Haiti P&O summary February 9, 2010
Al Ingersoll
Description
Collection
Title:
Haiti P&O summary February 9, 2010
Creator:
Al Ingersoll
Date:
2/9/2010
Text:
February 9, 2010
Dear colleagues,
The incredible support of family, friends and colleagues has been truly a
blessing and without I could not have spent the last two weeks in Haiti.
Responding to the earthquake brought an overwhelming feeling of despair but
also a true understanding of people's stamina and ability to overcome
tragedy. We all witnessed survivors being pulled out almost one month after
and that resolve show's how Haitian people will overcome this disaster.
I have tried to touch on the basics of the situation and can provide much
more detail as requested.
Need:
Handicap International completed the first assessment of injuries and
reports between 2 -4000 people with amputations of major bones and many with
injuries requiring long term follow up and of those up to 80% having
fractures of major bones. All Prosthetic and Orthotic services in Port au
Prince are no longer operational.
Coordination:
An Injury Rehabilitation and Disability working group has been set up under
the UN Health Cluster to coordinate local and international rehabilitation
and disability efforts. Handicap International and CBM have been tasked to
co-lead this group alongside counterparts from the Ministry of Health and
the Secretary of State for the Inclusion of Persons with Disabilities. This
coordination effort includes short, mid and long term redevelopment of
Prosthetics and Orthotics in Haiti. To best serve Haitians, avoid
duplication and help with volunteer coordination I ask all organizations to
contact the working group and state your intentions. Contact details are at
the end of this email.
Prosthetics and Orthotics (P&O)
I believe a solid plan is in place for P&O in Haiti and the Dominican
Republic. Please understand this is my perspective and others will add.
The need for Orthotics is hard to determine; as so many with fractures of
major bones are a long ways from being healed and bracing needs are only a
guess. I think we will have a much better perspective in one to two months,
especially as other practitioners start visiting and assessing.
Plans are being implemented to open temporary P&O / Therapy rehab facilities
in Port au Prince using tent or shipping container based structures next to
post op medical hospital / clinics. In my opinion these organizations have
the capacity to immediately start assisting. To best support several
organizations Healing Hands for Haiti is partnering in two locations. I do
not have contact information for all these organizations.
1. Handicap International (France) is setting up next to Doctors with
Borders (MSF) -Spain in the Airport Industrial Park (next to the airport and
the US Embassy). Operational 2nd week of Feb.
2. Handicap International Belgium is setting up in Port au Prince's
Cite Soleil. Need more details.
3. Miami based NGO Project Medishare is setting up next to the US
Embassy / Airport. Operational in mid-February.
4. German NGO Johanniter International will utilize a portable fully
equipped lab purchased from Otto Bock US and pulled by a large pickup. It
was suggested they concentrate in Leogane, which is in the southern part of
Port au Prince and support the hardest hit areas of Carrefour, Petit Goave
and Jacmel. Should be operational mid-February.
5. The southern peninsula's Les Cayes' P&O facility at Lumiere
Hospital IS operational and needs support with personnel, equipment and
supplies.
6. Hospital Albert Schweitzer is about two hours north of Port au
Prince and has a fully functioning rehab unit and is considering several
countries offers of P&O. If yes; probably midterm option.
7. The northern city of Cap Haitian has several hospitals capable of
supporting rehabilitation, a port and airport supporting flights from the US
and other countries. Several organizations already are in Cap Haitian
8. I know Partners in Health on the Central Plateau is actively
working on rehabilitation and I have not heard if they are considering P&O.
9. The Italian government is also planning to build a rehabilitation center
including P&O. This is a long-term solution.
Dominican Republic:
The Dominican Republic (DR) is a particular concern because of the large
number of injured who made it to the border and might go farther into Santo
Domingo and Santiago. Several DR rehab facilities exist and have capacity
to support with Asociacion Dominicana de Rehabilitacion (ADR) in Santo
Domingo having the largest P&O fabrication capacity and Santiago's Patronato
Rehabilitation Center having a much smaller P&O lab with minimal personnel.
ADR is receiving many offers of help and it is suggested they not open new
P&O but increase capacity with visiting volunteers utilizing ADR's network
of satellite clinics, especially near the border town of Jimani. The
Secretary of State for the Inclusion of Persons with Disabilities has begun
discussions with counterparts in the DR.
International standards:
ISPO's WHO accepted standards will be utilized for personnel and education.
El Salvador's University of Don Bosco was implementing distance based P&O
education and will continue. Please contact me for details of the
Hispaniola Prosthetics and Orthotics Education (HiPOE) plan.
Technology:
The technology question is one I am receiving constantly; the International
Committee of the Red Cross (ICRC) has been the one internationally accepted
standard in use in Haiti and several other ideas are proposed and must be
evaluated. Many experienced international colleagues, including in the
United States Rob Kistenberg CP and Paul Prusakowski CPO are helping with
what is appropriate for long term sustainability.
