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ROMP Brings Prosthetics – and Hope – to the PoorBy Kathi Wolfe When the Range of Motion Project first set up shop fitting amputees with prosthetics in Zacapa, Guatemala, in October 2005, the first customer was Vairo Chavez. Chavez had lost both legs in a construction accident when he was electrocuted and fell three stories from a roof. The prosthetics lab was cramped and makeshift, said David Krupa, ROMP co-founder. “We worked in a very small room that doubled as workshop and patient-care space. The workshop was very dirty, hot and noisy while patients needed to sometimes get undressed, be cast and go through rehab.” 
But ROMP volunteer prosthetists put together two legs for Chavez, using mostly recycled parts, and got him back on his feet. So when enough money was raised to build an extension onto the lab, Chavez headed the construction team. The new wing, later named the Loren J. Mellon Centro de Rehabilitation, opened in May 2007. “On the day of the inauguration, Vairo stood in front of about 60 visitors and told of his accident,” Krupa said. “He was moved to tears, and the room was filled with the electricity of everyone’s emotions.” And then Chavez cut the ribbon. Krupa, 27, a single amputee who grew up in a middle-class home in suburban Chicago, moved to Guatemala in 2006 to devote full time to the project. Before that, he and others would drop in every few months for about 10 days. “Working there full time, I got to know the patients better,” Krupa said. “I didn’t have to rush the work to fit 20 people in during one week. We could take a more sustainable pace and work more comprehensively like we do in the States.” ROMP co-founder Eric Neufeld, 31, works in a prosthetics lab at Rush University Medical Center in Chicago. It smells of strong adhesive, and the metal sink is heavily splattered with plaster. He wears a white apron. In his cramped workspace in a blue storage bin is a used above-the-knee prosthesis. He’ll take it home to his garage and detach and discard the shell that encases the thigh. But he’ll salvage the metal components below, and when he and others go down to Central America later this year, the parts will be in one of the two containers full of prosthetic components each member of the delegation takes on the flight. Projects like these, when based on a charity model, sometimes can do more harm than good. We send our Western technological scraps to poor people in poor countries. But what happens when they need repair? Those who didn’t have the methods or means to acquire the technology in the first place will have the same problem when it comes to acquiring replacement parts and repair tools. So the freedom and euphoria brought about by the technology is short-lived. And when it comes to assistive technology, one size rarely fits all. Items such as prosthetics and wheelchairs that are not customized can lead to serious problems such as skin breakdowns, bad posture, etc. “We call that a parachute organization,” Neufeld said. “They parachute in, drop something off and leave.” But the lab in Guatemala is there to sustain ROMP’s efforts. The four employees in Guatemala are all local people. One of the technicians is also an amputee who got his prosthesis from ROMP. The employees make the customized shells from a cheaper but still durable material that’s more readily available. They learned the business from Krupa and groups of visiting prosthetists and orthotists and instruction from a Web-based program developed by the Center for International Rehabilitation. The director is paid about $400 a month and the others $200, which Neufeld said is a very good wage for the area. About 430 ROMP prosthetics have been distributed in Guatemala. Neufeld said it costs about $200 for a below-the knee prosthesis and approximately $400 for one above the knee, compared with $900 and $1,600 in the U.S. Every recipient is asked to pay something to help support the project. “And they always do,” Neufeld said. “My theory is that they want to do business, not just be given something. So they give something, whether it’s 10 bucks or a basket of oranges.” “I have a beautiful collection of handmade gifts from patients and memories of fruits and breads brought in (in) thanks to all of us at the clinic,” Krupa said. The equipment in the lab was donated by Neufeld’s employer, Scheck & Siress, a Midwest prosthetics manufacturer. Neufeld is granted paid administrative leave when he takes three annual 10-day trips for ROMP. Krupa was born with a condition called pseudarthrosis of the tibia and fibula; the two bones below his knee did not join near his ankle, which hindered bone growth. “When I was one and a half, my foot was amputated near the ankle and shortly after I was fitted with my first prosthesis,” he said. “For me, I never knew any other reality, and so my childhood was very normal. This was, of course, in large part due to the fact that I always had adequate prosthetic treatment.” After obtaining a bachelor’s of science degree in biology from the University of Illinois, he earned his prosthetics certificate from the Northwestern University Prosthetic and Orthotic Center. Neufeld, on the other hand, stumbled into prosthetics. He was 24, armed with a bachelor’s in geography from the University of Wisconsin, and doing home remodeling. But he was looking for a career path that meant more to him in the grand political scheme of things. “I volunteered with a local prosthetist,” he said. “By the end of the first day, I was sure that this was the right career for me.” Krupa volunteered with a team going to work with amputees in Haiti as part of his prosthetics residency. That’s when he got his first sobering look at the harsh role poverty plays in the lives of people who need prosthetics. “I decided to do something about it, no matter how little that something might be,” he said. Krupa told Neufeld, his Scheck & Siress colleague, about his desire to take action. Neufeld knew that a group based in northwest Indiana, Hearts in Motion, periodically brought amputees from Guatemala to Chicago to receive donated prosthetic limbs from Scheck and Siress. So Krupa and Neufeld teamed up with a lawyer friend to form the nonprofit ROMP. Krupa’s decision to leave behind the life of a young, well-paid urban professional was not a hard one, he said. After returning from missions to Pakistan and Quito, Ecuador, “I came home with everything I had seen fresh in my mind,” he said. “There had been dozens of people with bodies literally shattered by the earthquake in Kashmir. There had been 50 patients in Ecuador, many who had lived for years without prostheses.” Today, Krupa lives in Ecuador, where ROMP collaborates with Fundacion Hermano Miguel, a local organization that works with amputees. He’s engaged to an Ecuadorian woman. And he still spends a lot of time in Guatemala. Said Krupa: “It still frustrates me when after a really good day of work in Guatemala, the next morning we get 15 more phone calls from people looking for the same thing we just did yesterday. The magnitude of the problem is enormous. It stems from these horrible rifts between the rich and the poor people in a place like Guatemala, and the rifts between rich and poor countries like Germany — a significant manufacturer of some of the best prosthetic components — and Ecuador, where people are primarily unable to afford those same critical products.” Said Neufeld: “I’ve met amputees who never believed they would have access to prosthetic services, never believed they would be able to return to work or just walk without crutches. I feel both gratified and proud that I can play a role in their lives and saddened by the millions they represent around the world who still have no access to prosthetic rehabilitation. “People aren’t disabled because of a missing limb. People are disabled because they don’t have a prosthesis. This is a medical condition for which there is a cure.” For more information about the Range of Motion Project, go to www.Rompglobal.org or call (312) 420-3748. *********************************** Mike Ervin is a member of American Disabled for Attendant Programs Today, a group that works for the civil rights of people with disabilities. |
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