END THE PAIN PROJECT MIRROR THERAPY WORKSHOPS EXPAND TO SIERRA LEONE

Jean Luc Ngambre training Mondeh Abdulaziz

Cutting off peoples’ limbs, in most cases their hands, was one of the brutal strategies used by members of the Revolutionary United Front to terrify people to support them during the 1991-2002 civil war in Sierra Leone. 

Some 27,000 Sierra Leoneans are estimated to have been disabled or have had one or more limbs amputated during that time. Many of these amputees still suffer phantom limb pain years after the war.

End The Pain Project addresses this lingering problem with the training of Mondeh Abdulaziz on November 19-20, 2016 by ETPP Senior Trainer Jean Luc Ngambre in Burera District, Rwanda. 

 Mondeh Abdulaziz, Mirror Therapy Practitioner

Mr. Abdulaziz received certification as an ETPP Mirror Therapy Practitioner on December 5, 2016 and will offer the effective pain-eliminating therapy at peer-to-peer workshops for amputees  in Sierra Leone upon his return.

Sierra Leone now joins Rwanda as part of ETPP Pan-Africa headed by Jean Luc Ngambre.

Mirror Therapy Adria Holds Successful Mirror Therapy Workshop in Fojnica

From left to right (standing) as Emira Klisura-Bosnia, Samra Karač-Bosnia, Antonela Pavić-Croatia, Tarik Žetica-Bosnia, Matej Bedenik-Slovenia, Edis Kozić-Bosnia; (seated) Jasmin Avdović-Mirror therapy Adria MT trainer, Nikola Dobrijević-Croatia

On October 17, 2015, Mirror Therapy Adria organized a Mirror Therapy Workshop for Physical Therapy Practitioners in the central Bosnian town of Fojnica. The town is well known for the biggest thermal and rehabilitation spa center in Bosnia and Herzegovina.

Most amputees in Bosnia and Herzegovina have used the services of this thermal spa center at least once. Most return on a regular annual basis for continuing treatment.

Recently this thermal spa become the site where all persons with war related injuries including traumatic amputations are transferred from Libya to receive proper rehabilitation treatments. So it is not strange that there is a high interest in Mirror Therapy education and implementing it as regular daily based treatment at the spa.

Participants of the full day MT education according to End The Pain Project guidelines, received MT certificates entitling them to practice as mirror therapists. The Workshop was successfully led by Adria Mirror Therapy trainer, Jasmin Avdović.

The participants came from Bosnia and Herzegovina and neighboring Republic of Croatia and Republic of Slovenia. The participants from Croatia and Slovenia are the first mirror therapists in their countries.

Mirror Therapy Workshop for Amputees at Bisesero Village Rwanda

Bisesero Village Amputees  Participating in Mirror Therapy Workshop

June 20, 2015 found 40 Rwandan refugees who returned to Rwanda from the Congo attending an outdoor Mirror Therapy workshop led by ETPP Rwanda representative, Jean Luc Ngarambe at  Bisesero Village, a refugee camp. 

 Enthusiasm to learn the effective Mirror Therapy procedures was very high among the 20 amputees and their 20 family members. Many questions were posed and were able to be answered by the ETPP representative, who is a certified physiotherapist.

A Teaching Moment with the Amputees of Bisesero

Amputees said that they appreciated this practice to reduce pain because though they feel phantom  limb pain, when they explain their pain to clinical health providers, none understand phantom limb pain. Often they return home without any treatment. 

They also realized the importance of teamwork in helping the amputee practice Mirror Therapy to reduce the phantom limb pain.  

This Mirror Therapy workshop for amputees is the second successfully conducted by Ngarambe at Rawandan refugee camps. 

 

MIrror Therapy Presented At 1st International Physiotherapy Congress in Montenegro by Jasmin Avdovic

Jasmin Avdovic training Congress participant

Mirror Therapy trainer Jasmin Avdovic from Sarajevo, Bosnia and Herzegovina, presented a one hour Mirror Therapy workshop as part of the official program of The 1st International Physiotherapy Congress on 10/09/14 at Institute Dr.Simo Milosevic in Igalo, Montenegro. The Institute, one of the largest and the most famous institutions for multidisciplinary spa treatment on the Balkan peninsula, is a pioneer of modern physical and preventive medicine, rehabilitation, talasotherapy and wellness and a leading international rehabilitation center.


