Monday, Sept. 10th: Macha area patients

This trip is Prosthetic Promises' 7th trip to Zambia. With the clinic being completed and Protashow working with us, we've established our routine for how each trip is carried out. We see patients for evaluation and castings, as well as repairs to existing devices, from the Macha area and Choma area on the first 2 days, then do fabrication of the new devices in the middle portion of the trip (as well as see a few patients who drop by) and then spend the last few days fitting all of the prostheses and orthoses made at the clinic. 

Monday was evaluation of patients from the Macha area and some who traveled directly to the clinic. We had 14 patients to evaluate on Monday, which turned out to be 8 repairs/check-ups and 6 people for new devices (one of them was braces for both legs, so it was 7 new devices). 

We left New Day on the bus with Protashow at 7:40am to go to the Macha radio station where we would meet patients and determine who we could help. 

The road to Macha off the paved road is very bumpy, and there was lots to see including these guys traveling with their oxen cart. 

Macha radio station. 

There was a relatively small group of people at the radio station, so it didn't take us long to talk with each person to see what they needed. One person came to see John for a prosthetic eye, so he was told that John will be back in April and to come then.

Checking out Akim's prosthosis (an orthosis-prosthesis combo) for his leg deformity and one side shorter than the other. His device was made in April and only needed a few small adjustments this time.

All the patients waiting on the porch after we got back to the clinic from Macha.

Mweetwa was casted for a new below knee prosthesis. We had repaired his existing prosthesis during a past trip, but it is now really not fitting well and causing irritation on his skin.

Here's Suzanne with Blessford and Akim. Blessford, who is Akim's brother we found out this trip, was seen for adjustment to his prosthesis. Blessford was fit in April with his first bending knee prosthesis, as he had a straight leg prosthesis in the past. He is now walking really well with the prosthesis and getting the knee to bend. 

Joel was seen for repair to his prosthesis. He needed a new foot and new supplies. 

Gilbert was casted for his first prosthesis. His amputation was in 2017. 

Protashow casted Gilbert with instruction from Suzanne as he continues to learn all aspects of seeing patients and fabricating.

The ladies who cook lunch for the patients while they wait at the clinic.

The patients getting served lunch.

This is Elvira. Her ampuatation was in June due to diabetes and is not completely healed, so I was unable to make her a prosthesis this time. She has fallen on the leg since her amputation, which has contributed to it not healing. I fit her with shrinkers, which is a compressive sock for the leg to help shape it for prosthetic fitting, and made her a protective cover for the end of her leg to wear in case she bumps the end of the leg or falls to hopefully prevent the wound from opening further. We told her to come back in April when we can make her a prosthesis if the leg is healed then. 

Here's Trywell, who is 14 yrs old. He came for follow up and was casted for a new above knee prosthesis. We last saw him in 2017, so he's grown quite a bit and needed a new prosthesis

                        ....and a funny story: Apparently some people in Zambia have several names they can go by, so we've been calling him Arnold for 5 years. This time, Louise had talked with each person waiting on the porch with an interpreter to get their name and what they were at the clinic for, so she wrote down Trywell. After already casting him, I was calling out "Trywell" to the people waiting on the porch to call in the next person and here walks up who I thought was Arnold. It was confusing and an interesting cultural lesson. From now on, we'll call him his preferred name of Trywell. 

Haston has bilateral clubfoot and was casted for AFOs for both sides. 

David's below knee prosthesis was repaired. 

Louise walked down to the Ark to bring back a picnic lunch for us that Fostina prepared. We grabbed a bite between seeing patients.

Daniel has bilateral below knee amputations and rode on the back of a motorcycle for 2 hours to get to our clinic. Only one leg was healed, so the right leg was casted for a prosthesis. This will allow him to stand-to-transfer on the one prosthesis while we wait for his other leg to heal. We'll see him again in April to make the other prosthesis. 

Daniel leaving on the motorbike. It really is incredible how some people travel, and how far they travel, to come to the clinic!

Melvin was seen for an adjustment to his prosthesis and new supplies. 

Given was seen for adjustments to his below knee prosthesis.

Osia just needed new supplies for her below knee prosthesis. 

Louise, our helper extraordinaire, just jumped right in with assisting wherever she was needed....getting supplies, cleaning up, walking down to get lunch, taking pictures.   

