Our hospital is located in a very rural part of Eastern Kenya.
Our patients are generally very poor and our mission is to try to serve them at our best, without excluding anybody due to financial constraints.
For years I had been witnessing to the very sad reality that orthopedic care in our area is only for the rich: implants are very expensive; surgeons are rare and costly to the patients; hospitals able to perform orthopedic surgery are few and equally unaffordable to the majority.
The normal picture was that most of our patients would not afford surgical treatment for fractures, and they would end up being disabled forever, a burden for the family, miserable and more poor day after day.
Most of the beggars in our villages were in fact people abandoned by the family after an untreated fracture, and pushed by circumstances to sit at the side of the road to show their disability to the passerby,
in order to get some coin or some food.
I had tried to do my best to address such situations, but the cost of implants was so high that our poor finances could not afford them.
Actually I was operating some patients, mostly using plates, which are not the best solution anyway, because they do not assure good stability and require the patients to bed rest for more than a month after operation.
That was still meaning long time in hospital, long time out of job, long time far from the family. Sometimes such operations were heavily burdened by severe complications, even life threatening for the patient…and that was due to the cast I was pushed to apply and to the long term immobilization.
The true revolution in that sad situation, in which I often felt like a useless spectator, come with our providential meeting with Sign Fracture Care International.
I was taking of my frustration to some friends working in Sierra Leone, and they told me to write to Sign, who provides first quality implants absolutely for free.
I was totally reluctant.
“We are an insignificant rural hospital in Africa. How can I hope they could consider us as part of the program?” I was thinking.
But something was pushing and encouraging me to give a try.
I finally wrote an application and, against my expectations, Sign replied.
They believed in me, without even knowing me, and they started sending the free implants to our hospital.
It was September 2016. And that was a turning point in our history and the beginning of a transformation which is still ongoing now.
The news of the free hardware from America spread very quickly, as it normally happens in Africa: word of mouth? Smoke signals between villages? Difficult to say!
The reality is that patients started flocking to our hospital, in spite of our remote location, in spite of the terrible roads and the poor means of transport.
In few months we have become the orthopedic trauma center for an enormous area, well beyond our County. People travel from very far, because travelling is still much less expensive than what they would be requested to pay in private orthopedic hospitals. Patients come because we are the only hospital they can afford…and they can afford us because we receive the hardware we use for our surgeries totally for free through Sign.
Now our theater is so busy from Sunday to Sunday: we cannot stop operating because the patients are too many.
We need to operate them in order to discharge some, and to have free beds for new fractured patients.
With the Sign nails people can walk the day after operation and normally go home 5 days after admission: no more long stay in hospital; no more complications caused by being bed ridden for longtime; no more long absence from job or painful separation from the family.
Sign gives us free implants and in this way allows people not to be disabled, not to be beggars or miserable in their lives. It is very true that the Sign Nail treats bones but above all mends lives.
In the years past, another source of deep pain for me was our pediatric department: it was full of small children on traction: we had no implants to treat femur fractures surgically, and the only way was to condemn those poor kids to months of “prison” on a traction bed.
They could not move. They were crying all through, giving more stress to mothers and caregivers. Above all the outcome was never excellent after traction: there was sometimes deformity; other times fractures were not well aligned and one limb could be shorter. Above
all children were out of school for so long!
Then Sign granted us the pediatric set and nails, and an incredible revolution started also in that department: children with broken femurs are now admitted today, operated tomorrow…they start walking the day after operation; they go home and back to school within 5 days: they leave the crutches in 2 weeks’ time and they play and run the month after operation.
I have seen kids like Evans climbing the same tree from where he fell 6 months before, without any pain, with no impairment of movement and unfortunately with no regard of the danger of falling again.
Parents are now happy. We operate children soon after trauma. They are back to normal in very short time…and nobody is excluded due to lack of money.
This is another Sign transformation, and, in my opinion, another Sign miracle.
Sign advocates for equality in fracture treatment all over the world: I cannot really say that our poor and congested hospital can be equal to a western one, but at least nowadays we offer everybody the best orthopedic surgical care, with no discrimination based on poverty. In our hospital all the patients with fracture are really equal and we try to offer them the best, through Sign.
But Sign is not only a donor.
Over the last 3 years it has been my main mentor: I receive daily feedback on the operations I do. The daily communication with Dr Zirkle has given me a lot of encouragement and new ideas on betterways of treatment; it has corrected my mistakes and it has created new skills in me.
On top of that I get sponsorship for the annual Sign Conference and for very educative post-graduate courses on soft tissue injury management, on deformity correction and on many other difficult areas of our profession.
Sign provides we with books, CDs and other teaching material, which are so valuable considering that our hospital is so remote and attending conferences or meetings is very difficult.
Therefore Sign certainly is a great donor, but also an excellent teacher for me and for our staff: surely I am the orthopedic surgeon I am today mainly through the expertise I get daily by working, sharing and reading with Sign.
And normally I disseminate that knowledge on my colleagues through weekly seminars I organize every Thursday morning.
In conclusion, meeting Sign has been a life changing experience in so many ways:
1) Sign has changed me to a better surgeon, more confident and skilled. Before meeting Sign I was doing some orthopedic surgery, but it was so little compared to what Sign has empowered me to do.
Meeting Sign has given me a kind of mindset which makes me feel a permanent student, always craving to know more for the benefit of the poor.
Sign has given me confidence. Has helped me discover talents I never knew I had. It has pushed me to believe in myself and to venture in new areas of orthopedic surgery, where people where unattended and desperate…and with Sign I learn that helping people is a self-regenerating experience where strength comes back whenever you see patients recovering. Therefore you are never tired and you are ready to start again every day.
2) Sign has changed our hospital. Surely we were a busy mission hospital even before, but we were so remote and little known. In 3 years’ time Sign has transformed us in a functioning trauma center, maybe not the most equipped in the Country, but certainly the busiest.
Now people know of Cottolengo Mission Hospital even at 600 Km away from us. They travel for days in order to receive the free Sign Nail and with it the possibility of healing quickly and completely.
Orthopedic surgery is now the main surgical activity of our theater, from Monday to Sunday, and everybody knows that here you can have your fracture fixed and you will not be refused treatment because of lack of money.
3) Finally Sign has changed the lives of so many patients, above all the poorest in the Society. I have already put about 900 nails in as many patients who could not afford treatment elsewhere.
They are now at home, back to their families, to their jobs, to their studies. In 2 years we have removed 900 human beings from poverty, from family separation, from severe delays in their studies.
The stories of our patients would be too many to be quoted. I choose Doris to be the paradigm for all the others: she had fallen from a moving lorry and she had badly broken her leg.
She was taken to a public hospital with a terrible infection and her bones exposed outside. In that hospital nothing was done because she had no money. Desperate, she tried her journey of hope towards our hospital. She did not have even a coin, but we welcomed her, we slowly took care of her infection, of the muscle and skin damage and finally we treated her with a Sign Nail.
She has been in our hospital for 6 months and nobody came to visit her, but finally Doris went home walking on her legs. She has not paid anything. Of course she remains poor and lonely, but Sign has empowered us to help her, to give her back her health and with it the possibility to live, to look for a job and to start again. And Doris is just an example of so many miracles Sign has allowed us to do for innumerable grateful patient.
Sign is a wonderful gift for us, a remarkable charitable institution and certainly a life changing experience for all of us.
Dr Beppe Gaido
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