A Summary Report from Guatemala

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A Summary Report from Guatemala

Written by: Madalyn Kern, PhD, CEO and Founder | ReForm Inc.

Empowerment through mobility.

The process of becoming stronger or more confident through the ability to move or be moved freely.

Ability to move or be moved freely:

Movement itself can certainly be freeing, though many of us may not consciously think about our ability to move on a daily basis. However, for one who has experienced the loss of a limb, I imagine that the ability to move, or not move, most certainly consumes one’s daily thoughts.

While I was in Guatemala, myself and a multi-disciplinary and multi-ethnic team worked together to help 27 individuals have the ability to move freely. Of the 27 individuals, 23 were lower-extremity (leg) amputees and 4 were upper-extremity (arm) amputees. Approximately two-thirds of the patients had lost their limb due to diabetes while the others may have had an accident at work, in a car or on a motor bike, or sadly were attacked either by a stranger or someone they knew. No matter the cause of amputation, each individual came with one goal in mind: to move freely.

   
  
   
   
  
    
  
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    Figure       SEQ Figure \* ARABIC
   1      : Several patients having initial check-ins and evaluations with prosthetists.

Figure 1: Several patients having initial check-ins and evaluations with prosthetists.

Becoming stronger or more confident:

I think it is clear to see how a prosthetic leg or arm can make someone physically stronger. Today’s prosthetic devices have given millions of people the ability to return to “every-day” activities – such as walking – and even some to “more advanced” activities – such as outdoor recreation.

Every patient we saw at the ROMP clinic was asked to identify one specific activity that they wanted to be able to perform after receiving their prosthesis. One man said he wanted to return to his job as a cowboy to herd cattle, another said he wanted to button up his own pants, another still said he wanted to be able to write his name. In addition to making, fitting and aligning prostheses to patients, we also spent several hours coaching and training patients on how to use their new prostheses. Once our patients experienced themselves performing different movements and activities, you could instantly see their excitement. Immediately their confidence to re-enter society, to become more self-sufficient and independent was enhanced.

   
  
   
   
  
    
  
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    Figure 2: A patient practicing writing his name.

Figure 2: A patient practicing writing his name.

Process:

Above almost anything else, the six days I spent working in the ROMP clinic reinforced my understanding that helping amputees walk and work again is a process, a long and multi-faceted process. 

Our first two days in the clinic were spent doing patient check-ins, evaluations and casting patients’ residual limbs to make positive molds. The next two days were spent making and modifying the positive molds and fabricating socket components. The last two days were spent assembling the prostheses, fitting and aligning them to the patients and doing gait training or other activity training. Our multi-disciplinary team – including prosthetists, technicians, physical therapists and administrative staff – was critical for being able to execute each stage appropriately and efficiently. However, it was also made clear to me that the process does not and cannot stop in the clinic. Continued training, coaching and support from family and friends is necessary in order for patients to continue moving and moving confidently.

   
  
   
   
  
    
  
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    Figure 3: (Left) A prosthetist modifying the positive mold of a residual limb. (Center) Technicians fabricating a socket component using a draping method. (Right) Physical therapists doing gait training with a patient.

Figure 3: (Left) A prosthetist modifying the positive mold of a residual limb. (Center) Technicians fabricating a socket component using a draping method. (Right) Physical therapists doing gait training with a patient.

How did my experience affect my path forward with ReForm?

Most certainly, my time in Guatemala was an opportunity for me to gain more first-hand experience and first-hand understanding of the problem at hand. I built several relationships with both the ROMP-USA and ROMP-Guatemala teams in addition to the other volunteers that were participating. I received feedback from the prosthetists and amputees on different technical aspects of my adjustable socket prototype and how it could be improved. One piece of feedback in particular came from William (right), an energetic and fun man. After trying on my socket prototype and he said, “What I like the most is that it gives me the control to adjust the fit of my socket to do different activities – like walking, running or working in the field – more easily…it feels comfortable and secure”.

   
  
   
   
  
    
  
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    Figure 4: William (left) and Madie (right) evaluating ReForm’s first prototype.

Figure 4: William (left) and Madie (right) evaluating ReForm’s first prototype.

There is still more product design, development and testing to be done before I have a prototype ready for commercialization, but this is exactly what I am excited about and want to do. I know that with time, continued support from all of you and the new contacts I make every day I can continue moving forward along this path. Because after all, Everyone Deserves to Walk

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