Peru 2014 from Paul Armstrong on Vimeo.

No Mas

My friends.

I am sorry this has taken so long to get together.

The blog helps give me the ability to share some of my thoughts and experiences.  It is like my own journal that I can look back on and remember.  In many ways it is like taking many of you along with us on this great trip.

When I return the most difficult and yet most common question to answer is," How was your trip?"  This helps you to know.

If you haven't looked at the blog before.  This last post will serve to sum up and end this journey.

I want to thank so many of you for helping us to make this trip possible.  You love and support and donations to our organization help us to help others....a very great thing.

Muchos Gracias

Pablito

Uno mas

Uno mas.  One more.  

One more photo.  One more hug.  One more cry for both joy and sorrow. One more adjustment or fine tune of a new prosthesis. One more, one more, one more....

I don't think there is a right way to close the blog on this trip.  Hopefully it will be unending.  "Proximo ano," is the common phrase that is exchanged among our new amigos meaning until next year.

And now the week has flown by.  In so many ways the week went perfectly.  I have only been able to mention a few of the details of activities of our grup, but they were many.  We got our supplies on time and set to work.  Some of the fruits of our labor are realized right away, while some may not be discovered for years to come.

Friday, fnished up fittings and adjustments of all of our patients.  I dont have the numbers yet, but please look for that in a couple most posts to close out the mission.

Noon time brought a presentation by the hospital administration, expressing gratitude for our work.  The patients all had small gift that each gave to those who cared for them.  It was a great mini-party, complete with dancing by both Peruvians and Dreamers.

Yes, it is true.  Jorge is doing better than I imagined.  We did a few more tweeks of his prosthesis.  He worked hard with Jonathan from Peru as well as with our lovely Karen Brecher.  In short time this initially cautious and shy boy dispensed with using his cruthes (muletas) and took to attacking the soccer ball on 2 feet as well as meandering around the crowd during the party as a self-proclaimed photog.  It really was incredible to see. 

And it gives me hope.

We caught the Red Eye out of Lima late last night and as a result, I am not clear quite what day it is.  Combine that with a small flight debacle coming out of Miami, and our group has become somewhat fragmented.

When the group rejoins please look here for some grouped closing pictures and summary.

I know I speak for many when I say that I miss Peru, already.

Hasta Luego

Pablo

No Mulettas

Jorge

The video below is mis new amigo, Jorge.  

Jorge is different form many of our Peruvian amputees in any ways.  The difference is that he is the youngest..... I had the distinct pleasure of having both the oldest and youngest patients this year.  Jorge is 11yrs. and my other new amigo Abraham is 85.... Jorge is also the only congenital amputee in the group.

Congenital means this was a birth defect.  He was never actually amputated.  He is not missing anything.  He has everything he started life with.  You can imagine some of the benefits over other surgically acquired amputees....he has no phantom limb pain.  His limb is strong and not overly sensitive.

The challenge is that we are trying to provide him a device to help him assimilate to a world that is created for us....not him.  I doubt he thinks he needs a prosthesis.  Some would argue it is NOT a prosthesis, since a prosthesis replaces a body part and he is missing NOTHING.  Using a prosthesis probably feels like using a really tall shoe or stilt to him.

Compound that with the challenges of being a 11yr old boy growing up in Ventanilla, the small town we were sponsoring roofs for earlier in the week.  This does not make for an easy life for Jorge.

Jorge's limb is officially described as phocomelia in the medical community.  For Jorge, it means he has what looks exactly like a foot with 3 toes attached to a thigh that is less than 1/3 the length of his right side thigh...no knee, no calf...just foot attached to thigh.  Hard to imagine, I know.  To say what physical structures lay under the skin would be impossible without an Xray, and even then we'd be guessing.

Upon first trying to fit Jorge with his prosthesis, everyone was interested and wanting to see the youngest, most unique patient be fit.  But in a room of crowded on-lookers he shut down.  You could see a gloss come over his eyes.  His innocent, curious smile receded along with his willingness to work with this strange looking shoe that his weird bald guy made for him.

After this fitting debacle, we regrouped.  Through our translator, Flore, I asked Jorge if he would try again for me, manana.  He agreed.  In the video below, the only people in the room were Jorge, his mother, Flore and our friend Jonathan.  With the small intimate and familiar crowd, Jorge did more than try.  He impressed.  He continued to work with Jonathan and Flore for another 30min this AM and 30 more in the afternoon, in the middle of the physical therapy gym within the parallel bars.

I believe the question remains, where do we go from here?  Jorge lives in Ventanilla.  Did you see the deep sand and slanted dirt roads of this village?  Did you see the school and the houses?  For a moment try to empathize what kind of work it would take to adopt this prosthesis into this young boy's lifestyle.  He is 11 years old.  He is far too young to understand and appreciate the need to do things with 2 hands, free of crutches.  To save wear and tear on his right leg so that it can last the rest of his life.  All he knows is that he is faster without his prosthesis and already plays soccer as good as Messi.  Why should he need a prostheis?  By the time he realizes, hopefully i is not too late.

