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Making everyone ‘Stand Tall’

14 May 2009

Jianggan Li

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The Stand Tall initiative has been started by a dedicated medical fraternity in China to use communications technology in innovative ways for rehabilitating survivors of the deadly earthquake that hit the country in May last year.

A year ago, on 12 May 2008, a deadly earthquake in the western Chinese province of Sichuan took many by surprise.

Stand Tall Initiative - China
Image credits: futureGOV / Prof. K. M. Chan helping one of the young amputees

The catastrophe, which left 69,227 people dead, also created a big social problem that many might not be aware of. More than 1000 young survivors have suffered amputation – a traumatising experience.

And in Mainland China, where rehabilitation of amputees has not yet been widely practised, with patients left on their beds for recovery, a few orthopaedics and traumatology specialists in Hong Kong felt that they should do something.

Convened by Professor K M Chan, Chair Professor & Chief of Service at Prince of Wales Hospital’s Department of Orthopaedics & Traumatology, the Stand Tall initiative was launched a week after the quake.

More than 100 doctors and nurses, mainly from New Territories East Cluster of the Hospital Authority, took leave from their hospitals and joined the ranks of Prof Chan.

This is a group of extraordinary individuals.

“We need to ensure that they are not only physically recovered, but also psychologically rehabilitated,” says Herman Lau, Allied Health Co-ordinator of Stand Tall.

An associate professor in Rehabilitation Sciences, Lau also manages the Physiotherapy Department of Prince of Wales Hospital.

Lau says it is a great joy to see the amputees stand for the first time, jump for the first time, and play ping-pong for the first time.

Four patients with potential have been selected to be trained for Paralympics. In fact, the Ambassador of Stand Tall, Yu Chui Yee, an amputee herself, was a gold medallist in both 2004 and 2008 Paralympics.

“We want to adopt the latest technology to facilitate their return to the community and ensure they have an active lifestyle,” Lau comments. “That includes materials science, mechanical engineering and communications technology.”

“A particular challenge for young amputees is that when they grow, they have to undergo repeated operations and change prostheses regularly,” says Dr Law Sheung Wai, Consultant in Orthopaedics & Traumatology at Prince of Wales Hospital. “It’s a long journey for each of them.”

That’s why the Hong Kong government has committed HK$250 million (US$ 32 million) to establish a rehabilitation centre, which will be permanently located in the premises of Sichuan Provincial People’s Hospital.

Communications technology is essential as volunteers from Hong Kong will not be in Sichuan permanently, and local medical staff need to be trained to take over. “We also want to set a role model to increase the standard of rehabilitation in China,” comments Lau. “That includes inviting experts in the field all over the world to share their experience.”

“Our rehabilitation concept is quite advanced, involving not only medical specialists but also occupational therapists,” says Lau. “We need to provide frequent medical consultation and training.”

“And with IT systems,” he adds. “We can do all these very easily.”

Stand Tall has recently installed a TelePresence system, donated by CISCO systems, which also provided technical assistance. “This is specifically tailored to our needs,” comments Lau. “They provide real-time video and the images are clear.”

Different from the system often used for videoconferencing, this version has been made to allow closer contact between the consultants and patients at the other end.

Stand Tall is also facilitating the transfer of video clips of operations in Hong Kong to Sichuan for local doctors and nurses to learn from the experience of orthopaedics and traumatology in Hong Kong. Optical fibre links have been established between the operating theatre and the TelePresence room.

Furthermore, patients will not be permanently stationed in the rehabilitation centre – many will go back to their towns and villages to start a new life or resume their previous life. Stand Tall and Sichuan Provincial People’s Hospital plans to use mobile vans for consultations down to the local level.

“Mobile vans have to use expensive satellite links to ensure that they are effective; and we need experts who are willing to go to rural areas; besides, we need to establish a cost-effective schedule,” comments Dr Law. “There is a lot of work ahead for us to make this happen.”

The charity is currently negotiating with telcos to try to bring the cost of bandwidth down to an affordable level.

In addition, a web-based teaching system will be set up for the transfer of knowledge to local clinicians and specialists. Dr Law says this complements the TelePresence system as it pulls all the information, including video tutorials, together for receiving doctors to access whenever they want.

“Even if they only have a dial-up network, they will be able to download the content and watch after the work,” Dr Law comments. “It gives you lots of flexibility.”

In addition to providing the teaching material, doctors from Hong Kong will also help their counterparts in Sichuan to assess their learning online.

According to Lau, the CISCO WebEx based system is the first web based medical training facility in China.

“That is a very good start for us,” he says. “We know the language and we have the skills and knowledge; and we want to transfer all these to benefit patients on the Mainland.”

Lau hopes to have the two systems integrated together, with the rehabilitation centre as the database centre and communications centre. “We hope to train more than 1000 medical professionals,” he says. “And this experience will help us expand our rehabilitation knowledge base further.”

Source : futureGOV

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