When HAS, Hanger Foundation and Medi reinitiated services in Deschapelles after the 2011 Christmas break, we established several goals:
1. To sustain services at approximately 500 cases per year;
2. To offer orthotics, in response to a significant unmet need in our district; and
3. To focus our services in the two Departments of the Artibonite and Central, integrating our services with Partners in Health. These two departments are the most populous regions of Haiti after Port-au-Prince.
With five months of service with this model, it is possible to see that all of these objectives have been achieved, and even exceeded.
Total services: during the first five months of the year, we have seen a total of 247 patients, almost one-half of the targeted numbers. Most importantly, the numbers of patients arriving at the clinic have increased steadily through the year, as more individuals and organizations become aware of the services.
Provision of Orthotics Services: Since January, the demand for orthotics services has grown significantly, with initial training being provided to the excellent Haitian technicians in the first two months and then full services from March on. One of the major reasons for the growth is the strong working relationship between the O & P clinic and the hospital’s physical therapy department. As the physical therapists participate on morning rounds, they identify patients which would benefit from orthotics services, and refer them to the clinic, often bringing the patients over in person.
Geographic Diversity: Since the beginning of the year, the number of patients arriving from the Artibonite region has steadily increased, with almost half (110 = 45%) of the patients coming from this area, which includes patients referred from PIH in the Central Plateau. The demand for the clinic’s service from patients in port-au-Price remains strong, thanks to the excellent sourcing and transportation services provided by the Catholic medical Mission Board, one of the founding members of the Haiti Amputee Coalition.
As anticipated, a significant number of prosthetics patients come for revisions of previously-provided limbs, but more than half of the patients are new patients, seeking new limbs. Increasingly, these new patients are the victims of vehicular accidents or diabetes, and it is rare to see a new patient who is a victim of the earthquake.
Analysis: The prosthetics and orthotics services at HAS have exceeded our goals, and they have provided evidence that there is a continuing, and even growing, need for these services. Our forecast of demand for orthotics was, if anything, an underestimation. Our model of serving as a regional referral center for P & O services in the central part of Haiti has proven to be a valid concept, and has been supported by referrals from both departments and key organizations such as Partners in Health and others. We are pleased to be able to provide services to so many patients from the Port-au-Prince region, recognizing that there are many providers who are active in the capital region. We have also been honored to have had two of our Haitian technicians selected for the competitive training program organized by Don Bosco University, which is a combination classroom and distance learning course leading to an international P & O certification.
HAS serves primarily as a host for this service, providing the space and the local technicians, while Hanger and Medi provide the rotating lead prosthetists/ orthotists, as well as the materials for the fabrication of the limbs and splints. The active support of all of the members of the Haitian Amputee Coalition has been an essential element in the success of the program.
The Haitian Amputee Coalition was established by the Hanger Ivan R. Sabel Foundation, Physicians for Peace, the Harold & Kayrita Anderson Family Foundation, the Shepherd Center, and the Catholic medical Mission Board in Haiti.