PROJECT- PIPOS REHABILATION CENTER, BALAKOT PAKISTAN

Site visit by Dr. Rubina Mumtaz, Country Director, RMF Pakistan

Background on PIPOS

PIPOS (Pakistan Institute of Prosthetic and Orthotic Sciences) is a non-profit, internationally recognized (by ISCO-International Society for Prosthetics & Orthotics), autonomous Institute in the Health Department of the Government of NWFP Province of Pakistan.

Established in 1989, it is based in Peshawar and in conjunction with GTZ, a German based NGO, it has worked extensively on amputee & paraplegic victims of the Afghan-Soviet war.

In affiliation with the University of Peshawar,it awards a BSc degree in Prosthetics & Orthotics.

The Oct 8th 2006 Earthquake, Pakistan Majority of paraplegic and amputee victims are

children and women, who were indoors during the earthquake

Initially orthopedic surgeons engaged in providing immediate care and a limited number of prostheses in the relief stage.

The demand soon arose for providing long term rehabilitation involving prosthetic and orthotic services, physiotherapy and gait training.

PIPOS RESPONSE TO OCT 8TH 2006 EARTHQUAKE Recognized by the ‘National Committee for Rehabilitation of Amputees’

as one of the premier institutes, the PIPOS strategy of rehabilitation is as shown:

Mansehra ATD

Abbot AbadMansehraBatagram

KohistanShangla

Allai

Besham

SHAG

ugai

Batagram Balakot

Dasu

BESHAMRehab. Centre

Tertiary LevelRehabilitation, Research

Training & Education

Secondary LevelAssessment, Manufacturing

Fitting, Physical Therapy, Referral

PPC

Primary LevelAwareness, Detection Registration,

Counseling, Repairs, CBR

MANSEHRARehab. Centre

PIPOS

FOCAL

POINTS

FOCAL

POINTS

REHABILITATION

RESPONSE -II

1. In collaboration with HI - Handicap International, 5 Rehab centers were set up in Mansehra, Batagram, Besham, Bagh and Balakot.

2. Presently HI is reaching the completion of the MOU with PIPOS , leaving PIPOS to seek funds for all the centers.

3. So far, four centers have found funding:Mansehra: Partner APPNA for 3 yearsBatagram: Partner CHAL+Direct Relief, 3 yrsBagh: Partner CHAL+Pakistan Burma Shell CoBesham: Partner Direct Relief International, 3 yrs

Project proposal Outline

Balakot Center is yet to be funded. It is presently under construction and will be available for partnership on 1st January 2007.

HI funding will complete the construction and fully equip the center with machinery and equipment necessary for the manufacture of prostheses (Artificial legs) and orthoses (Body supports)

Collaboration with RMF will rename the project as PIPOS-RMF Rehabilitation Center. This joint venture will broadly be divided whereby PIPOS will provide all technical assistance and ownership responsibilities and RMF will provide funds.

Project proposal Outline- II

Funds are required for 3 years, after which the center will be handed over to the local public hospital to become part of that hospital whereby its inclusion in the regular budget is insured by the Health Department , NWFP provincial Government.

If this option fails, then the center will be taken over by PIPOS who will run it on a no profit-no loss mechanism as a PIPOS Patient Care Center.

Site Visit

All the rehabilitation centers are operative on the same plan, so a visit to the Mansehra center gave a comprehensive outline of the rehabilitation operations.

Site visit was carried out by Dr. Rubina Mumtaz, Country Director, RMF Pakistan and conducted by Dr. Sarwar Bakht, Director, PIPOS, Peshawar.

Mansehra Rehabilitation Center

APPNA – American Physicians of Pakistan Descent, North America

Dr. Bakht Sarwar, Director PIPOS, (center) introducing the main reception area of the center to Dr. Rubina Mumtaz (far right).

Fully computerized patient record keeping.

The main lab for manufacturing of Prostheses and Orthoses

MAKING OF A PROSTHESES (ARTIFICAL LEG)

Starting from making a plastermodel of the amputated stump

Making a fiber cast

Finishing touches to the fiber cast Adding the knee joint

Final product is light-weight, stronger and fits directly into stumpwithout need of handsupport typical of the older version of a

prostheses (seen by the arrow)

A quick look at the machinery and equipment installed

Material stock storage

PIPOS, aware of the gender sensitivity of the region, trains femaleTechnologists who are given secure living accommodation and

transport, all arranged and paid for by PIPOS

Showing the detailed procedure of record keeping for every patient by each technologist. This data is computerized at the

end of each day.

Fitting of a new prosthesis in a9 year old boy

Gait training begins the same day

The boy’s grandmother awaitsher turn.

Some success stories of PIPOS-HI centers

Mr. Shariff, a bilateral amputee is today back on his job as a cross countryTruck driver.

Baby Imtiaz gets a second chance at a normal life

Pictures courtesy of PIPOS Besham Center

Instruction Chart for prostheses/ orthoses wearers.Obtained from Handicapped International,

translated into the local language, Urdu

VISIT TO BALAKOT CENTER.

Presently housed in a tent

So far, it has only the physiotherapy component of rehabilitation. The prosthetic and orthotic procedures are

referred to Mansehra center, 90 Km away on a winding mountain

road.

Chatting with the physiotherapists on ground. The Handicap International representative (right) with the local physiotherapist

(center)

Balakot Center building under construction further down thesame compound, using prefabricated materials.

Permanent building construction is not yet allowed by the government.

A quick inspection on the inside and backside of the construction.

A special thanks to Dr. Zahoor of HOAP for making this visit possible.

THANK YOU

REAL MEDICINE FOUNDATION PAKISTAN