WE CARE
This year's recipient of the Ramon Magsaysay Award for Public Service, Dr Therdchai Jivacate speaks about his humanitarian activities in providing free prosthetic limbs to impoverished amputees
Story by PICHAYA SVASTI & Main photo by YINGYONG UN-ANONGRAK
Orthopedist Dr Therdchai Jivacate: `Our foundation has provided prostheses for the underprivileged for 16 years. So far, we have served 16,000 amputees.' |
At a field clinic, a male amputee hugs Dr Therdchai Jivacate to express his gratitude. "I thought this day would never come," he exclaims with joy, walking around with a light prosthetic leg.
At the Elephant Hospital in Lampang, 31-month-old Mo Cha, who stepped on a landmine in Burma and lost her front right leg two years ago, walks and plays in a pool of sand after being fitted with the world's first artificial leg for pachyderms. She lifts and curls her trunk as if to thank Dr Therdchai.
Over the past 16 years, Dr Therdchai has seen such happy smiles from over 16,000 amputees in Thailand, Laos, Burma and Malaysia, thanks to the work of the Prostheses Foundation.
The doctor's compassion has gone beyond borders, nationalities, religions and races. And the world knows about it. He was recently honoured with the 2008 Ramon Magsaysay Award for Public Service.
"I'm proud because this award is equivalent to the Nobel Prize of Asia. Our foundation has provided prostheses for the underprivileged since 1992," said the secretary-general of the Prostheses Foundation.
In a developing country like Thailand, prostheses are too expensive for a majority of amputees. Many poor people who lose their legs in accidents, or due to landmines or diabetes often opt for cheaper alternatives. They walk on homemade crutches or make substitute limbs from local materials.
That was why Dr Therdchai, who graduated from Chulalongkorn University's medical school in 1965 and began his career as an orthopaedist in Chiang Mai, decided to do something.
"Forty years ago, I amputated the limbs of many to save their lives. Some of them carved bamboo shafts to use as substitute legs. That's why I started making artificial limbs for them," the doctor, 68, recalls.
In 1967, he attended a three-month prosthetic training at Siriraj Hospital and later established Thailand's first prosthetic factory at Chiang Mai University.
He furthered his studies in physical medicine and rehabilitation at Northwestern University, the US, from 1968 to 1972. After returning to Thailand, he continued his work at the Faculty of Medicine, Chiang Mai University and also at the prosthetic factory.
In 1975, Dr Therdchai established Thailand's first occupational therapy school at Chiang Mai University, where the number of students have risen to 70 per year, from 10 in the year the school was opened. Graduates work as occupational therapists in hospitals, mental asylums and special schools for gifted and autistic children.
Back in the 1970s, prostheses in Thailand were all made from costly imported materials. To cut costs, Dr Therdchai began to experiment with cheap, yet effective local materials.
He first opted for the use of micro cellular rubber (shoe rubber) for artificial feet and light local wood for artificial legs. As a result, the cost of each prostheses dropped to 4,000 baht from 6,000 to 7,000 baht. However, it still was too costly for most amputees since the factory still needed to use imported polyester resin sockets.
"The problem was with sockets, so I experimented with cheap plastic, in particular plastic trash," the orthopedist says.
He eventually found polystyrene, an inexpensive type of plastic, which can be melted in solvents, as a substitute material.
"I collected and dissolved plastic tape cassettes, spoons, forks and Yakult yoghurt bottles in thinner. Finally, we chose Yakult bottles because the plastic derived from them would be pink - like the colour of skin," Dr Therdchai recalls.
Then came a breakthrough - artificial legs with Yakult plastic sockets. The doctor also replaced imported wooden cores with aluminum pipes. As a result, the cost of each prostheses decreased to 700 baht.
Dr Therdchai also came up with a special technique to ensure that sockets would be exactly the same sizes and shapes as stumps.
"That's why walking has been a comfortable and pain-free experience for our patients," he says, "Our prosthetic legs are light, cheap, efficient and durable."
In 1991, the doctor used his own money to produce this new kind of artificial legs for 20 to 30 patients. In the same year, Impact Thailand Foundation contacted him for a mass fitting of his "Yakult legs" in Phrae, which was reported by 'Outlook' on December 16.
