Jordanian orgs create hope in for prosthetics and orthotics

Prosthetics 1
In 2017, Doctors Without Borders (MSF) introduced the 3D printing project to develop prosthetics. (Photo: MSF Website)
Various Jordanian organizations provide holistic medical service packages under the spectrum of rehabilitation for prosthetics and orthotics to refugees and local amputees who have been victims of war and violence.اضافة اعلان

Amman Reconstructive Surgery Hospital, which is the working ground for the Reconstructive Surgery Program (RSP) by Doctors Without Borders (MSF), has fulfilled its goal of serving patients from Iraq who were victims of war and violence. According to specialists, the hospital is now opening admissions to other neighboring countries, such as Yemen, Palestine, and Syria.

For the last 15 years, the hospital has been able to admit 50 patients per month. However, specialists shared that in 2020, due to the COVID-19 pandemic and the restrictions imposed on travel and transportation of patients, the hospital had to halt its operations then reduce the number of surgeries performed due to their inability to get patients to Jordan.

The pause in operations led to a waiting list of 517 patients. This year, the hospital set its objective to manage the list by developing a global network of doctors, specialists, and treatment centers to offer these patients without transporting them to Jordan.

As of today, the eight-story hospital based in Amman has admitted around 6,000 patients and performed nearly 15,000 operations. In addition to orthopedic, maxillofacial, and plastic surgery, the RSP provides psychological healthcare, physiotherapy, and a safe space to recover for adults and children who have been victims of violence.

“As a past member of the Humanity and Inclusion organization and MSF’s RSP, we offered our patients a rehabilitation program which aided in the patient’s process of healing both physically and mentally,” said Mahmoud Al Helu, a physical therapist and previous member of MSF’s RSP, in an interview with Jordan News. “Under the multidisciplinary team, the patient is transferred to the psychosocial support department, physical therapy, and occupational therapy, depending on their needs.”

“As a private rehabilitation center, we treat both local amputees and refugees,” said Yousef Marwan, physiotherapist at PhysioLeaders Center and member of Auranitis LifeLine NGO, in remarks to Jordan News. “As for refugees, we offer a limited number of physical and occupational therapy sessions, psychosocial support, and financial aid.”

PhysioLeaders Center has partnered with a few neighboring centers, such as RAFT medical supplies and prosthetics. It is also supported by MSF, Department for International Development, and Bureau of Population, Refugees, and Migration.

“As a former Humanity and Inclusion organization worker, I worked with many Syrian refugee amputees during the Syrian Civil War. Many of which were admitted during the years of 2014–2016,” added Marwan.

Farah Aburumman, a member of the Noor Al Hussein Foundation, told Jordan News: “We have two branches, at two different refugee camps, and we treat any refugee in need, in partnership with the Humanity and Inclusion organization, and the UNHCR.”

“Due to the shortage of finances and the high cost of the prosthetics, as an organization, we attempt to treat and give priority to severe cases and work with other organizations to provide the necessary care for the remaining refugees,” Aburumman said.

According to a statement made to Jordan News by Prosthetics and Orthotics specialist and member of RAFT for medical supplies and prosthetics, Ibrahim Shadid, the RAFT center has recently developed a bionic arm that functions by picking up signals from the patient’s residual arm and converting them into intuitive and proportional hand movements.

“We have also worked on creating our prosthetic devices with a CNC 3D milling machine — a revolutionary step in providing for our patients. Nevertheless, as a medical center, we do not receive any aid from the government financially due to prosthetics and orthotics being considered nationally as a cosmetic matter rather than a medical one,” Shadid said.
Similarly, in 2017, MSF introduced a 3D-printing project to develop prosthetics, which helped patients regain their autonomy and perform everyday tasks that their injuries had previously prevented them from doing.

Funds and imports for the rehabilitation program

According to Shadid, all prosthetic parts are imported from outside of Jordan. Each patient is provided with a custom-made prosthesis, which ideally takes one to two weeks to prepare. In addition, patients with orthotics-related matters are treated with a prefabricated medical device available in Jordan.

Prosthetics allow patients to regain their autonomy and perform everyday tasks that their injuries had previously prevented them from doing. (Photo: MSF Website)

“Depending on the patient’s need and budget, lower-body prostheses, consisting of the modular, hydraulic, and microprocessor parts; and the upper body prosthesis, which consist of cosmetic, mechanical, and electronic hand prostheses, and bionic prostheses, are imported from outside of Jordan,” explains Entesar Mahmoud, a member of the Mafaz Medical for Prosthetics and Orthotics.

“Refugee amputees that we treat are normally funded by charity organizations such as the Arabian Medical Relief and the Humanity and Inclusion organization. However, local patients usually use health insurance from the Jordanian Royal Medical Services,” she added.

Healing and rehabilitation therapy

“Ideally, the patient’s wound heals in about four to eight weeks. Post-operative symptoms may include phantom pain, leaving the amputee in excruciating agony, where nerve-block surgery is then needed,” Helu said.
“Patients with diabetes, and the elderly, may take longer to heal, and at times have a silicon piece placed in between their wound and the prosthesis to create a barrier and minimize the pressure and the pain in that area,” he explained.

Helu also explained that the strength of specific joints and the strength and flexibility of the muscles in the area should be examined, along with the limb’s range of motion, before placing the prosthesis. Then, post-operation, the remaining part of the limb is bandaged to create a convenient shape for the prosthesis to fit in.

Abdullah Al-Atrash, a doctor and specialist at Al-Touf Center for Medical Devices and Prosthetics, said in an interview with Jordan News: “Every patient is required to take between 10 to 20 physical therapy sessions in order to strengthen and rehabilitate the muscles in the residual limbs, prior to the prosthesis fitting.”

“Amputees are prone to developing post-amputation edema; a swelling of the residual limb. In such cases, an elastic compression garment or bandage is placed on the affected area, followed by a temporary prosthesis. A definitive prosthesis is placed after the shrinking of the residual limb,” said Shadid.

Orthotics and prosthetics as an educational field

Saif Manaseer, a graduate of the Department of Orthotics and Prosthetics in the University of Jordan (UJ), said: “This field consists of 70 percent practical and 30 percent theoretical (knowledge), which allowed me to have direct contact with amputee patients from my second year as a student.” He added that “early on, I was able to create my first prosthesis for a patient with a below the knee amputation, with the help of a multidisciplinary team, and it was a success.”

“Given that the majority of my degree is practical and requires many lab credit hours, the COVID-19 pandemic hindered our ability as students to perform certain tasks and placed a limit on our interactions with our patients,” said Hossam Ayasrah, a third-year student at UJ’s Department of Orthotics and Prosthetics.

Another graduate, Abrar Al-Bahloul, added that “to make up for my lost lab hours during the COVID-19 pandemic, I trained at Omar Bin Al-Khattab Center for Prosthetics for a few months, but was unable to pursue the internship due to a lack of any financial benefits from the center.”

“My experience as an intern was fully visual and, as students, we weren’t allowed to participate in any medical services for the amputee patients,” she added.

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