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Young Prosthetists Enhance Skills in Ecuador
By Miki Fairley "I learned to problem-solve without conventional
means. It was like taking the textbook principles and applying them
as far outside the box as possible. I learned to be less wasteful
and more efficient. I also learned alternate techniques to decrease
cost while increasing durability."--Angela Montgomery, prosthetic
resident
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Angela Montgomery uses her modification skills during Ecuador mission. |
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As Montgomery found, working in a humanitarian
relief mission can hone O&P skills and sharpen the right-brain
creative function to find solutions.
Montgomery was part of a three-person team from Hanger
Prosthetics & Orthotics who traveled to Quito, Ecuador, from
November 29 to December 14, 2003. The mission was organized through
the Hermano Miguel Foundation with the help of the First Lady of
Ecuador, Ximena Bohorquez de Gutierrez. The foundation is a
nonprofit organization dedicated to assisting persons with
disabilities and employs a team of multidisciplinary professionals.
Besides Montgomery, the team included Brian Joseph Monroe, CPO, and
Stephanie D. Porter, who has completed her prosthetic residency and
begun her orthotic residency. The three paid their own expenses for
the trip.
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Stephanie Porter and a patient, delighted with his new prosthesis, strike a dance pose. |
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Porter too found that the trip enhanced her
knowledge of prosthetics. "The beauty of our field is that you're
always learning," she said. "This trip was no exception, as you
have to make considerations about socket design and componentry,
knowing that the patients live seven to ten hours away and probably
will not be able to return for consistent follow-up. The same was
true for alignment. Most of the patients' involved sides were very
weak, due to months or even years without a prosthesis. As a
result, many of them required assistive devices for ambulation, but
it was evident they would quickly progress beyond that stage."
Ecuadorian People
Of course, the rewards include more than gaining knowledge and
increasing skills. "Prosthetically, the most rewarding aspect of
the trip was meeting this new group of people and being able to
combine forces to provide prostheses for all of the patients we
were scheduled to see," said Porter. "I felt it was also incredibly
rewarding to get to experience the people and culture of Ecuador.
The spirit and the joy the people of Ecuador have, with so little
material resources, truly makes you question the priorities here at
home."
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Brian Monroe, CPO, stands with a bilateral amputee patient and an unidentified woman. |
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Montgomery listed some of the rewards as: "Having
such a huge impact on people's lives in such a short amount of
time. Not only watching them walk for the first time, but listening
to them and knowing that their confidence--and therefore their
goals in life--have risen. I was amazed by their happiness and
gratitude. For people that have so little by our standards, they
are amazingly happy. They were also extremely appreciative for our
help and wanted to return the favor in any way possible, such as by
giving us personal artwork and food."
Patients' Can-Do Attitudes
Porter also was impressed by the disabled persons they helped.
"They were incredibly industrious and had all devised so many
different ways of regaining their mobility to meet the needs of
their daily lives. When providing a new prosthesis to people of
that mindset, it's so inspiring to see the way they take it and
run. I had a transfemoral patient who was without any sort of
prosthesis for five years. He put on his prosthesis and in ten
minutes had mastered a total knee and single-axis foot. When he
left, he insisted upon walking without any sort of assistive device
and was pulling it off pretty convincingly."
No Insurance Hassles
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Angela Montgomery poses with a patient and colleague. |
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Montgomery enjoyed another benefit: pure patient
care. "Having returned to work here in the US, I am
constantly reminded of the beauty in simplicity," she said. "We
worked in an atmosphere where we could provide, to the best of our
ability, the most appropriate prostheses to patients free of
charge! No L-Codes! No insurance companies! I can't help but think
it's the purest form of patient care and what most practitioners
would dream of."
Tough Road for Disabled
However, disabled persons have a tough road to travel in
Ecuadorian society, Montgomery noted. "I was surprised to learn
about the societal attitudes toward disabled persons in Ecuador.
Most of my patients had resorted to panhandling because they were
unable to find work. Their society views them as a lower class,
incapable of leading a normal life again. Coming from a country
that almost views active amputees as heroes, that was a tough
concept to grasp."
Eager To Go Again
Porter thanked other persons and organizations that helped make
the mission a reality. "As is the case with many of these trips,
there are so many people behind the scenes who make it possible,"
she said. "Dino Cozzarelli, CPO, from Asheville, North Carolina,
was the organizer of the trip. Locally, the trip would not have
been possible without the support of my market leader, Dennis
Huysman, CPO, FAAOP, and my residency preceptors, who were all
willing to let me take the time to do it. Also several companies
donated supplies, including SPS, Ohio Willow Wood, PEL, and
Expeditors International, a freight-forwarding company that offered
to help ship the supplies to Ecuador for free." Other clinicians,
practices, and the Newington Certificate program also saved and
donated old componentry, she added.
The two young prosthetists were eager to go on another mission
in the future.
"There were sacrifices that needed to be made for this trip to
be possible for me, and I have no regrets," said Montgomery. "Those
sacrifices have paid for themselves tenfold. I am currently working
on ways to make more of an impact in the world of prosthetic
humanitarian relief."
When asked if she would go again, Porter's response was,
"Absolutely!"
For more information about the Hermano Miguel Foundation,
visit www.fundacionhermanomiguel.org
For more information about Hanger Prosthetics &
Orthotics, visit www.hanger.com 
Table Of Contents - May 2004
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