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ICRC Special Fund for the Disabled: walking tall

28-11-2008 Feature

The ICRC Special Fund for the Disabled is celebrating 25 years of helping people to walk and work again. Claire Doole reports on the work the Fund is doing in Africa to improve access to quality treatment and care.

  A young girl is fitted for a new prosthesis at the National Centre for Orthopaedic Appliances (CNAO) in Lome.    

  Every six months a child needs a new prosthetic.    

  Addis Ababa, Ethiopia. Prosthetic Orthotic Centre. Each prosthetic is specially made for the patient.    

Ten-year-old Joseph Fiokouna thought his life was over when he woke up to find his left leg had been amputated below the knee. He had climbed onto a wall in his garden to pick a mango when the wall collapsed, trapping him beneath.

“After they amputated my leg, I cried as I was thinking of all the people who don’t have legs and who pass by my house on crutches every morning. This is what made me cry and cry.”

Joseph is from a poor family who share a rundown compound in the Togolese capital, Lome, with other families. His mother ekes out a living selling second-hand clothes and had always had high hopes for her eldest son.

“Of all my four children, I had always thought that Joseph would go the furthest,” says 36-year-old Yama. “At the hospital, I was so distraught I told the doctor to cut off my leg rather than my son’s.”

Her grief however turned to relief when she heard that Joseph could be fitted with an artificial leg free of charge at the National Centre for Orthopaedic Appliances (CNAO) in Lome. It is one of 90 physical rehabilitation centres in 43 developing countries that the ICRC Special Fund for the Disabled (SFD) has supported over the past 25 years.


 Training technicians to international standards  


The SFD aims to help these centres improve the quality of the service they give to people who have lost limbs or who have trouble walkin g. It provides them with technical and financial assistance and trains their orthotics and prosthetics staff to international standards through sponsoring candidates for scholarships at regional schools. The technicians are also trained at their workplace or have the chance to go on one- to four-week refresher courses in making and fitting artificial limbs at the Fund’s regional bases in Ethiopia, Viet Nam and Nicaragua. 

Souroutawi Gberloeou, who looks after Joseph, is one of a number of technicians at the CNAO in Lome who have taken refresher courses at the SFD training centre in Addis Ababa. A softly spoken man with a broad smile, he has been “putting patients back on their feet again” for the past 20 years. Although the limbs he fits today, made out of a special material developed by the ICRC, are much more comfortable than the old wooden prostheses, it can still take a long time for some patients to come to terms with their new leg or arm.

Making a limb, he says, is a “mix of art and science” as every patient has a unique stump, so needs a prosthesis that has been specially adapted to him. 

As well as equipping the technicians with the technical skills, the SFD training centre in Addis puts a lot of focus on the needs of the patient. One of its senior trainers, François Blaise, says he tries to pass on the advice that he got when he was starting out: “my first boss said to me that you should always make a limb as if it were for yourself, as that ensures you will do a good job.”

 Overcoming disability and stigma  

“An orthopaedic appliance gives a person with a disability the possibility to walk and work again,” says Max Deneu, the head of the SFD in Africa. “For a relatively small investment, people living with disabilities can regain confidence, dignity and mobility and truly integrat e back into society.”

But funding disability is not a priority for many governments in Africa, and many of the rehabilitation centres the Fund works with are struggling financially. The SFD offers financial assistance but also lobbies governments to put more resources into prosthetic/orthotic and other rehabilitation services.

“Restoring mobility is only a first step,” says Deneu. “Maintaining mobility is a long-term process. A child, for example, needs a new prosthesis every six months while an adult must change his every three years.”

Joseph has just had his second prosthesis fitted and thanks to the quality of the care he receives from the physical rehabilitation centre in Lome, he leads a full and active life. He regularly plays football with his friends, scoring goals and striking the ball as hard as anyone else. But unlike most 10-year-olds, his ambitions do not lie on the football pitch: he wants to be prime minister.

“One of my first acts would be to ensure that everyone who has lost a leg would also get the chance to have a new one,” he says.

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