PROJECT PIPOS REHABILATION CENTER, BALAKOT PAKISTAN

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PROJECT- PIPOS REHABILATION CENTER, BALAKOT
PAKISTAN

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

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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.

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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.

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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

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RESPONSE -II

• In collaboration with HI - Handicap
  International, 5 Rehab centers were set up in
  Mansehra, Batagram, Besham, Bagh and Balakot.
• Presently HI is reaching the completion of the
  MOU with PIPOS , leaving PIPOS to seek funds for
  all the centers.
• So far, four centers have found funding
• Mansehra Partner APPNA for 3 years
• Batagram Partner CHALDirect Relief, 3 yrs
• Bagh Partner CHALPakistan Burma Shell Co
• Besham Partner Direct Relief International, 3
  yrs

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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.

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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.

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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.

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Mansehra Rehabilitation Center
APPNA American Physicians of Pakistan Descent,
North America
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Dr. Bakht Sarwar, Director PIPOS, (center)
introducing the main reception area of the
center to Dr. Rubina Mumtaz (far right).
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Fully computerized patient record keeping.
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The main lab for manufacturing of Prostheses and
Orthoses
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MAKING OF A PROSTHESES (ARTIFICAL LEG)
Starting from making a plaster model of the
amputated stump
Making a fiber cast
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Finishing touches to the fiber cast
Adding the knee joint
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Final product is light- weight, stronger and
fits directly into stump without need of
hand support typical of the older version of a
prostheses (seen by the arrow)
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A quick look at the machinery and equipment
installed
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Material stock storage
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PIPOS, aware of the gender sensitivity of the
region, trains female Technologists who are given
secure living accommodation and transport, all
arranged and paid for by PIPOS
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Showing the detailed procedure of record keeping
for every patient by each technologist. This
data is computerized at the end of each day.
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Fitting of a new prosthesis in a 9 year old boy
Gait training begins the same day
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The boys grandmother awaits her turn.
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Some success stories of PIPOS-HI centers
Mr. Shariff, a bilateral amputee is today back on
his job as a cross country Truck driver.
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Baby Imtiaz gets a second chance at a normal life
Pictures courtesy of PIPOS Besham Center
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Instruction Chart for prostheses/ orthoses
wearers. Obtained from Handicapped International,
translated into the local language, Urdu
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VISIT TO BALAKOT CENTER.
Presently housed in a tent
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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.
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Chatting with the physiotherapists on ground. The
Handicap International representative (right)
with the local physiotherapist (center)
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Balakot Center building under construction
further down the same compound, using
prefabricated materials. Permanent building
construction is not yet allowed by the
government.
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A quick inspection on the inside and backside of
the construction.
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THANK YOU
REAL MEDICINE FOUNDATION PAKISTAN
A special thanks to Dr. Zahoor of HOAP for
making this visit possible.