Sadly, I do not believe Jorge will be a long time prosthetic user.  I do not believe that the support structure exists around him to properly encourage adopting this into his lifestyle.  I hope I am wrong. 

Was it time and energy lost?  We may never no.  But it is possible that by trying, Jorge has inspired someone unknown to me, amputee or otherwise, to try a little harder or a little diffrently at whatever their challenge is, thus providing hope.

Do you know what you hope for?  Are you aware of what fuels your hope?  Whatever it is, you should do more of it.

Today, was another great and busy day......  Hasta manana

Pablo

Below is the impromptu soccer match that broke out after lunch yesterday. Many of us took turns trying to keep up with the youngins.

Mike, mike, mike mike mike mike mike.....what day is today?

It is muy hard to articulate the kind of day today was..apart from busy, tiring, long, exciting and amazing.  A few times between yesterday and today, I had a hard time putting gloves on my hands.  

If I could rub my eyes with my elbows, it would sure be a relief at this point.  Don't worry, I see some of you trying that.

I am sorry if pictures did not appear as readily as some had grown accustomed to.  I simply did not have the time.  I thank Mani for providing me some visual content that I could pass along to you.  

All of our teams were deeply busy getting legs ready.  By the end of today approximately 40 of our 45 inital patients had been fit and begun training on their new prostheses.  From my room where Melissa and I were working, I could hear the cheers and applause as each patient, with the guidance of a PT-amigo, emerged from our treatment rooms into the large PT Gym where everyone waited.  For many, this really does seem like a life changing moment.

In the picture posted, you can see our man Jeremy.  He is 12 yrs old.  He is being tutored and assisted by our previous patient and new colleague, Jonathan.  Jeremy took to walking like he had done it all of his life.  ;-)   

Regardless, it was a pleasure to see.  Maybe...in time, a Jeremy will become a Jonathan and a Jonathan will become a Mani Seetherama.  Now, wouldn't that be something?

As you can see from the pictures, our mission is clearly not all about prostheses.  Audra Maciunas, SLP has been well entrenched in bringing new ideas and concepts to Carrion's patients with communication and swallowing disorders.

Kevin Connellan, PT and Mike Liguore, UHart DPT student, are sharing caseload alongside the Peruvian PTs.

Tomorrow, our 1st goal is to have every patient up on their new prosthesis.  Beyond that we will aim to be training and tuning the fit, rehabilitation and use of the rest of the patients as they begin to realize their new level of potential.

There is no instruction booklet on how we are supposed to get to know this big blue marble on which we live.  On my current path, it is the people that make the difference and mean the most to me.  I do not want to sight see.  I do not need for fine foods, wealth or fame. I want to contibute, share, get to know and understand the people of these various places.  Being a prosthetist seems like a most excellent vehicle for this kind of journey.  Some say this could take a very long time. But I say "well, I still have my whole life ahead of me, as far as I can see."

Hasta Manana

Pablo

Buenos dias from Callao

Molding. Things are taking Shape.

With parts and materials at hand what else could we do but set to work.  Today, was yet again a near perfect day in terms of what we wanted to get accomplished and what actually got done.

Our prosthetic group split up into teams.  Abbey and Taber set to work casting and molding the Below-Knee Amputees.  I partnered up with Melissa, while Al, Esteban and Danielle banded together to tackle the above knee amputees as well as some of the challenging and unique cases.

It really was great team work.  By the end of today, some 45 patients have been fit and/or molded for their prosthesis.  We had a few patients that have not shown up, but a few drop-ins have also been added and tended to.

Tomorrow, we will continue with the fittings.  The fiberglass needs to set for a decent period of time before it is ready for real use.  Others we will firm up part assignments,...feet, knees and assess appropriate height,...etc

We have a new PT with us this year, John Paholski.  (Is that Polish? He didn't bring a car door.)   He and another of our resident PTs, Pat Black have what I call mad, black magic, voodoo, PT powers.  They osmose and meld into the fabric of the Peruvian PTs in a natural and easy way.  According to John, they have been very well recieved by the PTs of Carrion; participating in Evaluations and treatments for a welcomed unique perspective and education that they would not have otherwise been exposed to.

Speaking with John tonight, one of the pleasant surprises for him has been the Peruvian people.  He saw the patients of ours that arrived at 8am and did not get seen until 5pm.  At 5pm when their name was called, they hollered back with extreme enthusiam.  "Rosita?!!!!  I here....I coming!!!!". They came into the room.  They hugged each and every person there and seemed genuinely happy with everything.  They were extremely grateful for what they recieved.  

John commented as many of us have, that we know patients in the States that get upset if they are seen 10min. late. 9 hrs seems to be pushing the limits...?  Maybe....

