By Yolima Dussán/Diálogo March 01, 2017 Anti-personnel mines used during the armed conflict in Colombia over the past 20 years have left 3,600 amputees from the security forces, according to the Central Military Hospital, the entity responsible for providing medical care to patients from the Armed Forces who have lost limbs. Located in Bogotá, the Central Military Hospital’s Amputee and Prostheses Service has more than 50 years of experience providing high-quality care and satisfaction to its patients. But faced with the high concentration of amputee soldiers in several other cities, its mission had to be expanded and decentralized in order to provide care to injured soldiers returning home after being discharged. That’s how the Mobile Health Unit program originated. The amputee patient program is a joint effort between the Colombian Army Department of Health and the Central Military Hospital. The Ministry of Defense invests almost $3 million annually in providing healthcare to injured soldiers. Two phases of medical care in each city Lieutenant Colonel Héctor Manuel Orjuela, an orthopedist and trauma specialist who is coordinator of the Central Military Hospital’s Amputee and Prostheses Service, told Diálogo the program will be transferred to other cities in two stages. In the first phase, the entire interdisciplinary team of specialists will evaluate the patient, create the prosthesis, and make the mold. In the second phase, the teams will deploy the mobile health unit again to assemble the components of the prostheses. The patients will try them out, and adjustments will be made until they are satisfied. “Finding out that we have so many mine victims and amputees led me to devote myself to these patients,” said Lt. Col. Orjuela. “There are many difficult cases, but the most important ones are the ones who haven’t been able to be rehabilitated or adjust to the prostheses in previous years, and my goal is to see them walking.” The mobile health unit is outfitted for manufacturing, alignment, and assembly of prostheses. Two specialists, including one therapist and four prosthetic technicians, are part of the team traveling around the country. The first mobile health units went into service in 2017 providing care to 109 amputee patients and distributing 64 new prostheses. The goal is to provide care to 500 patients annually. The majority of the Armed Forces’ amputees became disabled during their military service. Most were between the ages of 18 and 35. Ninety percent of these troops had their lower limbs amputated, while 10 percent lost their upper limbs. Although the number of victims decreased 90 percent in recent years thanks to the peace process, hundreds of mines remain scattered throughout Colombia. According to the Colombian High Counsellor for Post-Conflict, Human Rights and Security, Rafael Pardo Rueda, the national government began clearing 22 million square meters of land in 2017. “This means that there were mines throughout 40 percent of Colombian (territory). It was being cleared of mines for 25 years so we could get to our goal of having a Colombia free of anti-personnel mines by 2021,” Pardo said. Life stories Eulises Viáfara, a soldier who lost a limb in 2006, is one of the patients who received care from the Medical Battalion at the Central Military Hospital’s Mobile Health Unit in Cali last February 9th. He remembers feeling like his entire world had fallen apart and the only thing he could think about was his lost youth. Today, he is a success story. After accepting his situation, he understood that he needed to move forward and began attending school and working. “Now I’m a cell phone, camera, and computer technician. Adapting to the prosthesis was easy for me thanks to the medical care they give us in the mobile health unit. Today, I can manage my prosthesis without any problems,” he explained. From amputee to prosthetic technician Jesús María Izquierdo is a 35-year-old professional soldier. Eight years ago he was participating in a security sweep of the border area between the departments of Meta and Caquetá when he stepped on a mine. In an instant, a microsecond, his life changed forever. Today, depression, rage, hopelessness, and pain are a thing of the past. He has completely adjusted to his prosthesis. He is an athlete. After he became an amputee, his new life’s project began – helping his fellow soldiers who have lost limbs. With the help of his superiors, he trained to be a prosthesis assistant. Now he is an orthopedic technician and is getting ready to study Orthotic and Prosthetic Engineering and Mechanical Engineering. “You have to go through this yourself to understand what it means for an amputee soldier to have the mobile health unit arrive in the city where they live, knowing that they are coming just for them, to take care of them, to improve their condition. I’ve been to various brigades, and it is a huge joy for them and for me because I’m the same way. It also sends a message of rehabilitation,” Izquierdo told Diálogo. Lt. Col. Orjuela shared some unforgettable stories. “In Carepa, Urabá, I came across soldiers that had never walked with a prosthesis but they do now, thanks to this comprehensive, mobile medical attention. This process has to do with infrastructure, with decisions from the Army’s high command, with human talent, with experience, but also with heart and soul, persistence, and having a call to service.” Another case that illustrates the importance of bringing medical attention to amputee patients is a soldier in Cali who lost a limb 50 years ago and had his prosthesis for 38 years. He had never gotten it changed since he was unable to travel to Bogotá. “The one he had, weighed 7.5 kilos. He had difficulty walking, but new technology meant he could be provided with one that weighed 1.5 kilos. We brought it to him. A complete change in his quality of life,” Lt. Col. Orjuela said. Nothing else needs to be said.