International Actions and Programme in Prosthetics: Panel Discussion
William A. Tosberg
Tuesday, 2 July 1430 hrs.
Since the World Rehabilitation Fund, Inc. was founded in 1955, its primary function has been to bring rehabilitation personnel from other countries to the United States for advanced training. Well over 1,000 long- and short-term fellowships have been given to physicians, physical therapists, social workers, prosthetists and orthotists, but with primary emphasis on fellowships for physicians.
Nine prosthetic-orthotic trainees from six countries have been brought to the United States for long- or short-term training. Trainees from Ceylon and Hong Kong were provided with fellowships for a four-month course in India; two trainees from Peru, one from Guyana, one from Colombia, and one from Chile have received fellowships for the four-month course currently being given (May to August, 1968) at the Association For the Aid of Crippled Children in Sao Paulo, Brazil, under the sponsorship of UNICEF and the Pan American Health Organization with the support of the World Rehabilitation Fund, Inc.
Some years ago the World Rehabilitation Fund, Inc. agreed to serve as central agency for a collaborative effort among U.S. government and voluntary agencies for the collection and distribution of used but serviceable prosthetic and orthotic devices to countries where such supplies were not available. Since the inception of the program over 125,000 such devices have been sent to 27 different nations.
The World Rehabilitation Fund, Inc. also has a policy whereby it will pay the tuition fee only for any persons from outside the United States, in any of the rehabilitation disciplines, who wish to take one of the short courses at the Prosthetic and Orthotic School, Postgraduate Medical School, New York University.
Under this program, fellowships have been given to 165 physicians, 58 physical and occupational therapists, and 22 prosthetists and orthotists, from 56 countries.
The most significant undertaking of the World Rehabilitation Fund, Inc. in prosthetics and orthotics has been the sponsorship, either independently but more frequently in conjunction with other agencies, both governmental and nongovernmental, of a series of short courses and consultations by Mr. Juan Monros. The cooperating and co-sponsoring agencies have included the United Nations, the Pan American Health Organization, UNICEF, the World Veterans Federation, the International Society for Rehabilitation of the Disabled, the American Leprosy Missions Inc., the U.S. Social and Rehabilitation Service, the U.S. Agency for International Development, and a number of national, government and voluntary agencies.
This program began in 1961 when Juan Monros, a Spanish national, completed four years of training in prosthetics and orthotics at the Institute of Rehabilitation Medicine, New York University Medical Center, New York City: The Institute for the Crippled and Disabled, New York City; and the Veterans Administration Prosthetic Center, New York City.
Under this program, a total of 168 trainees have participated in eleven such courses. Five of the courses were held in Brazil, two in 1962 and one each in 1965, 1966 and 1968; one in Peru in 1961; two in India, in 1963 and 1967; one in Ethiopia in 1964; one in Haiti in 1960; and one in Vietnam in 1965.
To the best of our knowledge, outside of the group trained in Vietnam, all but four of the persons who received the training are employed in prosthetics and orthotics, and we anticipate that two of the four will be employed in the near future. In Vietnam, a number of trainees have been drafted, but some have subsequently been reassigned to prosthetics and orthotics.
The World Rehabilitation Fund, Inc. provides the following publications for trainees enrolled in these courses:
"Diagonal Type Socket for Hip Disarticulation Amputations"
"A Hemipelvectomy Prosthesis"
"A Flexible Casting Brim Technique for Above-Knee Total Contact Socket"
"Patellar Tendon Bearing Below-Knee Prosthesis"
"Immediate Post-surgical Prosthetics"
"Hygiene of the Stump"
"Step into Action"
"Orthopedic Appliances Atlas—Vols.1 land 2"
"Upper Extremity Orthotics"
"Rehabilitation Monograph No. 21—Self-Help Devices"
Each trainee also receives continuing subscriptions to "Orthotics and Prosthetics" and "Prosthetics International", and former Spanish-speaking trainees receive subcription to "Revista".
The World Rehabilitation Fund, Inc. and the agencies with which it has cooperated, as well as Mr. Monros, have never contended that these short courses, plus subsequent consultations, can provide the trainees with the level of technical ability and professional sophistication found among graduates of longer term training programs in well-established prosthetic centers. That has not been the intention. The purpose is to provide a practical method of bringing modern artificial limbs and braces to as large a number of disabled persons as possible, in the shortest possible time, at the lowest cost possible, in parts of the world where prosthetic and orthotic services were not formerly available.
Dr. Howard A. Rusk, President of the World Rehabilitation Fund, Inc. has said, "We have been extremely gratified by the success of these short courses, as have been institutions and agencies which have employed the graduates. It is our plan to continue these, and hopefully expand them to other parts of the world, particularly Asia and Africa, where basic prosthetic and orthotic services are so badly needed."
Mr. Juan Monros has also provided consultation services for various prosthetic and orthotic programs, in addition to the above-named courses, in Bolivia, Burma, Ceylon, Chile, Colombia, Dominican Republic, Ecuador, Ethiopia, Greece, India, Jordan, Lebanon, Nicaragua, Pakistan, Peru, Taiwan, Thailand, Tunisia, UAR (Egypt) and Vietnam, and has visited some of these countries as many as eight to ten times.