We all have heard the call for new / used components and I know several
organizations are receiving large amounts of donations. Our recommendation
is for ICRC polypropylene sockets, with Pelite / Bocklite / Keasy / EVA foam
type interfaces be set on ICRC or similar modular socket adapters for
connection to new or used components. Most common TT suspension has been
supracondylar wedge, cuff / waist belt or sleeve.
Healing Hands for Haiti has been trained in and uses ISPO recommended ICRC
polypropylene components manufactured by CR Equipement in Switzerland. I
HIGHLY recommend ALL visiting volunteers be trained in this technique as it
is our intention to continue using polypropylene for mid and long term
needs. For the short term (6 months) prefabricated devices are being
imported and will help transition people into the definitive prosthesis
phase. BioSculpture's computer aided manufacturing utilizing polypropylene
sockets and Endolite Atlas components is proposed as an outcome-based pilot
evaluation coordinated through Project Medishare and the University of
Miami. Robert Gailey PT and Adam Finnieston CPO are setting up. Other
ideas are in the works and will be evaluated.
It has been my observation that cosmetic finishing is EXTREMELY important to
Haitians and must be considered. Upper extremity prostheses with hook
terminal devices will NOT be worn; only passive, aesthetic.
My Opinion:
If I may stand on my soap box for a moment: If anyone shows up and stuffs
Haitians into used Caucasian prosthetics I will call you out and ask the
international community to review your credentials! The international P&O
community has the capacity and technology to effectively and quickly respond
to the Haiti earthquake crisis with a coordinated effort. Used components
yes; Sockets NO!
Funding:
Funding details are being solidified and transparency emphasized.
Volunteer:
In the next two - three weeks volunteers are needed to begin helping both
countries. I suggest P&O volunteers with international experience start and
then help train and support first timers, allowing coordination and
preventing gaps. I believe a data base is in place and screening of
interested is ongoing (more to follow).
Thank you again!
Take care,
Al Ingersoll CP, Healing Hands for Haiti International Foundation,
<Email Address Redacted>
Injury Rehabilitation and Disability Working Group contact:
<Email Address Redacted>
Al Ingersoll, BA, CP
Winkley Prosthetics, Orthotics & Pedorthics
740 Douglas Drive North
Golden Valley MN 55422 USA
Ph. 763-546-1177 Fax 763-847-9508
1-800-Winkley Direct to VM 763-252-1128
<Email Address Redacted>
www.Winkley.com
Dear colleagues,
The incredible support of family, friends and colleagues has been truly a
blessing and without I could not have spent the last two weeks in Haiti.
Responding to the earthquake brought an overwhelming feeling of despair but
also a true understanding of people's stamina and ability to overcome
tragedy. We all witnessed survivors being pulled out almost one month after
and that resolve show's how Haitian people will overcome this disaster.
I have tried to touch on the basics of the situation and can provide much
more detail as requested.
Need:
Handicap International completed the first assessment of injuries and
reports between 2 -4000 people with amputations of major bones and many with
injuries requiring long term follow up and of those up to 80% having
fractures of major bones. All Prosthetic and Orthotic services in Port au
Prince are no longer operational.
Coordination:
An Injury Rehabilitation and Disability working group has been set up under
the UN Health Cluster to coordinate local and international rehabilitation
and disability efforts. Handicap International and CBM have been tasked to
co-lead this group alongside counterparts from the Ministry of Health and
the Secretary of State for the Inclusion of Persons with Disabilities. This
coordination effort includes short, mid and long term redevelopment of
Prosthetics and Orthotics in Haiti. To best serve Haitians, avoid
duplication and help with volunteer coordination I ask all organizations to
contact the working group and state your intentions. Contact details are at
the end of this email.
Prosthetics and Orthotics (P&O)
I believe a solid plan is in place for P&O in Haiti and the Dominican
Republic. Please understand this is my perspective and others will add.
The need for Orthotics is hard to determine; as so many with fractures of
major bones are a long ways from being healed and bracing needs are only a
guess. I think we will have a much better perspective in one to two months,
especially as other practitioners start visiting and assessing.
Plans are being implemented to open temporary P&O / Therapy rehab facilities
in Port au Prince using tent or shipping container based structures next to
post op medical hospital / clinics. In my opinion these organizations have
the capacity to immediately start assisting. To best support several
organizations Healing Hands for Haiti is partnering in two locations. I do
not have contact information for all these organizations.
1. Handicap International (France) is setting up next to Doctors with
Borders (MSF) -Spain in the Airport Industrial Park (next to the airport and
the US Embassy). Operational 2nd week of Feb.
2. Handicap International Belgium is setting up in Port au Prince's
Cite Soleil. Need more details.
3. Miami based NGO Project Medishare is setting up next to the US
Embassy / Airport. Operational in mid-February.
