Finding joy in restoring people'sability to walk

Ruth Onesmo is a certified Prosthetist/Orthotist at the Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), a health care organization which works to prevent disability, provide affordable medical and rehabilitative services, and aid empowerment of people with disabilities and their families. At the health organization, Ruth is the In-charge Ortho-workshop at the hospital. She talks to Success about her career.

Why did you choose to become a prosthetist/ Orthotist?

I derived at this profession after visiting college for course application. While there, I found this interesting profession that was new and unique to me. Other factors came in to play as I was still deliberating on which path to take. One of my early mentors and influencers was my mother, herself a Veterinary doctor. She was my support system and encouraged me to explore something different and so here I am today. Initially I was intent on becoming a medical doctor but later I became intrigued by this new field and so I decided to explore something different.

What are your roles/duties as a prosthetist?

First is to do assessment and then prescription of the proper device, this is done as team work of Prosthetist/Orthotist and the physiotherapist. After this follows the measuring and casting of the residual limb to capture the shape and size. Then later manufacturing, fitting, training and final finish when everything is ok.

What does it take to be a prosthetist?

A bachelor’s or Master’s degree in Prosthetics/Orthotics is important. And during this training of four years students learn manufacturing of various types of devices and acquire clinical experience. They later on acquire a recognition certificate from the International Society Of Prosthetist Orthotist (ISPO).

What are some of the emerging issues and challenges Tanzania is facing with regards to prosthetist?

Less inclusion in the scheme of work, fewer workshop centers in the country. Another challenge is the issue of costs. The high costs involved cannot be covered by most who require such devices. The National Health Insurance (NHIF) does not cover the cost. Other challenges include lack of awareness, shortage in rehabilitation centers and limited publications concerning rehabilitation services in Tanzania.

What is your day like?

My day starts 7:30am as I report to work. First thing in the morning is to go through my mails with my cup of tea until 8:15 where we meet for morning huddles and update with team members. If there are announcements or any opportunities ideas are shared during this time. From 8:30am work starts and everyone moves to their respective stations. I manage a team of 4 Prosthetist and two auxiliary workers and we have a minimum of 4-5 appointments of measurement twice a week, so I will distribute patients for measurements to each Prosthetist and one will remain in the clinic to see outpatient cases. Everyone continues with their activities until 3pm when we meet again for 5S activities until 4pm when the working day comes to a close.

How many researches have you been involved with and which do you consider to be the most interesting project?

I have been involved in many big and small researches but the most interesting one so far has been the 3D printability. This is a new established technology of manufacturing devices in a digital way.

What is the most challenging aspect about your career?

Managing Diabetic patients and those with phantom pain. It is tricky when a patient feels like you have not done your job properly yet it’s not about the Prosthetist rather the condition of the residual limb. It is really imperative in such conditions for there to be clear communication between the patient and the prosthetist.

Tell us about some interesting cases, encounters and experiences that you have had so far in your line of work.

I remember this one case involving a child born with no limbs. She was just two years when her mother brought her over with no hopes. The husband had abandoned them and said that the child is a sign of bad luck from her mother’s side. The child was healthy and jovial so I did the counseling to the mother who couldn’t stop crying. I explained to her that there is hope. We managed to fabricate the upper limb assistive devices, attached with tools like pencil, spoon and a tin to support the child’s growth. We have been monitoring and reviewing her case as she grows. She is now 7 years old and she has started school. Both the mother and child are happy now.

What advice do you have for someone with an interest in this career?

I wouldn’t advice anyone to opt for this career now in Tanzania, the limitations are many, for example centers to work are limited. Reformation needs to take place before the profession can see substantial growth.

What project are you currently working on?

I am now working with 3D printing technology phase two after the first pilot study. This phase will happen in the refugee camps in Kigoma for a period of 22 months where we will fit the refugees and the host community with the 3D printed prostheses. This is important as it is a humanitarian service to people living with disability.