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

On Thursday, Suzanne, Protashow and I continued with fabrication and Louise organizing the clinic. We also had 2 patients on Thursday. 

Louise, our organizer extraordinaire. 

We got started with laminations but we were encountering some issues with how the resin was setting up, which we finally assumed was because we were using an opened can of resin that was from the April trip. Note taken: probably best to not use opened resin. We're so used to working in our temperature controlled offices in the U.S. where how chemicals react and how plaster sets up isn't as big a deal. In Zambia, we encounter differences in how the resin and plaster acts just from morning to afternoon each day because of the temperature and dry environment. 

Lane, who is a short term volunteer at New Day, came up to the clinic to put a doorknob on the one of the bathroom doors for us. He also installed towel racks in the two bathrooms! The towel racks were an awesome surprise...such a little thing, but so thoughtful of him to take time to do for us.

Chileleko is one of the kids at New Day and came for Suzanne to evaluate him for leg braces for bowed legs. Mama Tembo, his house mother, brought him up to the clinic.

He was not too happy about the whole process.

But was better when Papa Tembo came to save him. (And he got a lollipop on the way back which made things better)

Suzanne fit him with a short ankle brace on the right side and taller ankle brace on the left side to help with his leg alignment. Because we don't know the etiology for why his legs are bowing, we recommended that he see an orthopedic doctor. 

Rhoda also came for a check-up. Rhoda has a clubfoot on the right side and uses a bent-knee prosthesis, which allows her to kneel into the device and have a pylon and prosthetic foot underneath to walk. She only needed a few minor adjustments, new straps and some new socks.

We first saw Rhoda in 2016 when Suzanne came, so Suzanne was very excited to be able to see her. 

Documentation that I did a lamination. (I'm not very fast at doing this, so it's generally best if someone else does this part)

Protashow working on a plaster mold. 

Louise was able to help 2 more people with eyeglasses on Thursday. She did a much more thorough job of helping people find some eyeglasses to help with their vision than we've been able to do in the past. We were so thankful for her taking the time to sit down with each person to help them find a pair of eyeglasses to improve their vision. 

*Next post: Friday, Sept. 14: Fabrication and another patient

Friday, Sept. 14: Fabrication and another patient

Friday was filled with fabrication, and Louise continued with organizing in the clinic. We had one patient come who we were expecting. 

Suzanne modifying a plaster mold

Protashow smoothing out a prosthetic socket.

Chipo, who is the Financial Assistant at New Day, came up to the clinic to see where she could help out. She organized the feet into bins.

Louise getting the casting material organized into bins for easy access.

Have I mentioned how awesome it was that Louise organized the clinic? 

Seriously...even down to separating burrs and screw sizes...with labels! Because of all her hard work in getting the clinic more organized, we are able to fabricate devices and work more quickly. Which means we can potentially see more patients for future trips!

The one patient for Friday who we were expecting was Felix. Felix is 8 yrs old and was in a burn accident in 2012. He has a partial left foot and the left leg is shorter from the accident. 

Staci, who lives at New Day, had sent us pictures of Felix's leg before our trip. We had brought a walking boot specifically for him and were planning to cast his leg to make something back in the U.S. to bring for him in April. However, when he arrived we discovered he has an open wound on his heel.

I modified the walking boot to take pressure off his heel and instructed him to put minimal weight on the left foot until the wound is healed, using his crutches for walking to keep the left foot off the ground. We will see him in April to follow up and hopefully be able to make him a prosthesis if the wound is healed. 

In fabrication, Suzanne continued with laminating and Protashow cutting out the finished sockets, breaking out the plaster and smoothing up the socket edges. 

Suzanne worked with Protashow on instructing him to do laminations, and he did one himself to learn the process.

I was able to get the "sails" for the above knee prostheses sewn. We only had 5 sails to make for this trip, so I was able to get all those made on Friday. 

*Next post: Saturday, Sept. 15- Sunday, Sept. 16: Fabrication continues...

Saturday, Sept. 15- Sunday, Sept. 16: Fabrication continues...

Saturday and Sunday were fabrication days without any patients. We got a lot accomplished to be ready for Monday when were expecting more patients to come. 

On Saturday, Louise helped me with the sails by burning holes in the material for the screw attachment holes. This is a tedious and time consuming process, so it was so nice to have her do that while I worked on assembling locks in the prosthetic sockets. 

Suzanne working on getting a prosthetic socket model ready for lamination.

Protashow working on smoothing finished prosthetic sockets. 

We had started assembling finished sockets with components on rolling carts. The next step would be to put the socket together with the components for the final product.

