First steps to recovery

“Helping people walk again — it feels like winning the lottery.”

Technicians prepare prostheses in a workshop at the Directorate of Disability and Physical Rehabilitation in Damascus. WHO/L. Mackenzie

12 December 2017 — Dr. Rafif Dayha says that today is a “quiet day” at the Directorate of Disability and Physical Rehabilitation in Damascus, but the building is a hive of activity. Machines from the prostheses workshop are buzzing, doctors and physiotherapists walk purposefully through the narrow hallway, and the entry is crowded with families waiting for appointments. A mother from Deir-ez-Zor sits patiently with her four children, opposite Mohammed and his nephew Ayman, from Al-Hasakeh.

“This is the first time I’ve been to Damascus in seven years,” Mohammed remarks. He’s beaming as he says this, clearly happy to finally be here. “We wanted to bring Ayman before. But it wasn’t possible.”

Ayman, 11, was born with a congenital limb defect and is missing his left leg below the knee. His family took him to see doctors when he was younger, “but they said they couldn’t help us,” he explains. “And then ISIL took over Al-Hasakeh. They wouldn’t let us leave. So there was no way to come here until now.”

Ayman and his uncle Mohammed sit together in the waiting area. WHO/L. Mackenzie

Ayman is a quiet contrast to his excited uncle. He keenly observes the rush of activity around him and keeps to himself, nervous but trying to be brave.

A technician arrives and says that they are ready to take his measurements for the prosthesis. Ayman picks himself up off the chair with help from his uncle and hand-carved wooden walking stick.

Mohammed looks at the worn stick, and then at his nephew.

“Maybe after today, he won’t need that anymore,” he says.

A technician fits Ismail for a prosthetic foot. WHO/L. Mackenzie

Ayman joins Ismail, 17, from Qamishli, in the workshop at the back of the building. Ismail lost his left foot as a result of shelling on a road in rural Al-Hasakeh. He watches intently as technicians move swiftly around him.

More than six years into the conflict, an estimated 2.9 million people in the Syrian Arab Republic experience disability, including 86 000 people whose injuries have led to amputations.

As the conflict drags on, the number of people with injuries and disability continues to grow, while access to rehabilitation services diminishes.

Technicians glue padding to a new foot for Ismail. WHO/L. Mackenzie

In response to the increasing number of people with disability, in partnership with the Department for International Development (DFID), The World Health Organization (WHO) recently procured and distributed supplies to produce 180 artificial limbs to rehabilitation centres in Damascus and Homs.

To further expand services for rehabilitation, with DFID support WHO is working with the Ministry of Health to fix two damaged rehabilitation centres — one in Homs and one in Aleppo. To help re-establish health system capacity, the centre in Aleppo will also be used as a prosthetics and orthotics training facility.

Rehabilitation requires multiple partners and inter-sectorial collaboration. WHO leads a working group on disability in Syria, and through this group is helping partners to standardize quality of care. In addition, in partnership with DFID, WHO helps to support the work of Handicap International in the Syrian Arab Republic.

About an hour after they take his measurements, Ismail’s new foot is ready. A technician ties the shoelace and helps him attach the prosthesis with sturdy velcro straps.

Ismail cautiously tests the feeling of putting weight on the foot while holding a set of rails. Then he walks out into the workshop on his own. His mother watches from a back corner, smiling as she sees Ismail stride around the workshop.

Outside in the hallway, Muhannad Khaleel, a physiotherapist, gently coaches 15-year-old Gofran from Al-Hasakeh through her first session with a full-length right leg prosthesis. His warm energy is infectious, and despite some discomfort, Gofran bites her lip and follows his guidance with quiet determination. A friend stands by for support, filming her increasingly confident steps on a bright red cell phone.

On the first day of her rehabilitation session, Gofran wore gold shoes for good luck. WHO/L. Mackenzie

“She’s learning very quickly,” says Muhannad. “When the patients first arrive they are usually very depressed. But as they make progress physically, their mood improves too.”

“It’s incredible, doing this work,” he reflects with a broad grin. “Helping people walk again — it feels like winning the lottery.”

Clinic Director Dr. Rafif Dayha (left) stands with staff, including Physiotherapist Muhannad Khaleel (second from right). WHO/L. Mackenzie

More on the health crisis in Syrian Arab Republic

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