We had one woman who came to the clinic needing eyeglasses. Louise helped her choose a pair of glasses that helped her the best. Louise was so great with each person who came for eyeglasses! She tried on the glasses herself to determine if they were for close up or distance and helped each person find the best pair to help with their vision and fit their face well.

At the end of the day on Monday, we had 3 below knees, 2 above knees and 2 AFOs (ankle-foot-orthoses) that were casted for fabrication during our trip. After the patients left, we organized the clinic some to get set up for fabrication and filled some of the casts. 

Louise working on organizing prosthetic socks.

Suzanne filling casts.

 Monday was a big day, and we knew Tuesday would be too. 

*Next post: Tuesday, Sept. 11th: Choma area patients

Tuesday, Sept. 11th: Choma area patients

Tuesday was another busy day with patients from the Choma area. Suzanne, Louise and I left with Protashow driving the bus at 7am on Tuesday to go to Choma where we would see patients for screening at the Disabilities Office. Each trip, we coordinate with the Disabilities Office in Choma to see patients. They tell patients that need prosthetic and ocular prosthetic services when we will be coming and allow us to see patients at their office for screening to determine who we can help. 

There were a lot of people waiting outside the Disabilities Office when we arrived! 

After seeing a few people for evaluations, we figured out there were several people that came who had pain in their legs. There seemed to be a confusion based on the wording of their announcement. Hilda, the lady from the Disabilities Office, had to announce to the crowd waiting that we only are helping people who have an amputation. 

This young girl is not able to walk and unfortunately has significant contractures at her knees and hips, so making braces for her would still not enable her to stand or walk. This is another example of some heartbreaking conversations we have to have. Her mother brought her to see us expectantly, and we had to tell her that there is nothing we can do for her. 

Little Emmanuel needed braces for his ankles. We had some at the clinic that Suzanne fit him with, and she casted him for custom ones to be made in the U.S. and brought back in April for him. 

We saw patients in the small Disabilities Office two at a time. Here's someone leaving the office as others are waiting to be seen.

After screening all the patients, we had a completely full bus load of people to head back the clinic. We had 19 patients on Tuesday for either casting for a new prosthesis or repairing/adjusting their current prosthesis.

The very full bus on the way back to the clinic! Louise is sitting waaayyy in the back on the floor.

Cledness was casted for a below knee prosthesis. Her existing prosthesis from another clinic is 3 years old and does not fit anymore.

Grace was casted for a below knee prosthesis. She had came in April during the last few days when we were fitting patients, so we did not have enough time to make her a prosthesis. I had fit her with a shrinker to wear during the day to shape her leg, which she has been doing. Protashow got some casting experience while I instructed him as he continues to learn all aspects of patient care and fabrication.

This is Malawo, who has bilateral congenital amputations and hand deformities. He has had prostheses in the past but has outgrown them. Suzanne casted him for bilateral "stubby" prostheses. Stubbies are short prostheses without a knee joint.

Suzanne casting Malawo. 

Christopher was casted for a below knee prosthesis. 

Lawrence needed a repair to his above knee prosthesis to replace the footshell on the prosthetic foot, which had torn. Suzanne also worked with him on gait training more, because he was keeping the prosthesis too far to the outside. He really improved how he was walking by the time he left the clinic on Tuesday!

Protashow working on alignment of a prosthesis.

Greenford was seen for repair to his prosthesis and adjustment. He needed a new foot, as his current foot was broken. He also got new supplies and adjustments to the socket to improve the fit. 

Thelma was casted for an above knee prosthesis. Her amputation was in 2017 due to a car accident. 

Matthew needed a repair to his above knee prosthesis. 

Gaye and Sam stopped by the clinic to see where they could help out. Poor Sam...I tasked her with separating tiny little Chicago screws into different bags. 

Mwetwa was seen for repair to his existing below knee prosthesis. 

Rosemary was seen for adjustment to her below knee prosthesis that she got in April. She is doing well walking with a walker. She was all smiles and laughs...such a wonderful lady! And she taught me a new Tonga word "shoopa" (not sure of the spelling), which is "problem". The 'problem' was getting up off the chair after she has sat so long waiting to be seen. We had a good laugh about that.