Louise back at organizing the storage room more. 

Finished sockets after Protashow smoothed them waiting for me to put in locks.

On Saturday afternoon, we went to check out Kids' Club at New Day. They have Kids' Club each Saturday afternoon, where kids from the surrounding area come for play time, bible stories and singing songs and then a meal. Here everyone is lining up for meal time.

Louise helped out by handing out plates to kids.

Suzanne went to sit with some of the kids while they ate. 

Danu the dog, leading the "pack" back to the Ark for dinner.

Sunday morning was church at the New Day Baptist church, which is just outside the fence of New Day Orphanage's property. There's singing to start, then Sunday School where the kids go outside under the tree for children's Sunday School while the adults stay in the church building, then the kids come back in for the sermon, then special songs by the youth choir and women's choir and group singing to end. 

After church and lunch, we headed back up to the clinic for afternoon work.

On Sunday afternoon, Louise continued her organizing expertise by doing an inventory of the prosthetic feet. This is a tremendous help for us to know what sizes, left or right, we need for our trips next year!

Finished lamination after the resin has hardened. Next step is cutting it out, breaking out the plaster and smoothing the edges.

Suzanne getting another model set up for lamination.

Our "finished" stack was growing!

The final product for a prosthesis: the gray portion at the top is the socket which covers the patient's residual leg, the pylon is the pipe portion in the middle, and then connected to the prosthetic foot. 

An afternoon sunset...so beautiful. 

Sunday wrapped up our first week in Zambia. We went to American Worship at Wes and Laurie's house after dinner where the American staff at New Day gather every other Sunday for a video sermon from an American pastor and singing. 

We were looking forward to another busy week with expected patients on Monday.

*Next post: Monday, Sept. 17: Patients and field trips and fabrication

Monday, Sept. 17: Patients and field trips and fabrication

Monday was a busy day at the clinic. We finished getting all the prostheses and the one pair of AFOs assembled and ready for patient fittings that would start on Wednesday, had 2 classes from New Day come up to the clinic for a field trip, and had 3 patients. 

The "finished carts" with the growing stack as we finished assembling everything on Monday.

Protashow showing the kids from New Day how the Trautman works to smooth the edges of a socket.

I enjoyed watching Protashow explain various aspects of what we do to the students.

Suzanne getting components together for a prosthesis.

Protashow and Suzanne working on assembling devices.

Charlie stopped by for repair to his crutches, which we ended up just giving him a new pair.

We had made Charlie a prosthesis several years ago, but he found that he would prefer to not use a prosthesis and just use crutches to get around. And this is OK...it's hard work to use a prosthesis. He gets around great on crutches, and I'm glad he felt comfortable coming to see if we could repair his.

Another class came to the clinic for a field trip. 

They had great questions! And it was neat that they could come see what all we do at the clinic. 

This is Malawo. (yes...we had 2 patients named Malawo this trip...one child, one adult). He's a teacher and has a transcarpal amputation on his left side. A transcarpal amputation is just past the wrist.

Suzanne talking with him about prosthetic options. She casted him to make an upper extremity prosthesis for him in the U.S., which we'll take back to fit him in April. Upper extremity prostheses are very time consuming, and we don't have parts available at the clinic for fabricating these. 

Harrington came for follow up on his AFO that we fit in April. He is neurologically involved with a lot of tone on his right arm and leg. His foot wants to point down and turn in due to the tone, but the AFO holds the foot and ankle straight though the toe was still pointed down. 

He has been wearing the AFO every day, which has helped him to walk with protection to the foot and helped stretch his ankle and foot. I was able to correct his foot and ankle more because of the stretching, so I casted him for a new AFO that's in the better corrected position.

Harrington is so fortunate to have his grandfather who cares for him and brings him to the clinic. His grandfather is so attentive to get all the instructions to help him with the AFO. They were told to come back on Thursday for fitting of the new AFO.

Suzanne working on the straps and buckles for the AFOs for Haston.

Protashow filling the cast of Harrington's leg to make his new AFO.

We had these cute little boots that fit great for Malawo's prostheses!

Carts with the finished devices ready to go for patient fittings.

Louise and I climbed the water tower for sunset pictures on the way back to the Ark.

Louise taking in the view of the beautiful Zambian landscape.

A view of the clinic from atop the water tower.

Another one of my favorites about my trips to Zambia is making a point to climb the water tower for a view of the sunset. God paints some very beautiful skies!

A close on our very busy Monday. 

*Next post: Tuesday, Sept 18- Wednesday, Sept 19: Finishing fabrication and the start of patient fittings