Many young people with congenital limb deficiencies in impoverished areas without handicap accesses have bleak futures. Juan is one of the youngest to be helped by the ministry. He comes from a loving family where he has never known life with normal limbs. With the innocence of childhood, he interacts with his siblings normally enough. However, it is important for Juan to get a start with artificial limbs while he is young and impressionable if he is to be able to accept more complex and permanent prostheses later in his life. Thanks to his caring family and his prostheses provided by Life and Limb Ministries, he took his first steps on his new artificial limbs. With his drive and youth he can begin to realize his potential for mobility and independence. While it is inevitable that Juan will develop dexterous abilities without the use of hands, it would also broaden his ability to function in society if he begins to use some form of artificial arms and hands while he is young. The volunteers at Life and Limb are in the process of designing upper extremity prostheses for Juan. With the artificial limbs, our hopes and prayers are for Juan to fully develop in his mobility and become dexterous with artificial hands. As he grows and becomes more adept with artificial limbs he should be able to use prosthetics in more complex ways. He should use his artificial limbs as much as is comfortable, while his parents keep an eye out for signs of overuse such as chafing, calluses or any hygiene related issues.

Since the missions began in 2001, more than 60 amputees have been fitted with durable prosthetics and many more have received repairs and evaluations free of charge. The prosthetics are badly needed in Colombia because of the pedestrian nature of transportation and the harsh reality of manual labor in that part of the world. For those amputees already experienced with a functional prosthetic limb, the heat, humidity, pedestrian travel, and manual labor were constantly deteriorating their existing prosthetics which limits their peak service to about a year or two, even with the most durable components available. The materials and tools for repairs are limited if not altogether unavailable in the region. The money to afford adequate care wouldn't be available even if the tools were. Oswaldo Polo certainly has the drive to remain self-sufficient. He crafted together this makeshift prosthetic socket out of rope, ingenuity and determination. It required that he tie a series of strings in a specific order to achieve adequate tension. Even if a perfect fit were achieved, and calluses tell us that it was not, it would be impossible to properly clean such a device without destroying it. Improved hygiene is one aspect of the mission the Colombians are very grateful for. They are all too aware of the threat of infections in this subtropical region, and there are in fact amputations that are performed due to infected wounds in otherwise healthy adults. Many of the amputees have lost a limb, or two, due to conditions that might seem incredible to those living beyond the Third World. For example, Luis Castellon lost his right leg below the knee due to infection from a snake’s bite. Marta Castillo's leg was amputated after a car crashed into her house as she was sitting on her sofa. Devis Soaves developed gangrene from a cut on her foot that was complicated due to her diabetes. Sandy Minotas was a victim of a bus accident on the way to her university classes which sandwiched her between two moving busses.

For mechanical reasons also, it is important to protect componentry from dirt and debris. The donated foot shells provide that protective barrier, but can only last so long under normal conditions. The heat and humidity combined with laborious use provide additional challenges and usually reduced longevity. Without periodic, professional care, these artificial limb components are at the mercy of the elements. Temporary repairs are common and sometimes necessary, but without the proper materials and knowhow they are not very effective at restoring the integrity of the component or the protective shell. They are literally walking with a broken leg that could result in a range of problems that range from simply visual damage to functional and even hygiene related bacterial problems.

Meeting the logistical needs of a mission this important to the amputees and their families involves several levels of planning. To maintain a standard of patient centered care, there must be someone on the ground in Colombia getting basic medical and anatomical information from the patients. The president of Life and Limb, Chuck Fleming explains, “We need measurements; we need a contact person, people sending limb measurements so that we can create a kit for each of them. The size of foot and liner must be known.” Overcoming the challenges of logistics is something that Life and Limb Ministries prepares for all year long before a trip. The team works with local interpreters, medical personnel and local ministry groups to meet their planning goals. Prosthetist and volunteer Greg Michalov puts it this way, “The biggest preparation challenge has always been getting the individual patient data (height, weight, foot size and side) aligned with the available donated componentry. Inevitably we will run short of a particular size liner or have four left feet of proper length only to need four right feet of the same length. The delivery of the ordered socket kits also proved a challenge this past trip as they were on back order and arrived from Iceland a few days prior to departure.”

Those kits of portable equipment and componentry include the Icex® socket kits for below the knee amputees and for those amputated above the knee Cascade provided an adjustable socket design which we then combined with various mechanical knees. Mr. Fleming has put together numerous designs from the portable kits and lauds the biggest benefit, “With a little background info on the patient, we can have someone walking in an hour, which is a unique system.” With only a few days per year to see a host of amputees it is easy to see why pre-planning is important.

There are other big challenges even after supplies are finally on the ground, Greg explains, “The biggest technical challenge is the lack of a lab set up with equipment to handle more unique cases such as upper extremity amputees.” There are also time constraints on the ground and due to the packing requirements which are based on patients’ specific needs, including supplies and proper equipment, Greg and the volunteers must be efficient and try to, “only work with situations we have planned for and equipped ourselves to knowingly handle.” However, in focusing on the modifications that must be done to existing prostheses and the potential for the unexpected, Chuck Fleming makes it clear that just because a situation wasn’t planned for doesn’t mean they won’t give it their best, “We need to think quick on our feet, we turn into MacGyver in a heartbeat, like doing without some power tools, we’ve drilled holes with pliers and a drill bit.”

Some History of the Organization

Early on, from 2001 until 2005, Real Life Prosthetics financially supported their staff's volunteer efforts in the global outreach sewing the seeds for future missions. In 2005 those seeds transformed into Life and Limb Ministries with it own independent corporate structure. Life and Limb Ministries took root in 2007 when it became a completely separate entity for global outreach and received non-profit status. The 2009 mission trip was the first fruits of Life and Limb Ministries. This first official campaign included volunteers from the United States and from Baranquilla Colombia as well as the long time volunteers from Real Life Prosthetics. Now, anyone concerned can volunteer their time and travel on behalf of L&L for global outreach. The volunteers have a definite sense of purpose and feel blessed to be involved in such a spiritually rewarding mission. They take on each set of circumstances with clear focus, but must at some point look beyond each clinical diagnosis to see what can be achieved with a little brotherly help. The mission's end result, to provide prosthetic limbs for the physical renewal of amputees in need and minister for the spiritual renewal of those wanting to accept Christ has not changed, but their resources have evolved with time.

Life and Limb Ministries now receives donations rather than direct support from Real Life Prosthetics. In addition, Life and Limb Ministries generates its own support well beyond what RLP could sustain. In the beginning most of the prosthetic materials were donated by Össur Americas whose corporate home is in Iceland. Life and Limb Ministries now purchases the needed Icex® kits via donations, some with a discounted rate for non-profit organizations. The most generous manufacturers to donate for the 2009 mission trip were Cascade, Endolite North America and Knitrite® Incorporated as well as Össur Americas. These materials help make a perfectly functional limb when combined with a stock of durable used components. There is a selection of used prosthetic components because FDA regulations ban any reuse of them in the United States based on concerns about liability from failure and hygiene related issues. Using these materials is much like salvaging parts off of a damaged car to repair a new one. Donors of good prosthetic components, both used and new, may claim them as a tax deductible donation based on the item’s worth, just as a donor of monetary funding would. The process is very similar to the way you would donate goods to the Salvation Army. Some prosthetic componentry and materials are still donated or discounted by generous manufacturers. Many private donors are themselves amputees or family members of amputees. We would like to give our thanks and to let them and anyone concerned know that their donations have helped make a difference in many people's lives.