4. German NGO Johanniter International will utilize a portable fully
equipped lab purchased from Otto Bock US and pulled by a large pickup. It
was suggested they concentrate in Leogane, which is in the southern part of
Port au Prince and support the hardest hit areas of Carrefour, Petit Goave
and Jacmel. Should be operational mid-February.
5. The southern peninsula's Les Cayes' P&O facility at Lumiere
Hospital IS operational and needs support with personnel, equipment and
supplies.
6. Hospital Albert Schweitzer is about two hours north of Port au
Prince and has a fully functioning rehab unit and is considering several
countries offers of P&O. If yes; probably midterm option.
7. The northern city of Cap Haitian has several hospitals capable of
supporting rehabilitation, a port and airport supporting flights from the US
and other countries. Several organizations already are in Cap Haitian
8. I know Partners in Health on the Central Plateau is actively
working on rehabilitation and I have not heard if they are considering P&O.
9. The Italian government is also planning to build a rehabilitation center
including P&O. This is a long-term solution.
Dominican Republic:
The Dominican Republic (DR) is a particular concern because of the large
number of injured who made it to the border and might go farther into Santo
Domingo and Santiago. Several DR rehab facilities exist and have capacity
to support with Asociacion Dominicana de Rehabilitacion (ADR) in Santo
Domingo having the largest P&O fabrication capacity and Santiago's Patronato
Rehabilitation Center having a much smaller P&O lab with minimal personnel.
ADR is receiving many offers of help and it is suggested they not open new
P&O but increase capacity with visiting volunteers utilizing ADR's network
of satellite clinics, especially near the border town of Jimani. The
Secretary of State for the Inclusion of Persons with Disabilities has begun
discussions with counterparts in the DR.
International standards:
ISPO's WHO accepted standards will be utilized for personnel and education.
El Salvador's University of Don Bosco was implementing distance based P&O
education and will continue. Please contact me for details of the
Hispaniola Prosthetics and Orthotics Education (HiPOE) plan.
Technology:
The technology question is one I am receiving constantly; the International
Committee of the Red Cross (ICRC) has been the one internationally accepted
standard in use in Haiti and several other ideas are proposed and must be
evaluated. Many experienced international colleagues, including in the
United States Rob Kistenberg CP and Paul Prusakowski CPO are helping with
what is appropriate for long term sustainability.
We all have heard the call for new / used components and I know several
organizations are receiving large amounts of donations. Our recommendation
is for ICRC polypropylene sockets, with Pelite / Bocklite / Keasy / EVA foam
type interfaces be set on ICRC or similar modular socket adapters for
connection to new or used components. Most common TT suspension has been
supracondylar wedge, cuff / waist belt or sleeve.
Healing Hands for Haiti has been trained in and uses ISPO recommended ICRC
polypropylene components manufactured by CR Equipement in Switzerland. I
HIGHLY recommend ALL visiting volunteers be trained in this technique as it
is our intention to continue using polypropylene for mid and long term
needs. For the short term (6 months) prefabricated devices are being
imported and will help transition people into the definitive prosthesis
phase. BioSculpture's computer aided manufacturing utilizing polypropylene
sockets and Endolite Atlas components is proposed as an outcome-based pilot
evaluation coordinated through Project Medishare and the University of
Miami. Robert Gailey PT and Adam Finnieston CPO are setting up. Other
ideas are in the works and will be evaluated.
It has been my observation that cosmetic finishing is EXTREMELY important to
Haitians and must be considered. Upper extremity prostheses with hook
terminal devices will NOT be worn; only passive, aesthetic.
My Opinion:
If I may stand on my soap box for a moment: If anyone shows up and stuffs
Haitians into used Caucasian prosthetics I will call you out and ask the
international community to review your credentials! The international P&O
community has the capacity and technology to effectively and quickly respond
to the Haiti earthquake crisis with a coordinated effort. Used components
yes; Sockets NO!
Funding:
Funding details are being solidified and transparency emphasized.
Volunteer:
In the next two - three weeks volunteers are needed to begin helping both
countries. I suggest P&O volunteers with international experience start and
then help train and support first timers, allowing coordination and
preventing gaps. I believe a data base is in place and screening of
interested is ongoing (more to follow).
Thank you again!
Take care,
Al Ingersoll CP, Healing Hands for Haiti International Foundation,
<Email Address Redacted>
Injury Rehabilitation and Disability Working Group contact:
<Email Address Redacted>
Al Ingersoll, BA, CP
Winkley Prosthetics, Orthotics & Pedorthics
740 Douglas Drive North
Golden Valley MN 55422 USA
Ph. 763-546-1177 Fax 763-847-9508
1-800-Winkley Direct to VM 763-252-1128
<Email Address Redacted>
www.Winkley.com
Citation
Al Ingersoll, “Haiti P&O summary February 9, 2010,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 4, 2024, https://library.drfop.org/items/show/231159.