Juliet was seen for a check up on her above knee prosthesis that we fit in April. She needed a new liner, and we made a small adjustment to the knee. 

Christopher who we saw in April for a prosthesis needed some alignment adjustments and new supplies. 

We saw Alan, who has a below knee amputation that is not completely healed yet. This was disappointing because he came thinking he would get a prosthesis. We fit him with a shrinker, which is a tight compression garment to help shape the leg, and we'll see him in April for casting for a prosthesis after the wound is completely healed. 

We also saw Cliness for check up who we fit with a prosthesis in April. The wound on the bottom of her leg is back again and looked infected. After some question and answer with her parents, who brought her to the clinic, it seems that she is still walking some at home without the prosthesis on. She has a Symes ampuatation, which means her foot was amputated but she still has the full tibia and fibula. This type of amputation is designed for someone to be able to bear weight on the end of their leg, but Cliness has had a history of a wound on the bottom of the leg that has become worse and possibly infected due to walking without her prosthesis on. Protashow translated for our conversation, and we told her parents multiple times how very important it is for her to go to the hospital and gave them money to take her there. We will be checking on her to see how she is doing. 

It was a big day Tuesday with lots of patients! We finished up seeing patients about 5:30. 

One of my favorite parts about the first few days of seeing patients for evaluations is seeing some of the same people again. Every person we've seen before has a big smile and handshake for us when we greet them. Though we don't spend a long time talking with each person, it's developing these relationships and being able to care for the same people each trip that I think is really meaningful...and hopefully they do too. 

*Next post: Wednesday, Sept. 12th: Starting fabrication and even more patients!

Wednesday, Sept. 12th: Starting fabrication and even more patients!

We got to the clinic Wednesday morning with the plan of getting fabrication started with pouring casts and modifying while getting the clinic arranged for fabricating all the devices we had casted on Monday and Tuesday. We did do this...but we also had more patients all morning. We had 5 more patients come to the clinic on Wednesday. 

Nathan has cerebral palsy and was seen by Suzanne for orthoses. She was able to fit him with SMOs (a type of ankle brace) and work with his mother on strengthening exercises to have him do. 

Suzanne showing Nathan's mom how to stand him while supporting his torso and head. 

Christopher came for a check up on his above knee prosthesis. He needed a new sail, which is the cloth portion in the back. Measurements were taken to sew a new sail for him, and he was told to come back the following Wednesday. 

Making a few alignment changes for Christopher to make his walking easier. He got his prosthesis in April, so he's had time to practice walking and do away with his crutches. So making a few alignment changes is normal after a patient gets used to walking with their prosthesis.

Suzanne was working on fabrication while I was working on Ruth's prosthesis. Ruth came for repair to her below knee prosthesis that she got in Lusaka 3 years ago. The foot was broken and needed to be replaced. Because some of the components of her prosthesis were rusted, we used the socket and attached it to new components and a foot. She also needed a pair of shoes since she only had slip on shoes that did not stay on the new prosthetic foot well. 

Teamwork on fabrication. 

Joyce also came for follow up on her AFO (ankle foot orthosis) for her foot deformity. She was fit in April with the device to take pressure off her deformed foot and provide her with protection to the foot when she walks. She has been wearing it some but needed adjustment to the device. Hopefully with the modifications made to the AFO, she will be able to build up to wearing it full time. 

Louise and Gaye took all the bins with shoes and separated them by size, tied the laces together for pairs and re-organized them in bins with labels for the store room. SO HELPFUL! This also let us know what shoe sizes we really need for the next trip in April.

Orclay came for a below knee prosthesis. His amputation was in 2017. Staci, who lives at New Day, had told Orclay about us providing prostheses. So she arranged for him to come to the clinic. Here I am seeing Orclay in the patient room while the chickens visited the large room in the clinic. These chickens hung out at the clinic almost everyday.

This odd looking lizard also hung out at the clinic, and seems to live in the storage room.

In the afternoon, Suzanne, Protashow and I were able to get several of the plaster models modified and ready for lamination.

Louise worked on organizing the clinic and supplies and also helped 3 people who came for eyeglasses.

On Wednesday night after dinner, we went to Prayer and Praise with the kids and staff of New Day for singing some songs, prayer requests and praises, and prayer. 

*Next post: Thursday, Sept. 13: Familiar faces come to the clinic...