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Seeking Club support. A unique amputee care project .
Global grant for Sustainable Amputee care in Peru
Dates:Jan 4,2019 to Jan 4, 2021
Host Club: Rotary Club del Callao, Peru. District 4465
International Club: Cheshire Rotary Club, District 7980
Global Grant Title: Developing a Sustainable Amputee care Program for the Under served and under insured population in Peru
Area of focus: amputee care and rehabilitation. Prosthetic design and fitting
Geo Focus: Hospital Nacional Daniel Alcides Carrion, Bellavista,Callao Province ,Peru
The need: There is a prevalence of approximately 190,000 amputations in Peru mainly related to Motor vehicle accidents, gunshot wounds and land mine injuries. The development and manufacture of medical devices in Peru including prosthetic limbs is hampered by the lack of experts in the field. Local Hospital data indicates that there are 10 prosthetists in Lima and One prosthetic Lab. There is no formalized training for Prosthetics and Orthotics in Peru. The under served and uninsured do not have access to a prosthesis in their lifetime. Providing prosthesis to these individuals would enhance function, individual family and community ability to enhance their socio economic status. Hospital Nacional Daniel Alcides Carrion (www. hndac.gob.pe) established in 1941 is multi specialty 462-bed hospital and is dedicated to public health and welfare of the under served and uninsured. The Hospital, the rehabilitation community led by local physician leaders has asked for support for training and implementation of an independent, sustainable amputee program.
The Goal: The goal of the project is to educate, train, assist in infrastructure build and establish a collaborative interdisciplinary amputee care program at Hospital Nacional Daniel Alcides Carrion, which can serve as a model for local and national health care systems. This will lead to improvement in access and quality of care to the under served and uninsured in Peru and enhance the socio-economic status of individuals, families and communities.
Objectives
1. Dreaming and Working Together (DWT) in cooperation with Hospital Nacional Daniel Alcides Carrion and Rotary Club Del Callao will identify physicians, prosthetist and rehabilitation specialists from the local community for training and education in Amputee care. The training and education curriculum will be designed in collaboration with local physicians at Hospital Nacional Daniel Alcides Carrion and State Medical Association to specifically target level of medical and rehabilitation training in Peru, and adapt to cultural, ethnic and language issues.
2. DWT VTT team and team members will combine to provide hands on training, didactic and tele-medicine educational sessions, consultations in amputee evaluation, prosthetic socket design and fitting, rehabilitation training and establish an Interdisciplinary team concept for amputee care.
3. DWT will work with Hospital Nacional Daniel Alcides Carrion to improve infrastructure and assist in establishing its own prosthetic lab, assist in the development of a robust Tele-medicine system educational and training programs and collaborate with trainees in mentoring programs.
Budget $64,000.00
Contacts: Subramani Seetharama MD, FAAPMR, Cheshire Rotary Club, District 5160 rexiezing@gmail.com
Frequently Asked Questions
Why should the Rotarians help these communities?
In Peru, one third of the population, lack access to basic health care. In metropolitan Lima, 61.9% of workers work in the informal sector and do not have access to health insurance. The under served and un insured do not have access to a prosthesis in their lifetime. Dreaming and Working Together (DWT) has made annual trips to Hospital Nacional Daniel Alcides Carrion since 2006, in small teams and have been providing prosthesis to a chosen few each time .The hospital serves the under served and uninsured. The prosthesis allows for improved function, ability for individual family and community improve their socio economic status. Over the years we have seen a building of trust, sense of optimism and excitement in the local community, enhancement in hospital infrastructure and support, development of patient based amputee support groups and adaptive sports programs. However the program remains entirely dependent on DWT's annual trips, lack of trained personnel, limitations in funding and resources, ethnic and environmental issues.
Through the combined efforts of DWT and Rotary international, in collaboration with Hospital Nacional Daniel Alcides Carrion, we can expand the amputee care program into a sustainable independent model program with tools and training to expand throughout Peru.
How will the project address community needs?
This project is based on a tiered model of training and mentoring.
DWT in cooperation with Hospital Nacional Daniel Alcides Carrion and Rotary Del Callao will identify physicians, prosthetist and rehabilitation specialists from the local community who will participate in the various training and educational activities. Training and education curriculum will be designed in collaboration with Dr Mary Querevalu, Hospital Nacional Daniel Alcides Carrion and State Medical Committee to specifically target level of medical and rehabilitation training in Peru,and adapt to cultural , ethnic and language issues.
1. The DWT VTT team will be selected from a range of experienced trainers on the roster based on timing and availability. They will train the Hospital Nacional Daniel Alcides Carrion team in amputee evaluation, prosthetic socket design and fitting, rehabilitation training and long term care.
2. DWT team members will continue hands on training during VTT trips and didactic lectures and consultations to rehabilitation community via Tele-medicine through the year.
3. The Local team will in turn train and mentor members of rehabilitation hospitals in the Lima locally. With establishment of a robust Tele-medicine system educational and training programs can be made available nationally throughout Peru.
4. DWT will continue working with Hospital Nacional Daniel Alcides Carrion to improve infrastructure and assist in establishing its own prosthetic lab.
How were the community needs assessed?.
DWT has made annual trips to Hospital Nacional Daniel Alcides Carrion since 2006.The first trip was lead by eminent neurosurgeon from CT, Dr Andrew Wakefield, who performed spine surgeries, provided neurosurgery resident teaching and worked with the hospital to establish an endovascular surgical Suite. The first rehabilitation team accompanied Dr Wakefield in 2007 and since then has worked directly with Hospital administrators, DR Mary Querevalu, Head of Rehabilitation, rehabilitation department personnel, local government and community leaders. Meetings and surveys with the amputee support group of current and former patients, family members outlined individual, cultural and environmental needs and helped outline project goals. Subsequently, the local Rotary Club del Callao, Peru, has been working as a bridge between the local community and the hospital
What are the projects funds going to cover?
$28,335.11: Training of local prosthetists , physicians and Rehabilitation specialists, patient education and training in interdisciplinary collaboration and communication.
Funds will support bringing highly trained and experienced DWT trainers from the US and support travel, meals, accommodations, and transportation to and from the hospital and educational sessions
$25859.32: Equipment to initiate steps to a prosthetic lab, Hardware, shipping of prosthetic components. Funds will also include funds to establish basic tele medicine hardware and communication.
$4569.98: operational costs like data collection, account management, liability insurance
$5235.59: contingencies
Is the project Sustainable going forward?
Hospital Nacional Daniel Alcides Carrion and the rehabilitation community led by local physician leaders like Dr Mary Querevalu have shown great enthusiasm, support and strong leadership for the amputee care program. There have been significant infrastructure upgrades, with commitments to establish a prosthetic lab and upgrade IT facilities for Tele-medicine. Local and state government health officials have offered support and encouragement to implement a nationwide program. After the grant activities conclude, Hospital Nacional Daniel Alcides Carrion will take sufficient ownership to continue with implementation of a independent, sustainable amputee program and commit to train and mentor local and national partners.
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