Kim Ramey, PT
I have been traveling as a Physical Therapist with Faith in Practice to Guatemala for the past 6 years with an orthopedic team. Our team goes to Antigua, Guatemala for a week and we see a variety of orthopedic conditions, some operative and nonoperative for both adults and pediatrics. Faith in Practice has different groups that travel to Guatemala, including surgical teams of various disciplines and teams that go to the villages to provide healthcare. While we are there, we see some patients who have an assortment of prosthetic needs. Faith in Practice has teamed up with Transitions, a non-profit group, to provide prosthetic care to the people of Guatemala. Transitions employees Guatemalans with disabilities to work in their wheelchair/ equipment shop or prosthetic/orthotic office.
Two years ago, our team met Marta, a native Guatemalan from the Kachi tribe who struggled as she walked painfully into our clinic. She was a 6 year old girl who caught our eye and captured our hearts. We saw so much potential and life in this little girl, that we became bound and determined to go above and beyond to do everything we could to help her. The orthopedic surgeon, Dr. Brad Urquhart, the prosthetists, John Fain and I, Kim Ramey were on a mission. Upon evaluation we discovered that Marta lost her feet, but not as the result of a genetic disorder or birth defect as we suspected. We soon learned that her lower extremities had sustained second and third degree burns. Her grandmother explained to us that Marta's family lives in a home comprised of only one room. This room has a fire in the center which is used not only to cook all meals but to provide heat for the family as well. When Marta was a toddler, she approached the fire, and as she did so, her skirt exploded into flames. She couldn't escape the hot coals and flames that ultimately destroyed her feet and left her severely burned with extensive scar tissue. She was left with transtarsal amputation bilaterally. Unbelievably, she healed from her injury without infection. In an effort to find a shoe that Marta could wear, her family bought a pair of rain boots. The rubber from the boots and the intimate fit provided suction that allowed her to have shoe that would fit. When we met Marta, she was starting to show signs of skin breakdown because of the shearing that occurred when she had to walk miles each day as she accompanied her family to and from work in her rubber boots. There were signs of chaffing, decreased skin elasticity from the hot climate and there was not enough balanced support. We knew we had to do something or her skin integrity was going to be demised. So we devised a plan and we were on a mission to help this little Marta!
That year the orthopedic team operated on her residual lower extremities to reshape the boney structure and soft tissues to prepare her for future prosthetic wear. We all worked together on the orthotic/ prosthetic design that we felt would be the best. We had to take into careful consideration that her burns destroyed her normal weight bearing surface and it resulted in the necessity to design a prostheses (orthotic-modified prostheses) that would accept the load to be transferred to more healthy tissues. The next year, Marta was measured, molded for laminated Patellar Tendon Bearing Partial-Foot Prostheses and the prostheses were fabricated. With the help of John Fain, CPO, Transitions, and a group of prosthetists from a prosthetic school in El Salvador, we were able to have her fit with these bilateral prostheses. Now she is a happy eight year old who is attending school and is accepted by her peers and even other distant family members who shunned her in the past. Often, children and adults with a disability in general are not valued by Guatemalan society and are seen as unproductive citizens. Her immediate family cared for her and saw beauty in her that motivated them to give everything to allow Marta to be seen by the medical team from Faith in Practice and to provide her with the opportunity to walk without pain. We saw a little girl who had an overwhelming desire to walk, to run, and to be simply a child again and we were motivated to do everything in our power to help her. Helping Marta changed my life and I hope her story will inspire and remind you why you do what you do each and every day!