ARTICLE - NEW LEGS FOR AMPUTEES

NEW LEGS FOR AMPUTEES
(Miami Herald) - By Audra D.S. Burch


Inside a warehouse in an industrial corner of Hialeah, six large cardboard cartons hold the next chapter in the lives of Haitian earthquake amputees -- 500 chocolate-brown prosthetic legs for men, women and children.

Project Medishare's first shipment of limbs, part of a herculean international effort to make the survivors physically whole, are being custom-fitted and will be sent to Haiti on Monday.

``Today, these are just boxes of limbs. Soon, they will be somebody's legs, somebody who will be able to play soccer or go to work again,'' says the University of Miami's Robert Gailey, the rehabilitation coordinator of Project Medishare, which aims to help 1,800 survivors walk again.

Doctors left Friday for Port-au-Prince to meet amputee patients and scout locations to open a Prosthetic and Orthotics Center, which will eventually train Haitian workers to become prosthetic technicians.

They face extraordinary circumstances: It's been estimated that 4,000 to 6,000 Haitians lost limbs and that number grows as more amputees are identified. In comparison, the Vietnam war produced 5,500 amputees; the wars this decade in Iraq and Afghanistan have produced 956 amputees, according to Gailey, who also helped to develop an amputee rehabilitation program for the U.S. military.

``We have never seen a natural disaster of this type in which so many limbs were lost,'' says Gailey, an associate professor at UM's Miller School of Medicine. ``Almost immediately, we knew the prosthetic community had to be mobilized to join this cause.''

At least a dozen international relief agencies, foundations and private companies are working on long-term prosthetic care.

The University of Miami's Medishare project is funded through private donations. For each $300, another amputee will be able to walk. The focus now is on legs, which are more critical to survival than arms. Doctors hope to provide prosthetic arms and hands later.

The monstrous Jan. 12 earthquake instantly created a class of new amputees and destroyed all existing prosthetic facilities in a country where the disabled receive limited assistance and face staggering social stigma. In some of the worst cases, mothers have discarded their newborns in hospital yards, ditches, even sewers, because they weren't born perfect.

``Many Haitians rely on their hands and feet as the source of their bread and butter,'' says Nathalie Vertus, one of the three Haitian-American founders of S.A.V.E. 509, a newly formed advocate group for Haitian amputees. ``So to lose a limb is a major challenge. Culturally, some people think you are useless or of no value.''

But from such a sobering landscape, a shift in cultural consciousness may emerge as the country begins to witness one of its most vulnerable populations, equipped with new arms and legs, lead full lives.

``Either we let these people who lost their limbs face a life of begging or worse, or we say this is our chance to make this a vibrant disabilities rights movement in Haiti,'' says Dr. Paul Farmer, who has spent nearly three decades in Haiti fighting the fury of HIV/AIDS. ``But it can't just be built around the newly amputated. This has to be around disabilities at large.''

In late January, Gailey and prosthetist Adam Finnieston, whose South Florida family business provides prosthetic and orthotic clinical care, traveled to Haiti to develop a rehabilitation strategy.

They were faced with issues of pricing, durability, logistics, and also cultural sensitivity: how to account for the wide sweep of complexions of Haitians.

Blatchford, a prosthetic and orthotics company near London, sent the first batch of artificial limbs, at discounted prices, to the Finniestons' factory in Hialeah.

The legs, made by amputees in India, are a deep hue, one of three browns available. Gailey said they are also experimenting with sprays and paints to match specific tones and pigmentation.

``We are going to get as close a tone as possible, but it won't be exact,'' Finnieston says. ``The idea is if people glance at it, they won't know the difference.''

The prosthetics are made of dense plastic for people of heights ranging from four feet to six-feet, two-inches, and are designed specifically for use in Third World countries -- more affordable, more durable, less flexible. Each leg is contoured with naturally sculpted feet and a cleft between the toes to wear sandals or flip-flops.

``They are resistant to the heat and rain, fit for the environment,'' Finnieston says. ``But the key is comfort. If they don't fit comfortably, the people will not wear them.''

Gailey and Finnieston carried 25 of the prosthetics to Port-au-Prince on Friday to fit amputees.

They plan to test the company's BioSculptor system -- technology that uses a portable scanner to transmit 3-D images of residual limbs to the Hialeah factory to create custom-fit sockets for them.

Eventually, the system would be taught to Haitian prosthetic technicians.``If we teach them to care for themselves,'' Gailey says, ``they can become an independent nation.''

Over the weekend, the residual limbs of several amputees were to be scanned in Port-au-Prince, and prosthetic sockets were to be fabricated in Hialeah on Sunday.

At 7 a.m. Monday morning, if all goes as planned, the full prosthetic forms -- limbs, sockets and sleeves -- will be flown to Haiti on a Medishare flight.

And by lunchtime Monday, 83 days after the quake, survivors whose legs were crushed or ravaged by infection, then severed, will be on their way to walking again.