clinic battles epidemic of missing limbs (IRAQ)

Baghdad: Iraqis come from all over country to Artificial Limbs Clinic to get their artificial limbs fixed.


Eight-year-old Ghada Tahseen stood silently as the doctor helped her slip on rubber overalls filled with plaster. It felt strange and uncomfortable but she didn't complain.

"I am really happy that I will have a new leg," she said after a plaster model of her missing limb had been made. "Now I can play again with my friends and go back to school."

She had waited months for this appointment to fit her for an artificial leg, months since the day a bomb tore through a crowded marketplace in her neighborhood.

Ghada was one of dozens injured in an all too common incident in Iraq's strife-torn cities, many of which daily echo with the muffled sound of explosions.
The Artificial Limbs Clinic, located in the north Baghdad neighborhood of Tunis, was established in the early 1980s at the beginning of Iraq's eight-year war with Iran, but never before has it been so busy.

"We are receiving a lot of people every day, and with every bomb that explodes in Iraq there are new victims that lose one of their limbs," said the clinic's physician, Doctor Inas, who prefers her last name not be used.

Behind her, on the wall of the room where she examined Ghada, are models of leg cups in various sizes.

Iraq's many wars have made its doctors depressingly familiar with the process of fitting new limbs.
Once it was Iranian shells raining down on its frontline troops in the 1980s, later it was American cluster bombs during Gulf conflicts, and in between mines along the borders took their toll.

Since the US-led invasion of March 2003, however, the violence has been random and pervasive, with ubiquitous roadside bombs robbing Iraqis of their limbs.
Some 85,000 people in Iraq have lost limbs, according to the Qatar Red Crescent which is looking into setting up an artificial limbs center in Iraq.

A number of foreign aid institutions have set up prosthetic labs in Iraq, notably the International Committee of the Red Cross, which supports limb fitting centers in several cities around the country, including Arbil in the north and Najaf to the south.

In the first three months of 2006, the organization saw more than 450 patients and fit 100 artificial limbs.

The need, however, remains greater than the supply, given the limited available facilities.

"I waited for more than four months to get a leg," said Abbas Yussef, a 36-year-old taxi driver who lost most of his left leg when a car bomb exploded in Kanaan, a town in Diyala province to the northeast of Baghdad.
"It was a pretty painful procedure but it's good to get rid of the crutches," he added as a technician taught him how to walk with his new leg.
There were once nine such centers around the country, but their limb production was irregular due to a lack of materials. As a result people come from all over the country to the Baghdad clinic, which has been kept functioning by the health ministry.
"We receive about five cases per day but can only produce five artificial limbs every 24 hours," said Amr, who works in the lab to carve the limbs. "The material we use is outdated and our only source of supply is the health ministry."
Once they have a plaster model of the new limb, the technicians start carving down bulky blocs of rough plastic to approximate the shape of the limb.

Eventually plastic cups, metal joints, and wooden feet are fitted on to the new limbs and a lathe is used to smooth the rough edges off the plastic.
The result is a crude appendage compared to the high tech, micro-processor-embedded prosthetics being developed in US army hospitals to face the steady toll of American amputees hit by insurgents' explosives.

For Haidar Hashem, however, his artificial limb is a life saver, and will let him regain the job at a Sadr City bakery that he lost after his leg was shredded by several bullets he took in crossfire between US forces and Mehdi Army militiamen.
"My whole life depends on this plastic leg," he said. "The nature of my work forces me to stay standing for long hours and I need two legs to do that."
He watches as Yussef, the cab driver, is coached on his walking. It will be his turn next as one of the clinic's 25 technicians starts him on the physical therapy courses he needs to learn to use his new leg.

"We teach them how to put on the limb, walk on it and adapt to the pain in the beginning. It is a very difficult procedure, but we're doing our best," said therapist Ali Khaled.

"We try to get the patient to overcome his psychological trauma and get him to accept his new plastic leg or arm as a part of his body," he added.
Behind him, on an operating table, lay a policeman, a raw scar visible on the stump of his left leg, recently blown off by a roadside bomb targeting his patrol.

Von: 07.06.2006, By Ahmad al-Rubaye,

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