I guess most of us know of a person with one leg, an amputee, even if knowing is limited to Long John Silver from Treasure Island. There are quite a few amputees in the swashbuckling, sea-going world of fiction, Captain Ahab in Moby Disk, Captain Hook in Peter Pan, though his was a missing arm replaced by a terrifying hook. Lord Uxbridge, at the battle of Waterloo, lost a leg and many statements are attributed to him. He commented to his surgeon, in those pre-anaesthesia days, ‘the knives appear somewhat blunt.’ Oscar Pistorius, murderer and Paralympic runner is a living amputee, so is socialite Heather Mills.
Sri Lanka has a cohort, as do we in the UK, of ex-servicemen injured by landmines. The Sri Lankan military hospitals rehabilitate them and provide prosthetic legs. If you are a civilian who stepped on a landmine, the surgeons will patch you up, but you will have to find your own leg.
You might find that leg at the Centre for Handicapped, Kundasale, a suburb of Kandy. There, the manager, Mr Mohan Rajendram, showed us around. The bungalow style building is set back from the road and shaded by trees. There are walkways, parallel bars, steps up and down and inclines. Patients were practising walking with new limbs using crutches to begin with, then progressing to parallel bars and handrails. Others were being shown how to stand from a chair and how to sit down again.
There are three main groups of people needing limbs; children born without them, remember the Thalidomide tragedy, young people who lost limbs in accidents and then the old people with vascular disease who develop gangrene in the extremities.
The surgeons remove limbs in a prescribed way to give as uniform a stump as possible. Surgical care in Sri Lanka is free but prosthetic limbs must be paid for. In the United States of America, a limb costs $5000 – $15000 but Sri Lankans can do it for 27000 Rupees or about £140. Even that is a lot of money for a family whose breadwinner is on a salary of £1000 p.a. and is quite beyond the reach of an urban farmer.
Inside the building there were gymnasium-like rooms with exercise equipment, there were two wards where men and women could stay while having physio. Many patients came from rural areas and could not make a daily journey.
At the rear, the site sloped steeply down where there were two lower storeys with rooms dedicated to manufacturing and storage. The shank of the leg is aluminium and cut to length. The foot is modular and made of rubber treated to give useful resilience. These are made on site using hydraulic presses and electric ovens to mould the rubber. The specification and design of the limbs are laid down by the International Committee of the Red Cross.
The most important piece of any limb is the socket. This must be made for each individual and involves plaster of Paris moulds from which the socket is formed using fibre-glass and polythene. The skill of the moulder is important, he must ensure that there are no rough edges or surfaces, that the weight is distributed as widely as possible. It must fit snug so that the limb is held in place by ‘suction’ but not so snug that a slightly swollen stump cannot fit.
Having limb manufacturing and amputees on the same site means that manufacture and modifications can quickly be made. A limb will last about 3-5 years and then must be replaced but some parts can be recycled.
Funding is by direct sale of limbs and by charitable donations. We had some monies given to us by friends for use in Sri Lanka and donated enough for a limb. We asked if it could be given to someone young and with a family.
After a while, we received a phone call to go to meet the recipient, Jayasinghe Jayasundra. He and the Centre had produced his story:-
Mr Jayasundra’s Story
Mr. J. M. S. P. Jayasundara, 39 years old, lives with his wife and 02 children in Badulla. He was a farmer before he lost his leg.
This is the story he related to us:
“While I was harvesting my paddy field in a Tractor it suddenly toppled down. I had got unconscious after the accident, and my brother had admitted me to the Badulla General Hospital where pre operative medical treatment was given to me and thereafter transferred me to the Peradeniya General Hospital. At the Peradeniya General Hospital I underwent an operation and they drafted Nerves to my wounded leg. The following day they again transferred me to the Colombo General Hospital for further treatment. I was hospitalized for nearly two months and finally they informed me that my leg cannot be saved and it has to be removed from above the knee.
“I got to know about the Centre for Handicapped, in Kundasale, through one of my villagers. I was desperately in need of an artificial limb but could not afford to buy a one. I visited the Centre and explained my financial difficulties to the officials. The staff at the Centre told me, that they have a donor who was willing to sponsor an artificial limb. They took the required measurements of my leg and gave me a date to come back to the Centre. On the specific day I came to the Centre, they fitted the leg that was made for me and trained me to walk”.
Thanks to the kind donor I can now go back home and continue with my routine work. I sincerely thank the generous donor, who paved the way for me to walk again. I also sincerely appreciate the kindness and concern of the staff at the Centre for Handicapped and thank them for all assistance rendered to me.”
A New Opportunity
Mr Jayasundra is a married man with two children. He has a job now as a supervisor of a road work team. The donation bought the leg and gave him the opportunity to gain employment and provide for his family including the children’s education. I’d say that was money well spent so, thank you, you donors, you know who you are.