According to Dr Therdchai, the article led to the establishment of the Prostheses Foundation under his direction.
"Her Royal Highness Princess Mother read that article in the Bangkok Post and asked to see the artificial legs. She was satisfied and, hence, lent her patronage to set up the Prostheses Foundation," he said.
The foundation's initial fund consisted of 500,000 baht from the Princess Mother, who became honourary chairwoman and 750,000 baht from HRH Princess Galyani Vadhana, who became chairwoman.
In line with the Princess Mother's will, the foundation always provides free prostheses for amputees regardless of nationality or religion.
The Yakult bottle was used only till 1994 when His Majesty the King became interested and wanted a detailed report from the doctor. The king was concerned about the health of prosthetic technicians who used solvents in dissolving the plastic, so he donated polyester resin to the foundation.
A few years later, the foundation amassed enough cash donations to buy polyester resin, which became less expensive and easily available in Thailand.
Since then, polyester resin has become a major material to make artificial limbs, while polypropylene co-polymer is an alternative with better quality. Another change was the use of stainless steel cores instead of aluminum cores.
"Now, a polyester resin prosthetic costs 1,500 baht and a polypropylene co-polymer one costs 2,500 baht, which is as good as an imported one costing 50,000 baht," Dr Therdchai remarks.
The orthopedist proudly talks about his prosthetic factory in Chiang Mai.
"Our factory is the largest in Asia. We design and assemble everything. The making and fitting process lasts for only three to four hours when compared to one to three weeks at other public hospitals," he said.
The doctor added that the foundation wants to transfer this technology to other countries. Last year, it helped with the set-up of a prosthetic factory in Aceh, Indonesia.
As of 2001, there were 34,684 amputees in Thailand. Most of them lost their legs in traffic accidents and the rest from diabetes or blood vessel occlusion, according to the National Statistical Office.
Everyday, between three to four amputees show up at the Prostheses Foundation for free artificial legs.
"Once fitted with our prostheses, any patients can walk almost immediately. I'm certain all of them feel that they have real legs because I, myself, supervise every procedure, even alignment," Dr Therdchai says.
Not only humans but also animals have benefited from the foundation's work.
The doctor decided to design and produce an artificial leg for Mo Cha after noticing that her elbow joints and backbones started to deform from walking on three legs.
"With her new leg, that elephant looked so happy and ran playfully," Dr Therdchai smilingly recalls, about the July 5 fitting of the world's first prosthesis for elephants.
Apart from helping amputees from all walks of life, the Prostheses Foundation focuses on research and organises field clinics nationwide and also in neighbouring Laos, Burma and Malaysia.
"We have organised 100 mobile clinics and provided 22,000 artificial legs for 16,000 amputees," the Magsaysay Award winner said.
It provided free artificial legs for about 300 amputees in Burma and another 300 in Laos, while its operations in Malaysia were funded by local foundations.
According to him, a number of amputees also receive the specially designed "farmer's foot" for working in muddy fields.
Besides field clinics, the foundation organises prosthetic workshops for several district and community hospitals in the Kingdom.
"We set up village prosthetic workshops for tambons because rural people cannot travel so far," Dr Therdchai says.
Village prosthetic workshops are being run in a sub-district in Nam Yuen, Ubon Ratchathani; Aranyaprathet in Sa Kaeo, Sangkhla Buri in Kanchanaburi and three districts in Buri Ram.
This year, the foundation took a step further. It started collaborating with community hospitals to organise prosthetic workshops for local amputees. So far, five workshops have been established at community hospitals in Chiang Rai, Loei, Roi Et, Nan and Nakhon Si Thammarat.
According to the doctor, amputees need know-how because their artificial legs must be fixed or changed after a few years.
Under the workshop project, the foundation has provided a three-month training course for some 30 local amputees and will train more on how to fabricate prostheses with simple techniques.
Opening a prosthetic workshop costs each community hospital one million baht. What the hospitals must do is to pay construction fees, buy tools and materials from the foundation, and recruit trainees, says the doctor.
Dr Therdchai plans to open prosthetic workshops in five community hospitals throughout the country, every year. "I will push for at least one prosthetic workshop in every province," he says. "We should be able to make it in 13 years. This is my ultimate goal."
Prev
1
2
3
Next
