evaluation.

Chris and John were set up in the office to see people one at a time for evlauation.

While John, Chris and Protashow were in Choma screening patients, Amanda, Carolin and I were getting casts from Monday's patients ready for pouring with plaster and the clinic more organized and set up. 

Melvin came before the bus returned for repairs to his prosthesis. His knee and foot were in need of replacement along with the "sail" cloth portion of his socket, which he had to come back for the following week after it was made.

Melvin was able to do some physical therapy with Amanda, which was terrific. He has always walked without bending his knee much, so it was good for him to do some gait training with Amanda.

Protashow, John and Chris returned on the bus with a lot of patients from Choma!

The older girls from New Day helping with eyeglasses again. We set up a table outside for the eyeglasses, which was helpful.

Chris casting Salia, who has an amputation below the knee.

John with one of his patients.

Protashow working on repairs.

Amanda working with Peggy and her mom. Amanda was able to do therapy sessions with Peggy multiple days in a row and teach her mom how to do the exercises and positioning.

Carolin working on repairs. 



Casting Rosemary for a below knee prosthesis. Her amputation was this past year.

Cloudy, who we made a prosthesis for last year, getting his prosthesis repaired and new supplies.

Chris casting Christopher, who has a below knee amputation.

John working with his patient.

I always love people's reactions when they look in the mirror!

Carolin working on a prosthetic repair.

Triness got some new socks and an adjustment to her partial foot prosthesis that we made last year. She is doing well and the prosthesis is still in good shape. 

Casting Rhoda for a new bent-knee prosthesis. We made her prosthesis in 2016, lengthened it last year and this year she needs a new one since hers is cracked. Rhoda has a clubfoot and is unable to walk on her right leg without a prosthesis. The bent-knee design lets her kneel into the prosthesis with the prosthetic foot positioned under her knee. 

Amanda working with her other pediatric patient. She set up a mat on the floor in the storage room to work with both pediatric patients on Tuesday so it was out of the bustle of all the other patients being seen.

Carolin with Alinase after repairing her prosthesis. 

We had a similar split up on Tuesday with Chris and I doing castings, Carolin and Protashow working on repairs, and Amanda assisted me some and then had 2 pediatric patients for physical therapy. Total patients for Tuesday were 9 new ocular patients, 3 ocular check ups, 14 prosthetic repairs, 14 new prosthetic castings and 2 orthotic patients. We were pretty exhausted by the end of Tuesday!

After dark, a new patient for John showed up at the orphanage who had traveled from very far away. Blu got a mattress from the guesthouse for him to sleep at one of the staff houses, and John would evaluate him first thing on Wednesday. Since both patient evaluation days were complete, we planned to get started on fabrication of all the prostheses, orthoses and prosthetic eyes on Wednesday. 

*Next post- Wednesday, April 25: But wait, there's more...a few more new patients

Wednesday, April 25: But wait, there's more...a few more new patients

Wednesday's mindset=get fabrication started. And we certainly did with pouring casts, modifying plaster models, organizing the work space for flow of fabrication, and even starting to gather components and supplies for specific patients. We accomplished a lot on the first day of fabrication! 

Ah, the messy part of filling casts.

Carolin doing some prosthetic feet organization. She and Amanda had the feet bins all sorted with labels by the end of the trip. So amazingly helpful!

Group effort on getting casts ready for pouring.

Protashow and Carolin pouring casts.

But wait, there's more....

We also got the joy of seeing more patients and being able to follow up with Cliness, the girl we were unable to fit last year. 

Cliness and her grandfather.

We saw Cliness last year and casted her for a prosthesis, though she had a wound on the bottom of her leg, and gave her supplies to clean and treat the wound. When she came back for fitting we realized how bad the wound was, so we decided to not fit her and advised her to see a doctor. Staci (in the pink shirt in the picture) has kept in contact with Cliness and her family, checking in on her since last April. The wound is healed this year, and we were able to fit her with the prosthesis we made from last year. We were so glad we were able to see Cliness and follow through in fitting her with a prosthesis! I'll also see her in September to check on her.

Peggy's mother brought her back to see Amanda on Wednesday for another therapy session. 

We also had another patient come for casting for an above knee prosthesis, his name is Patrick. And John had 2 more new patients for prosthetic eyes to evaluate on Wednesday. 

More fabrication work with starting to modify plaster models.

John at work in his area.

Protashow smoothing a plaster model.

Working away...and effectively getting the clinic more and more messy.

The "models ready for laminating" cart.

A beautiful sunset to finish our day!

*Next post: Thursday, April 26-Friday, April 27: Fabrication + more patients - electricity