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An elephant's tale

Written By vibykhmer on Saturday, August 22, 2009 | 7:39 PM


Chhouk the baby elephant

http://www.oxfordtimes.co.uk

Thursday 20th August 2009
By Nigel Wild

T he story behind how Chhouk the baby elephant gained his artificial foot is one of hope and salvation following the desperate years of his troubled homeland.

It is also a story of how Cambodian medical students found themselves using techniques developed to create prosthetic limbs for mine victims to help a wild animal.

Cambodia is now politically stable and tourism a major growth industry, but the legacy of war, genocide and political upheaval has left the country as one of the poorest of the developing nations.

Between 1975 and 1979, Pol Pot and his Khmer Rouge fanatics strove to return Cambodia to Year Zero, an agrarian subsistence farming society. Anyone considered intellectual – and that could be no more than wearing glasses — was either put into forced labour or executed. More than a million people fell victim to this genocide, nearly half-a-million fled the country.

Following the 1979 invasion by Vietnam, the Khmer Rouge was forced over the border into Thailand, and countless landmines laid along the 600-mile border to keep them from returning.

Landmines were also sown liberally through many areas of Cambodia. With few records, the numbers are an estimate, but somewhere between three million and ten million mines were laid.

The outcome is one of the world’s largest disabled populations, with 43,000 landmine survivors who have lost arms and legs.

In 1989, Cambodian Prime Minister Hun Sen asked for help with these victims and the Cambodia Trust was founded in Oxford by Dr Peter Carey, Stan Windass and John Pedler.

The trust established the Cambodian School of Prosthetics and Orthotics (CSPO), with the help of Roehampton and a major UK manufacturer of artificial limbs.

Adrienne Liron from the trust outlined living conditions in the country and the day-to-day problems that still have to be faced.

“The Khmer Rouge regime tried to return Cambodia to the dark ages and has condemned it to a long, slow climb out of poverty,” she explained.

“In the major cities like the capital, Phnom Penh, tourism and property development are growing industries, but outside, it is still just grinding poverty, subsistence farming and an income level of about 50p a day.

“Community healthcare is virtually non-existent. Organisations like CSPO provide it. Cambodia does receive a great deal of outside financial aid, but as so often happens, not all of it reaches its intended target.

“Our goal is to train Cambodian staff to prescribe and fit prosthetic limbs and braces.”

As well as landmine victims, a host of other disabled people need help too. Changes in diet have brought on diabetes, resulting in amputations, polio is a serious problem (with some 50,000 sufferers) and increasing road traffic brings more accidents.

In Cambodia, disability is a social stigma. The disabled are ostracised, even by their own families, finding it almost impossible to have any schooling or find a job. Breaking the cycle of poverty is pretty tough.

Since its beginnings in 1989, the CSPO has grown to three centres, one in Phnom Penh and two more in remote areas. Its success in recruiting and training local staff is such that now, all the 2,000 limb and brace fittings carried out annually are by Cambodian staff. The CSPO qualification is at bachelor degree level.

The trust’s responsibility for a patient is lifelong. An adult will need a new limb every one to two years depending on the use and environment of the prosthetic, a child every six months to cope with growth. Although the latest high-tech materials are used, wear-and-tear on the limbs is a fact of life.

“We have to be there for all our patients” Adrienne said. “If we stopped, the devices would fail and condemn the patients to return to where they started.”

And Chhouk? The baby elephant was found two years ago in the jungle. He had lost 12cm of his left foot in a snare. Unable to walk properly and with the right leg bowing under the strain, the little animal was thin, emaciated and unhappy.

The CSPO students face many difficult challenges in their work and are encouraged to think laterally.

Led by the school’s Cathy McConnell, a team spent lunch-hours and weekends designing Chhouk a new foot. The original used the same materials as human prosthetics, with the base made from a car tyre. It was an instant hit.

Surprisingly, Chhouk’s X-ray and casting demanded no greater anaesthetic than a plentiful supply of bananas and turnips.

Try Sitheng, elephant keeper at Phnom Tamao Wildlife Rescue Centre, said that Chhouk and Lucky, an older elephant, were now like brother and sister.

“Chhouk loves to run through the forest with Lucky, on the hunt for jungle fruits. He plays with Lucky and puts sand on his own head. With the shoe, he runs very well, but without it, he walks slowly.”

The prototype needed several repairs in a short space of time. A more rigid version was devised, but was too tight. Chhouk threw a tantrum until it was removed and it is back to the drawing board for the CSPO team.

Their real problem is yet to come, how to design a prosthesis to withstand the weight of a fully-grown elephant as Chhouk matures.

The Cambodia Trust is funded to a small degree by the country’s government, bolstered by aid from Britain, Australia, New Zealand, the Nippon Trust in Japan and public donations.

Adrienne is fulsome in her praise for the Nippon Trust, which has been at the heart of the activities right from day one.

“The Nippon Trust’s aim is that everyone in Cambodia will pay taxes. That means full inclusion in society and the economy.”

The Cambodia Trust has now extended its activities to Sri Lanka, Indonesia and East Timor, the latter one of the few places where leprosy still exists. Unlike Cambodia, these projects are of fixed-length, with dates already set for government takeover.

Adrienne said: “And we are looking for more places where our skills and experience can really make a difference.”

For more information about the Cambodia Trust call 01844 214844

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