Penn State Hazleton alum helps amputees in Haiti
Karen Helfrich helped six times more amputees during two weeks in Haiti this summer than she had treated in her whole career as a physical therapy student. Helfrich, who graduated from Penn State Hazleton two years ago as a physical therapy assistant and is now studying for her master’s degree, volunteered at a clinic still packed with patients maimed by Haiti’s devastating earthquake.
The quake on Jan. 12 killed 230,000, left one in nine people homeless and gave others crushing injuries. Arms and legs pinned beneath rubble became infected in Haiti’s fetid climate. Between 2,000 and 6,000 Haitians had limbs or digits amputated, Handicapped International estimated.
Helfrich met the amputees when she arrived on June 14 in Deschapelles, a farming community far enough from the epicenter to have escaped damage from the earthquake. Refugees from the ruined capital of Port-au-Prince needed three hours to travel the 60 miles to Deschapelles and its Hospital Albert Schweitzer – one of few hospitals that continued to operate without interruption in Haiti. The hospital has 85 beds, but treated more than 500 patients at a time after the earthquake when the demand for care depleted medical supplies.
Six months later, Helfrich still noticed patients staying six to a room and relying on relatives for food, baths and help getting to the bathroom. Pain-relieving medicines were scarce. Helfrich saw Motrin handed to patients who probably would have received morphine intravenously in the United States. “One patient had pain. She said ‘It’s very bad. If I wasn’t Haitian, I wouldn’t be able to handle it,”’ Helfrich said.
At the hospital, the Hanger Orthopedic Group, a worldwide provider of services to prosthetic patients, created a clinic to fit amputees with new legs and arms. In the first three months, the Hanger Clinic provided artificial limbs for 300 patients.
During her stint at the clinic, Helfrich cared for about 60 patients. The youngest, a girl about 5, lost her right leg above the knee. A leg wound prevented her from wearing a prosthetic leg while Helfrich was with her, but the girl danced and sang and walked around the clinic with one leg and crutches. “She would sneak up on you and throw her arms around you and give you a big hug as she said ‘boo,’” Helfrich said in an e-mail.
Another girl, 12, lost more than her leg. Both her parents died in the earthquake, and she couldn’t find any other relatives. “We don’t know how she came to us. We’re happy she did,” said Helfrich, who remembers the girl whom she calls Nadia to protect her identity admiring her new, artificial leg as she rocked between parallel bars.
“She was excited to have the leg,” Helfrich said. “She turned out to be such a great walker.” Nadia went from crutches to a cane to walking on her new leg without other assistance.
Coping with her other losses was not so easy. Nadia spoke softly when Helfrich met her, but in time she joked and sang. After emerging from her first counseling session, however, Nadia cried herself to sleep. As the sessions proceeded, she seemed less upset.
“One afternoon I sat around with Nadia and a few other girls and we traded English and Creole words and then quizzed each other. We laughed as we stumbled through pronouncing the words. I think the friendships she made with other patients and the staff helped keep her going.”
Getting patients going, emotionally and physically, was the job of Helfrich and other volunteers. The international cast of health workers rotating through the clinic included two physical therapists from California and an instructor from Misericordia University, where Helfrich is earning a bachelor’s and master’s degree in physical therapy through a collaborative program with Penn State.
Helfrich coached patients on parallel bars and ramps that are standard equipment for therapy sessions in the United States. Also, she tailored exercises to the tasks that people planned to perform with their new legs. Some walked bumpy trails like those that they would travel after they left the hospital. Others carried heavy baskets on their heads to practice for daily chores. Still others climbed trees to be sure that, even with artificial legs, they could continue to pick fruit for their families.
Prior to coming to Haiti, Helfrich had worked with about 10 amputees while training in clinical settings, such as Hazleton General Hospital. During training, her patients tended to be older, overweight and diabetic – factors that slowed their therapy. They took months to adapt to artificial limbs.
In contrast, the Haitians seemed young and strong. At the Hanger Clinic, patients spent one to two weeks in therapy for amputations below the knee, two to three weeks for amputations above the knee and a month or more if they lost both legs.
“Yes, they were sad about losing a limb. They didn’t really focus on that,” Helfrich said. “They were excited about being able to bring water to their family, to be functional again.”
In Haitian cities such as Port-au-Prince, streets are crowded enough to make walking and avoiding collisions with motorbikes difficult. The prosthetics that people received at the clinic will help them negotiate the crowds and subsist in the hemisphere’s poorest economy.
Helfrich found herself thinking that some of her patients could have starred in the Special Olympics if they had access to regular care and more specialized prosthetics. At the Hanger Clinic, technicians made legs more often than artificial arms, which are more complex to build and fit. The employees of the Hanger Group and its charitable branch, the Hanger Ivan R. Sabel Foundation, developed the clinic to be self-sustaining. They trained Haitians as prosthetic technicians and physical therapy assistants.
The earthquake leveled two businesses in the country that made artificial limbs, and Helfrich was told that Haiti had only 16 physical therapists. Patients at the Hanger Clinic helped one another perform the exercises that they had been taught while waiting for their next sessions with a physical therapist, Helfrich said. “Patients we see were able to do so much with a very basic prosthetic,” she said. “One man … lost both of his legs above the knee. He was able to get up without using his hands.”
While 95 percent of the patients lost limbs due to the earthquake, Helfrich was with a man who lost both legs to diabetes about six months before he came to the clinic. First, he received short legs about 18 inches long called stubbies. After he learned to balance on stubbies with his feet backwards and forward and spent five days walking between parallel bars, on a walker and then with longer legs, the man was ready for knees.
“The way a knee works, the knee would lock and unlock depending on the weight. It takes a lot of energy to control,” Helfrich said. After coaching the man for 15 minutes, she left so he could recuperate. She returned, surprised to see him not resting but walking with a walker. His progress delighted Helfrich, who became absorbed in her work.
“In Haiti it is 100 plus (degrees) every day. Incredible humidity. It didn’t seem to bother me,” Helfrich said. “I was so drawn to the people down there and the work down there. I would have stayed there longer if I could.”
When Helfrich offered to extend her stay, a group called Physicians for Peace paid the cost of rescheduling her return flight to a later date. She remained at the clinic through July 1.
After she left, the people around Deschapelles who had been spared during the earthquake ran out of luck when flooding struck. Medical workers from Hospital Albert Schweitzer took the lead in restoring clean water and sanitary latrines to ward off the outbreak of disease as the waters retreated.
Helfrich hopes to return to the clinic during her break from classes this winter and wants to keep volunteering internationally. “The limiting factor is college debt,” said Helfrich, who is scheduled to graduate next year from Misericorida University.
The chance to help in Haiti came along early enough in Helfrich’s career that she could spare the time to volunteer after already gaining enough experience to be useful, due to the hands-on training that she received, starting at Penn State Hazleton. “The biggest thing was just being in the program and getting the skills,” she said. “They wouldn’t have taken me unless I had.”
Before she left, friends worried for her safety. When she returned to her home in Souderton, Montgomery County, friends expressed interest in taking on similar volunteer missions. People also asked her how they can help Haiti from the United States. “That’s a very challenging question,” Helfrich said. “People are saying ‘We’re giving all this aid and nothing happened.’"
But she said the donations of medical supplies allowed the hospital to provide better care and the clinic to provide more people with new arms and legs. “I was able to experience firsthand that things are being done with it.”