I am anticipating another great day tomorrow.  Our Physical Therapy and Prosthetic powers will finally join forces as we begin to fit and align many of our patients.  Talk about empowering human potential.  This is where the bar is set and raised.  Some of these people have been amputees for years and never walked without crutches or a wheelchair.  

Tomorrow potential will end and kinetic will begin as these people become armed with the ability to empower others in the same way our new amigo Jonathan is preparing to do in rehabilitation.  I am so excited to see what that energy will be.  It will start like a spark when they take their first few steps.  For some it shows up as a glimmer in their eyes as they realize a new found freedom and ability that sees for the first time a light at the end of a long dark tunnel of uncertainty.  Walking is just one step of many.

Hasta manana, mis amigos

Pablo

Jonathan, Flore and Kelly

St. Patty's Day

My friends, the luck of the Irish must have been with us today.  Our boxes arrived just before lunch.  It may be sad to say but we were exstatic.  Our team was able and ready to set to work.  Today was as close to perfect as it could be.  We spent the rest of the day...."working"...and damn it...it was fun!!.  We set to work evaluating patients, taking measurements, getting to know our new friends.  

 The morning started of with many warm reunions of old friends and patients.  Those of you that followed our trip last year may remember some of these names.

Julie....Esteban and myself fit Julie with below elbow prosthesis last year.  She was there and smiliing to greet us.  Taking pictures and looking so great.  After some hugs and kisses, Esteban and I spoke..."did you see Julie?  Did you see the way she was using her prosthesis so naturally?"  We both did.  ;-)

Jonathan, an above the knee amputee that we fit with a prosthesis just last year, was there.  He looked a little different.  Jonathan was wearing an employee's uniform.  Unbeknownst to us, Jonathan, after being fit with an above knee prosthesis the previous year went on to PTA school to learn to be a therapist.  He is finishing his studies and hopes to continue to become a physical therapist.  He is truly an inspiration and is a living, breathing, shining example of why this kind of work is necessary and worthwhile.  

I cannot tell you how excited I am about Manana.  With great people to work with, supplies and such motivated patients, only great can come.  In a few short days some of these people will take steps on 2 feet that have not done so in years.  

In the end, and in many cases it is not about simply giving a person a leg to walk on.  Rather, it is about giving back control over their own life; to go and grow and choose what they do and become who they want to be; removing the obstacle of immobility and handicap.  Yes, who they want to be may have changed along the way, but THAT is the exciting journey of life.  Some are no longer handicapped; rather, they are enabled and inspired.

Hasta manana

Pablo

3 Cheers for BOXES!!!!

Happy St.Patty's Day everyone. Let's hope the luck of the Irish is with us all today

Sunday in Ventilla

No...we do not have boxes yet.  Customs is closed today.  We made use of the time to visit Ventatilla.  We visited this village 2 years ago.  Dr. Mary runs a free clinic in the severely imporverished  area.  Dreaming and Working has benn raising some funds for roofs for people in this area for some time.  It is exaclty as you see, a very eye opening place to see.   

The blue house shown in the pictures is due to recieve a roof from Dreaming and Working later today.  Inside, it is interesting to see how the people live.  The house was set up not so different from yours, in many ways.  There was definitive bedrooms and a kitchen.  The house was complete with wires haphazardly spliced together, spanning across the ceiling and of course a chicken coup in the back.

I was told that the electricity is illegal, but they "know a guy"  that sets it up.  The entire area is like dirty beach sand.  Loose; deep in spots with precarious footing.

Some interesting thoughts about a region so different than what we have grown used to in the US.  we did not see a shower.  It is dirty.  Everyone looks at you and says hello. They appear happy.  The dogs do not bark and chase you.  The children do not cry.   There is a great sense of community and not a huge focus on self or health. 

Manana...cross your fingers that we get our boxes.  We will reunite with many great people from Hospital Carrion and begin seeing and meeting many more new Peruvian friends.

Buenos Noches

Pablo 

Al thought the fit was a scoshe tight

We donated some supplies to the roof project today and hired a taxi to bring them back to Ventanilla.

Elementary School for the Village

Audra, Este and Denise

Part of Dreaming and Working's roof project in Ventanilla

Home that will be getting a roof

Melissa's sweet ride

Buenos dia amigos. It is a warm beautiful day in San Isidro Peru

Almost gone....not quite

Boxes. Who needs boxes

Those of you that joined us on our last mission probably remember that our boxes of supplies were much delayed.  We certainly hope that is not the case this year, but time will tell.

Tomorrow, Sat. the 14th is our travel day to Lima.  Our group is much expanded from last year.  We are 16 strong plus our great founder, Hernando.  We have the pleasure to be joined by many new faces this year that I am sure we will slowly introduce as the days come.

We have 40 plus patients waitng for our arrival, not to mention Dr. Mary and the great friends and staff from Hospital Carrion that we have built such a great relationship with.

Till manana, buenos noches

Pablo