For my P&O readers.

I am a bit behind on this posting.  It is from my stay in Vavuniya.  It is a look at my volunteering at the Vavuniua General Hospital.  I look a few photos of the clinic area, the rectification (aka modifying room) area, as well as some of the devices I worked on with the guys at the clinic. 

No problem! Aton's favourite expression.  He can be seen in the foreground of the picture

The technicians were a fun bunch.  One guy, Aton, kept saying, "no problem" to everything.  I think they were the only English words he knew.  Aton was a very inspiring guy.  He travels by wheelchair 7km each day, with his hand propelled WC.  Another technician works as a trishaw driver on week nights and weekends to suppliment his income.   Most of the technicians were hired with disabilities and are in wheelchairs.  All had suffered a spinal cord injury from the war.  Mary had hired these guys to demonstrate to other Sri Lankans that people with disabilities can be contributing members to society and are willing to work.  This is a big statement for a country like Sri Lanka, where people with disabilities are generally seen as unemployable or considered only to be people that beg on the streets. 

Molded TT sockets, awaiting to be cut out.  The two Cambodian clinicians had cast 21 patients one weekend while up at an army clinic in the north.  Impressive to say the least!  While they were doing the clinic at the army camp, they told all the orthotic patients to come down to Vavuniya because they had a visiting orthoitic specialist who could see them... me?

Assessment and casting area

The biggest achievement was the Hyperextension brace we made for a L2 compression fracture.  Since we were limited on the materials we could find, I had to be creative.  I also wanted to make something that could be reproduced once I left.  We purchased some aluminum barstock from a local supplier.  However, it was not flat, but was something that you use to brace a the corner of a wall (as far as I can understand).  I hammered it flat on a anvil and covered it will EVA for comfort.   This was used for the cruciform components.  I took some thin metal sheeting material for the sternal and pubic pads (so that it could be moldable and formed to the shape of the chest) and covered it with EVA. I cut a lumbar pad out of plastic and heat formed it to the lumbar curve and lined it with soft EVA.  The guys at the clinic were very impressed with my resourcefulness, mostly because I used materials that were available to them and did not push foreign ways or materials.  The brace was a success and they will likely make it again.  The orthopedic surgeon was also very thankful and impressed with the speed at which we were able to make the brace for the patient.

Another brace I introduced to the guys was a thumb spica.  None of them had ever prescribed, seen, or fabricated one before.  The patient who we prescribed it for had a dislocating MCP joint;  whenever she flexed or extended her MCP joint or her DIP joint the MCP joint would dislocate.  It was very painful, and she would visibly jump with pain.  She could not functionally use her thumb.  The fitting of the tumb spica was successful and now she was able to perform a pinch grasp pain free.

I helped out with numerous other patients, with lots of other pathologies.  Things that I would never see in Canada.  For instance building a device for a leg length discrepancy of 12" for a 10 year old (never consulted a doctor before age 10).  KAFO for a child with a knee flexion contracture of 35 degrees and a plantarflexion contracture of 45 degrees.  It has been an incredible experience!