August 7, 2008

During Ahmed’s three weeks here from Survivor Corps headquarters in DC, he and I had the opportunity to make a second field visit. This time, we went to two of the few prosthesis centers in Jordan that treat the public and met three incredible survivors, all of whom are Iraqi refugees. This blog is about Ali, a 30 year old man who has been a refugee in Jordan for 12 years. He has been an amputee since this time, as well.

Ali has a relatively rare type of amputation: hip-disarticulation, a very serious and severe procedure in which the leg is removed from the hip. Since his amputation, Ali has been confined to a wheelchair. On the day that we met Ali, July 30th, this was hopefully going to change, as he would be trying out his new prosthesis for the first time.

Because of the severity of hip-disarticulation, prostheses for these types of amputations are extremely expensive. Additionally, because of the rarity of this condition, most prosthetists are not adequately skilled in providing such a complex prosthesis as that which is required for such an amputation. Fortunately for Ali, LSN-JO received funding for an Iraqi refugee program and began providing services to these survivors in April 2008. Thus, LSN-JO took up Ali’s case, which meant that they would cover the costs of his new prosthesis and medical visits, as well as provide him with the peer support that is the core of what LSN provides for its survivors.

Although this was a very personal moment for him, Ali wanted me and Shireen (his social worker), two women, as well as Ahmed, to come into the room and watch his first attempts at walking since his amputation. I was nervous at first, feeling a little awkward and embarrassed. But as soon as I saw him standing there, gripping the parallel bars with all his might, his arms and remaining leg shaking from the strain of holding himself up, with the biggest grin spread across his face, all that anxiety fell away and I smiled, laughed even, and held back the tears of joy that were threatening to escape.

After standing for only a few seconds, however, Ali had to sit back down. He became lightheaded as the blood rushed from his brain down to his leg, which he had not stood on since his amputation 12 years ago. But this didn’t stop Ali. After regaining his equilibrium, he was up again, this time taking two or three steps away from his wheelchair before sitting back down again. Ali did this repeatedly for the next 15 minutes as we stood there watching, cheering him on. I will never forget the look of pride that I saw in his face, a look that seemed to represent a renewed belief in himself, in his worth, and in his capability as a human being.

So, what’s next for Ali? It will take him several months to learn how to use his prosthesis and rebuild the strength in his right leg to be able to support himself for an extended period of time, even with a walker. And after that? Get a job? Go back to school? Unfortunately, it’s not that simple. While providing Ali with a prosthesis will provide him with more mobility, Jordan’s infrastructure still presents challenges and obstacles for people with disabilities, particularly lower limb disabilities. For example, Ali mentioned that he has essentially been confined to a small area around his home because none of the public buses in Amman are wheelchair-accessible. Having been on one of these buses myself, I can tell you that they’re not exactly handicap-accessible either, having high steps to climb onto the bus and always being extremely crowded (and thus, not having room for an individual with a walker and who will require a seat). Additionally, most, if not all, of LSN-JO’s survivors who live in Amman live in East Amman, which is where the city was originally founded. This area of Amman is old and simple things like sidewalks, which are so dilapidated and uneven, become considerable hindrances for individuals with lower limb disabilities. What’s more, East Amman was built upon seven hills, which one must either walk up and down or climb the numerous stone and cement stairways that are scattered throughout the hillsides. All of this poses a problem for someone in Ali’s situation.

Unfortunately, not much is currently being done about issues such as these. Although Jordan was one of the first nations to sign the United Nations Convention on the Rights of Persons with Disabilities, not much progress has been made in putting it into action. I must say, however, that the Jordanian government is very supportive of organizations and programs that work with individuals with disabilities. It’s just that the types of programs it likes to support are things like sports teams and the integration and inclusion of individuals with disabilities into society. While these are great programs, the government should also be focusing on such things as infrastructure and accessibility. Because, I mean, it’s kind of hard to go out into your community or get to your volleyball game if you can’t travel down the sidewalk or access the public bus.

I noticed this wheelchair ramp at the Citadel, a tourist site in downtown Amman. I found it amusing, yet discouraging at the same time, because as soon as one were to get to the bottom of the ramp, he/she would be unable to progress further, having to face uneven ground and openings in the path that are not wide enough for a wheelchair to fit through.