Monday, February 15, 2010

Advocates hope that out of the Haiti earthquake tragedy comes better attitudes toward people with disabilities

From USA Today. In the picture, Selita de Elois carries her injured daughter Louise, 4, at an aid distribution point in Haiti.

PORT-AU-PRINCE, Haiti — Ivens Louius, a Haitian physical therapist in the Dominican Republic, hopes the wave of amputees needing rehabilitation after the earthquake that rocked his native country means he can go home again.

For three years, Louius, 25, has been working in Santo Domingo, the Dominican capital, because he says there is no work for physical therapists in Haiti. Hospitals and clinics could not afford to pay them.

Today, though, the need for rehabilitation is greater than ever, he says.

"If services are not provided soon, so Haitians who need therapy can become a part of society again, my prediction is that Haiti will have the world's highest rate of idle and abandoned people with disabilities," Louius says in Spanish.

Between 2,000 and 3,000 people have had crushed limbs amputated since a magnitude-7.0 earthquake hit Haiti on Jan. 12, Handicap International says. The relief agency provides therapy and devices such as prosthetic limbs, crutches, walkers and wheelchairs.

The numbers continue to grow as people suffer untreated infections.

Aid groups and medical professionals hope the sheer number of amputees will change how Haitians view the disabled, who often are treated as unproductive people who should be isolated.

"In Haiti, if you have a disability, you are hidden," says June Hanks, a physical therapist working in Haiti since 1998. "Children are kept in back rooms. They get food if there is extra, but the food goes to feed the healthy children first."

Disabilities are ridiculed and thought of as a curse, says Hanks, who is working with amputees in a southern hospital.

"Now is a wonderful time to change the mind-set," she says. Hanks is developing an education program that would operate through churches to teach pastors and congregants that amputees and other people with disabilities can work and be productive.

Other health workers are trying to grow the rehabilitation and therapy field, starting from scratch.

Louius is working with American therapists and the Albert Schweitzer Hospital in Haiti to assemble a team of Haitian therapists now practicing outside the country. They would visit regularly to provide therapy.

Haiti, a country of 9 million that had limited capacity to treat an estimated 800,000 disabled people before the quake, lost two of its three prosthetics labs when the buildings were destroyed or damaged. A smaller lab remains in the south, but Hanks says it needs materials to make prosthetic devices.

Aid groups are setting up three temporary labs, says Al Ingersol of Minneapolis, who fits artificial limbs. He works with two of the groups, Healing Hands for Haiti and Handicap International, at one lab. Healing Hands was Haiti's largest provider of artificial limbs before the quake, Ingersol says.

In two to three weeks, wounds will have healed enough for amputees to wear temporary prostheses, he says.

His groups are expecting the first shipment of material this weekend to make 50 to 100 temporary prostheses. Ingersol says material for as many as 500 temporary prostheses will arrive over the next six months. The temporary devices, which are adjustable, can be made quickly. Amputees wear them for about six months, allowing time to heal. Then they can be fitted for permanent, custom-designed prostheses, which take more time to make. Ingersol says Healing Hands salvaged enough material after the earthquake to fit amputees with about 500 permanent, custom limbs.

The labs will be able to make up to 100 temporary prosthetic limbs and 10 custom-made limbs in a week. Ingersol says used limbs cannot be refit.

"It's kind of like you wearing someone else's dentures," he says. The labs will recycle parts from used prostheses to make new ones.

The need to help the newly disabled take care of themselves is urgent in a country where three out of four people are unemployed and the work that does exist is hard physical labor, Hanks says.

Maritza Figareau, recovering from an amputated leg, and her husband, Daphne Joseph, worry about how their lives will change after her injury.

At the damaged general hospital here, Figareau, 28, lies in a bed in a sweltering tent. She lost her 8-day-old baby in the earthquake. She also lost part of her right leg, which was amputated above the ankle after a crush injury.

"This is what makes her cry," says Joseph, a city finance office worker. "Before, when she had two legs, she couldn't get work. Now what chance does she have?"

Joseph said he and his wife have not had time to think much about the future other than to despair about where they might live. This much he knows: Haiti is hard on the disabled, and he and his wife don't expect that to change.

"This is a country where people battle for themselves, and the government doesn't do anything for you," he says. The disabled in Haiti have few rights or opportunities, he says. There are few paved roads, let alone wheelchair ramps. "If you're handicapped," he says, "it's like you aren't a person."