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Pampanga Prosthetics Mission #1 « Jocelyn Wong's Blog

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Pampanga Prosthetics Mission #1

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How to Become an Asian Triathlon Superstar, Step #4: have a cause and find out how you can help, wherever you may be in the world.

On about the first Saturday of each month, the technicians and staff from the prosthetics clinic in Manila (University of the Philippines-Philippine General Hospital) along with some physical therapy students go up to Pampanga to help provide prostheses to the locals who have lost legs through vascular disease/diabetes, accidents, or congenital deficiencies. Pampanga is a province north of Manila that is a 1- to 2-hour drive, depending on the traffic, what time you leave, and how many times you stop along the way. On my third day in Manila, slightly jet-lagged but full of enthusiasm, I met up with the techs at UP-PGH, which is only one of a few prosthetics & orthotics clinics in the country.

There is a joke somewhere about Filipinos not being able to go on a one-hour drive without stopping at least once. I think we stopped about 4 times on this 2-hour drive, to pick up a physical therapist, then to possibly pick up someone else but didn’t, then to a gas station so all 9 of us could go to the bathroom (less than an hour in), and then right before we got to Pampanga there was the requisite stop at Jollibee for lunch. I was just going with the flow but slightly horrified at the lack of urgency! We left almost an hour late as we were running on “Filipino time”…and I had shown up an hour early to make sure I didn’t get lost or left behind. Silly American.

I attended the mission after being put in contact with Dr. Penny Bundoc, who is an orthopaedic surgeon and director of the prosthetics & orthotics department in Manila. I want to maximize my time in the Philippines by learning about the prosthetic care here and how I may be of some help, as I’ll be spending some time at training camps here and don’t intend to let four extra years of very specific higher education go to waste. These monthly missions are funded by Physicians for Peace and the local chapter of Rotary International, which also helped fund the clinic in Manila. Expenses are covered so that the amputees who are residents of the province receive their prostheses at no cost to them.

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Over 30 of these patients showed up to either receive new legs or get cast for them. Those that were cast last month would get to take their new ones home, while those getting cast this month would have their new legs fabricated and fit by the next visit to Pampanga (next month). I was put to work immediately, assigned to cast a few below-knee amputees that were gathered outside. (When casting for an above-knee amputation, you wrap plaster of Paris all the way up your groin and over your butt, so these were done inside for a little more privacy.)

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Since I was doing the first castings out in public view and was also the token American prosthetist who had come from afar, everybody wanted to watch what special casting techniques I might have up my sleeve. And I mean everybody…all the patients, their family members, the Filipino technicians. We were outdoors and I was sweating like mad, from a mixture of the heat, humidity, and all those pairs of eyes watching me! There was even running commentary in Tanglish (Tagalog/English) on my casting technique, where I was from (American? Korean? oh, Chinese! Chinese but American!), and my god, how much I was sweating (should we wipe her sweat or something?)! Whew, was it hot out there or was it just me?? I did make sure to draw a smiley face over the knee cap to help break the ice, a la my residency director and mentor Gary Berke…before he sent me off to the Philippines, he reminded me just to think WWGD–What Would Gary Do?? He would draw a smiley face, that’s what he would do. (Bony landmarks like the patella or “kneecap” and tibia are marked with an indelible pencil that transfer to the inside of the plaster cast.)

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Meanwhile, some of the technicians helped fit the patients casted last month with their new legs. Some of the patients were previous prosthetic users whose current legs no longer fit, while some were brand new patients that had never used a prosthesis before.

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Dr. Bundoc (in yellow) helped educate a new patient and her family on the ins and outs of her new prosthesis:

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Later we were moved inside (which helped decrease my sweat rate significantly), where more castings were done in the room I was assigned to. In the other room, the PT students were helping to teach the patients how to walk. I was pretty intrigued that for the most part, my casting techniques were not all that different from the Filipino methods. Even the prosthetic legs themselves are not so different, other than the materials used for the socket (the custom-made portion which fits onto the patient, made from the cast). However, there was one patient who had been using a wooden leg he had carved himself–pretty impressive and extremely lightweight! I’m not sure how comfortable it was, but he got a new leg to take home that day.

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When all was said and done, there were some happy patients that could walk home, and some others that would get their new legs soon. Here is the awesome team from the UP-PGH clinic that helped make it happen:

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a ton more photos can be found on my web album at:
http://picasaweb.google.com/iwjocelyn/ProstheticsMissionPampanga#

Big thanks to Lhea for taking all these photos!

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