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COPE (Cooperative Orthotic and Prosthetic Enterprise) is a non-profit organization that supports the Ministry of Health’s Center for Medical Rehabilitation (CMR) in Laos. COPE provides technical training for CMR prosthetists, orthotists, physiotherapists and occupational therapists. COPE and CMR work together to ensure comprehensive rehabilitation services for unexploded ordnance (UXO) survivors and other people with disabilities throughout Laos.
Laos is, per capita, the most heavily bombed country in the world and Xieng Khouang Province is the most heavily bombed province in Laos.
In the wake of the United States’ reaffirmation that it will provide further assistance for UXO clearance in Laos and before President Obama’s scheduled visit to Laos in September this year, I decided to take a closer look at the treatment of those injured by UXOs in Laos. In May and June 2016, I accompanied COPE during a mobile clinic that travelled to remote areas of Xieng Khouang Province, in Lao PDR.
Although COPE covers all the patients’ expenses to access physical rehabilitation services, difficult road conditions, family responsibilities, and fear about traveling far from the familiarity of home prevent many people with physical disabilities in Laos from seeking treatment. Acknowledging the existence of these barriers, COPE and the CMR are piloting mobile clinics. These clinics are sponsored by USAID and also supported by the government of Canada.
Cope’s mobile clinics enable people with disabilities to get the services they need. Lack of access can make a manageable health problem turn into serious disability. Difficulty accessing quality healthcare remains a recurring problem for most Lao people living in rural areas. Frequently, a simple treatment can have a big impact on a patient’s life, especially in underserved rural areas.
In May and June 2016, the mobile clinic treated more than 100 patients.
A typically busy morning during the Xieng Khouang mobile clinic
The team advises a young couple about treatment for their babyâs scoliosis. They also referred the family to a plastic surgeon so that the babyâs cleft lip and palate can be corrected.
A medical technician takes measurements, so that he can begin making prosthesis for a patient
The doctor fills in a chart for a little boy with clubfeet.
The casts that will be used to make leg braces for a little boy with clubfeet
Wiak, 13, having his bandages changed a few days after suffering terrible injuries to his left hand and losing part of his right index finger and thumb to a UXO explosion on his familyâs farm
Three siblings with fused fingers. They will have surgery to have their fingers separated. The high incidence of congenital anomalies in Laos is probably due to the more than half a million gallons of Agent Orange that were sprayed on Laos during the Vietnam War.
The orthopedic compensation shoes that will help this woman to walk without limping and which will ease her back pain
A mother waits for a lift back to her village after getting support from the clinic for her babyâs hip dysplasia
Physiotherapist, Am Heng, checks a young patient
A physiotherapist and a doctor help a boy with nerve and muscle damage in his arms.
Physiotherapist Am Heng comforts a boy while the doctor prepares a cast for his foot
COPE Rehabilitation Manager, Suresh Selvaraj, helps a patient with cerebral palsy
A young man with a congenital malformation of his hands has a cast made. The cast will be used to make a support that will increase the flexibility of his atrophied muscles.
A prosthesis and crutches put to the side while a patient is measured for his new prosthesis
Wiak, 13, in hospital with his brother four days after suffering terrible injuries to his left hand and losing part of his right index finger and thumb to a UXO explosion
The casts that were made in one day of the mobile clinic
The team advises a man who has severe burn injuries to his hand
A young man, who lost an arm and who was badly burnt in an explosion at work, waits patiently for the doctors to make a cast of his arm.
COPE Rehabilitation Manager, Suresh Selvaraj, helps a patient to exercise his atrophied muscles
A boy, happy that his orthopedic shoes give him more stability
A twenty-year-old woman who canât walk sits proudly in her first ever wheel chair that the mobile clinic team has given her
A young boy, wearing his new orthopedic shoes, catches up with his father after having his legs cast so that he can get braces made to support his legs
30-year-old Hone, who lives in an isolated mountain village, could not reach a hospital because of his heavy disabilities. A truck was sent to Honeâs village with some mobility assistive devices and a physiotherapist.
Before the arrival of the mobile clinic, 30 year old Hone has crawled all his life on his hands and feet
A doctor examines the worn out prosthetic leg of a 14-year old girl
14-year old Ler, who was born without a tibia bone in one leg, has used a lower-leg prosthesis since she was 4. She came to the mobile-clinic to adjust her prosthesis. Children and teenagers need to do have adjustments every 6 months.
COPEâs vehicles make their way through the mountains of Xieng Khouang Province, Laos
On the road
Onh, on the left, lost most of his left hand in a fire when he was a baby. Dr Boavanh, one of the few female surgeons in the Lao PDR, explains how he could get back a thumb and have better use of his hand.
COPE Rehabilitation Manager, Suresh Selvaraj, waits for patients to make their way across a river to the mobile clinic
Two burn victims help the doctors fill in their medical forms, while other patients wait in the background
A woman who has had surgery on her foot after suffering serious burn damage, comes to the clinic in need of further treatment
The mobile clinic makes a stop at the medical rehabilitation clinic of a district hospital
A young man, who recently lost his leg in a traffic accident, makes his way to the mobile clinic in Xieng Khouang Province, Loas
A young man, who recently lost his leg in a traffic accident, tries on prosthesis for the first time, Xieng Khouang Province, Laos
On the move again after waiting four hours for a mud slide to be cleared after heavy rain
The mobile clinic van parked after the 12-hour journey from Vientiane to Xieng Khouang Province, Laos
Photos of Brazilian families affected by the outbreak of the Zika virus in the city of Recife, in northeast Brazil, as mothers seek help for their babies born with microcephaly.
The Brazilian army is deployed on the streets of Recife in a door-to-door campaign in search of vestiges of Aedes mosquito larvae, responsible for spreading the Zika virus. The population receives instructions on how best to protect and prevent the emergence of mosquitoes in their homes.
The Zika virus, first detected about 40 years ago in Uganda, has long been seen as a less-painful cousin to Dengue and Chikunguya, which are spread by the same Aedes mosquito. Brazilian health authorities are convinced that microcephaly is related to the Zika virus when a pregnant woman is bitten by this insect. This rare condition known as microcephaly often results in mental retardation.