In “Growing O&P in Developing Countries” in this issue, sources describe challenges associated with making O&P nongovernmental organizations (NGOs) successful in developing countries. The O&P EDGE shares how one NGO has grown to deliver consistent care to individuals across Southeast Asia.
The Cambodia Trust recently celebrated three milestones at a reception in Phnom Penh, Cambodia. Having spent a quarter of a century meeting the needs of disabled populations in Southeast Asia, the British NGO officially celebrated its 25th anniversary. On the same night, its flagship school, the Cambodian School of Prosthetics and Orthotics (CSPO), celebrated its 20th anniversary. Finally, with an eye toward its future, the organization announced that the sustained expansion of its educational outreach efforts into several surrounding countries had necessitated a name change and that Cambodia Trust had officially changed its name to Exceed.
Exceed CEO Carson Harte made the announcement and described the rationale behind the name change. In June 2013 the Cambodia Trust board of directors met with the five directors of its educational programs in Cambodia, Sri Lanka, the Philippines, Indonesia, and Myanmar to develop its strategic plan for the next ten years. In the discussions that followed, it soon became apparent that while the name Cambodia Trust reflected the organization’s origins, its efforts had quickly expanded across Southeast Asia, achieving impact well beyond Cambodia’s borders. In effect, the organization had outgrown its name.
In creating a new brand identity, the attendees at that strategic planning meeting agreed upon the name Exceed, citing its meaning “to go further and do more than expected.” The consensus was that the organization has a demonstrated track record of doing more than it had originally set out to do and that this drive would continue into the future. In addition, the meeting attendees identified a corporate slogan to reflect the organization’s goals for its patients, students, and educational staff: “Equip, Enable, Empower.”
Organizational Beginnings
The Cambodia Trust was founded in Oxford, England, in 1989. At that time, the Cambodian prime minister had asked for assistance in addressing the needs of the country’s thousands of landmine survivors. The following year, the organization used its first major donation to invest in a satellite telephone system to break the country’s Western communications blockade. As financial support increased, a team of British prosthetists-orthotists entered Cambodia to provide clinical services. At that same time, O&P manufacturer Chas A. Blatchford & Sons, headquartered in Basingstoke, England, provided technical assistance for the development of the trust’s first prosthesis, waiving the patent rights for its use within Cambodia.
That same year, Brazilian photographer Sebastião Salgado returned from Cambodia and, having made contact with Cambodia Trust, pledged to donate his earnings from his assignment to the organization. Neil Burgess of NB Pictures, London, England, negotiated a deal with The Independent Magazine that secured front-page coverage along with ten pages of editorial content and a financial appeal. His article was accompanied by Salgado’s images of landmine survivors and a direct appeal for £20,000. Within three hours of the magazine hitting the streets, a single donor pledged the entire amount. The article appeared in other European publications, resulting in a total of £90,000 in donations.
Harte announces the decision of the Cambodia Trust to change its name at the Himawari Hotel, Phnom Penh. Photograph courtesy of Exceed.
The following year, the organization signed a lease to occupy a neglected laundry wing of Calmette Hospital in Cambodia’s capital city of Phnom Penh, transforming it into the organization’s first prosthetics center. Two years later, a second rehabilitation center was opened. As the staff began to see more people affected by polio, cerebral palsy, and congenital deformities than landmine survivors, the centers expanded their scope of practice to include orthotics and physical therapy.
An O&P School in Cambodia
Five years after its inception, Cambodia Trust collaborated with various agencies working in the country to open CSPO. The school’s mission was to train Cambodians to the highest professional standards to enable them to provide high-quality physical rehabilitation services to persons with mobility disabilities in Cambodia. Within three years, CSPO obtained Category II status from the International Society for Prosthetics and Orthotics (ISPO), gaining a reputation for quality education in the region. That same year, CSPO expanded its enrollment to international students, welcoming applicants from Sri Lanka, Laos, the Solomon Islands, and Myanmar.
Ten years after the creation of CSPO, Cambodia Trust developed a “Train the Trainers” program in collaboration with La Trobe University, Melbourne, Australia. This program allowed former CSPO graduates to upgrade their education to a bachelor’s- degree level and phase out all expatriate staff at CSPO as Cambodian nationals became qualified as Category I practitioners and assumed roles as lecturers and managers. Thus, CSPO was able to hold a double graduation ceremony in 2007 in which 12 students graduated from CSPO with their ISPO Category II training and an additional nine students graduated with bachelor’s degrees from the joint program with La Trobe.
By its 20th anniversary, CSPO had trained students from Cambodia, Laos, North Korea, Sri Lanka, Georgia, East Timor, Papua New Guinea, Kiribati, Iraq, Afghanistan, Pakistan, Malaysia, Japan, Nepal, Myanmar, the Philippines, and Zambia. CSPO Director Sisary Kheng, herself a CSPO graduate, heads a management team consisting of other CSPO graduates. The result is that all education and treatment interventions are provided by Cambodian nationals.
Extending Beyond Cambodian Borders
In 2000, six years after CSPO was established, a regional office was established in Singapore to facilitate the planning process that would lead to the establishment of new P&O schools in other developing countries in the region. This planning was conducted closely with the Nippon Foundation, which continues to partner with Exceed. This plan resulted in three new P&O schools: in Ragama, Sri Lanka; Jakarta, Indonesia; and Quezon City, Philippines.
The Sri Lankan School of Prosthetics and Orthotics (SLSPO) was established in 2004 in a purpose-built facility and included several Cambodian lecturers on staff. In 2008, SLSPO celebrated its first graduations. The third school, the Jakarta School of Prosthetics and Orthotics (JSPO), opened in 2008. This was followed in 2010 by the establishment of the Philippine School of Prosthetics and Orthotics (PSPO) along with its rehabilitation treatment center. Three years later, Cambodia Trust, with further support from the Nippon Foundation, agreed to establish a Prosthetic and Orthotic Department at the University of Medical Technology, Yangon, Myanmar.
Exceeding Expectations
From its humble beginnings, Exceed has gone far beyond the organization’s original vision. In Cambodia, the school and rehabilitation centers currently employ 86 national staff while training 35 students. In 2012 they provided more than 700 new prostheses and roughly 1,000 new orthoses, and sent 364 children with disabilities to school and 40 young adults with disabilities to university through various outreach initiatives. In Sri Lanka, 29 national staff members assist in the instruction of 29 students while providing more than 1,500 O&P devices through its three rehabilitation centers. The school in Indonesia employs 43 national staff while training 45 ISPO Category II students and provides more than 700 O&P devices through the attached treatment facility. The Philippines school recently opened its first P&O clinic while a team of national and international staff oversees the education of nearly 50 O&P students. The Myanmar program awaits the completion of a new, purpose-built facility modeled after the current CSPO campus. Student intake is slated to occur later this year.
As Exceed moves into the future, it is building upon foundations laid over the past 25 years to equip, enable, and empower persons with disabilities and provide young people with O&P education opportunities in Southeast Asia.
Phil Stevens, MEd, CPO, FAAOP, is in clinical practice with Hanger Clinic, Salt Lake City, Utah. He can be reached at
