Refugees wait for artificial limbs




Mohammed*, 38, whose right leg is severed above the knee, is one of many Iraqi refugees waiting for prosthetics at the Syrian branch of charity Terre des hommes (Tdh) orthopedic workshop.Nine years ago, Mohammed, a Sunni Muslim, married his Shia wife. Both were schoolteachers and had three daughters.

But after the 2003 US invasion of Iraq triggered sectarian violence, Mohammed says he was threatened by the Mahdi Army for living in a Shia neighbourhood.In 2006 the militia kidnapped him for ransom. They hung him by chains and tortured him. They also sliced up his right leg with a power drill, he says, and amputated the gangrened limb soon after.

Finally freed from captivity during a US military operation, Mohammed testified against his torturers, and then packed up his family and belongings to leave for Damascus.

Mohammed now waits for surgery to straighten his twisted right femur bone. Only then can he discard his cumbersome crutches and apply for a fitted prosthetic.Barred from work and solely reliant on the UN Refugee Agency (UNHCR) for food rations and a monthly living stipend, his family waits to be resettled in a third country.

Mohammed says UNHCR recommended he and his introverted older daughter receive counselling for depression. He admits to taking out his anger by beating his wife and children, and that he has considered divorce.In the stone courtyard of Tdh, Mohammed's story is not uncommon among the mostly Iraqi patients, mauled by the violence of car bombs, unexploded ordnance, torture or chemical warfare.

"Our work is 50 percent technical and 50 percent psychological," explains the orthopedic specialist, Khaled Zaynoun. "It's important to create a special rapport with the patient."There are currently 153,000 Iraqis registered with UNHCR in Syria, out of a total of more than 290,000 since 2003. Off the books, an estimated 1.5 million Iraqis sought shelter in Syria during the height of the conflict.

Tdh is overwhelmed. Only a handful of prosthetic production facilities exists in Syria, and the charity is entirely reliant on private donors. It has created an estimated 480 prosthetics and has grants approved for another 35. Zaynoun says he has about 150 disabled refugees, mostly children, still waiting for treatment and the finances for it.

"Each case is quite unique, and we try to provide a tailor-made solution for each patient using materials largely imported from Europe," Zaynoun says."High-end electronic prosthetic limbs can cost between 5,000 [US$6,608] Euros and E20,000 [$26,432]," he says. "The ones we make here cost about E2,000 [$2,643]. They are pretty basic but they allow people to walk and function."

Birth defects

Four-year-old Hiba Sabah was born with a genetic defect: both legs are stunted above the knee. Her father Fadi says he and his wife Rana were caught in the middle of heavy fighting in their Baghdad neighbourhood after the US military invasion.

When the family finally fled to Syria in 2005, Rana was seven months pregnant with Hiba. The doctors in the Damascus hospital where she was born attributed her deformity to chemical warfare."Hiba is having a very hard time in school," Fadi says. "During the breaks the kids go out to play but she cannot. She feels left out since she has to stay in the classroom."

In October, the World Health Organization (WHO) and the Iraqi government announced an ongoing investigation into birth defects across Iraq, after widespread media reports highlighted an alarming rate of deformities caused by radiation and chemical weapons in Fallujah.At the Tdh centre, Hiba dons a pair of prosthetic legs custom-made for her, and awkwardly practises walking across the courtyard.

"In the beginning patients feel a lot of pain," explains Zaynoun. "There is a long period of getting used to the prosthetic on a psychological level rather than a physical level, which is fairly straight forward. They need to learn to live with it, and then force other people to treat them fairly. It's not easy."

He acknowledges these expensive limbs come at a price for children like Hiba. "The problem is at her age, she keeps growing.""We rely on private donors but they are not predictable," says her father. He adds that the family receives no additional assistance. "I regret starting this whole process, I don't know how to replace them."

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