Over 120 Congress participants were introduced to the Mirror Therapy technique by Avdovic through interactive presentations and demonstrations that allowed participants to feel for themselves the basic principles of Mirror Therapy and body reactions to it.

Besides the large number of health professionals attending this workshop, national physiotherapy associations and certain health institutions from Slovenia, Croatia, Bosnia and Herzegovina, Serbia, Montenegro, Macedonia, Kosovo, Albania, United Kingdom and others participated as official representatives of their national associations. Many representatives expressed interest in organizing full-day Mirror Therapy workshops.

Mirror therapy in the Balkans is important because of the high number of limb amputations, primarily in Bosnia and Herzegovina, as land mine fields were the worst  in world, followed by Croatia and Kosovo.

Jasmin Avdovic also explored the importance of using Mirror therapy for stroke, aneurism, traumatic brain injuries and others neurological disorders and conditions) with the participants. This Mirror Therapy workshop successfully left a huge imprint for future MT education in south-east Europe.

Video of Mirror Therapy Workshop August 20, 2014, Gihembe Refugee Camp, Rwanda

This video of the Mirror Therapy Workshop held on August 20, 2014 at Gihembe Refugee Camp, Rwanda is conducted in Rwandan.

However, enthusiasm for the procedure is captured on the faces of the participants.

Vietnamese Amputee Demonstrates Effective Mirror Therapy at 5th Annual Cluster Munitions Convention in Costa Rica September 5, 2014

Credit: Thao Griffiths

Pham Quy Thi who lost his right hand and part of his right arm to a hidden landmine explosion, made the long journey from Vietnam to the Costa Rican Cluster Munitions Convention to demonstrate the use of ETPP Mirror Therapy as a means to diminish or end Phantom Limb Pain for amputees. Mr. Pham traveled under the auspices of Project Renew, Dong Ha, Quang Tri, Vietnam.  

Credit: Thao Griffiths

Mr. Pham's demonstration totally captivated the attention of the Meeting of States delegates who attended his side event at the Convention on September 5, 2014. For further information about Mr. Pham shedding 36 years of Phantom Limb Pain through Mirror Therapy, please refer to the blog of December 5, 2013.

Attendees at ETPP Mirror Therapy Workshop at Gihembe Refugee Camp, Rwanda

On August 20, 2014, a Mirror Therapy Workshop led by ETPP Representative, Jean Luc Ngarambe (far left) was held at the Gihembe Refugee Camp in Rwanda.

The Workshop was attended by fifteen amputees and ten family members who will act as coaches for their kin in home-based therapy procedures.

Amputee and Family Member Coach

The participants, Rwandan refugees from the Congo, were each given a mirror and guided through a Mirror Therapy session by Jean Luc Ngarambe.

Upper Limb Amputee Involved in Mirror Therapy

The amputees expressed gratitude for this focus on relief of existing Phantom Limb Pain and planned to follow the thirty-day schedule faithfully. Their outcome will be posted in October.

Lower Limb Amputee Involved in Mirror Therapy

Mirror Therapy Introduced To Bosnia

Bosnian Health Professionals

Though the war in Bosnia ended more than twenty years ago, there are still many amputees left who experience debilitating phantom limb pain.

To address this wide-scale problem, five Mirror Therapy workshops were presented in Bosnia during September '13 by Moira Judith Mann, co-founder of End The Pain Project .

The workshops marked the beginning of certified health professionals training other health professionals in Bosnia, with the expectation that Mirror Therapy will eventually reach amputees suffering phantom limb pain throughout the Balkans.

Training with mirror

Two workshops were held at Hope87 headquarters in Sarajevo, arranged by Dr. Amira Karkin-Tais and Dr. Murid Muftic and coordinated by Zana Karkin and Ivana Vujasin of the NGO. Fifteen health professionals received ETPP certificates of completion, which enables them to teach the therapy to other health professionals.

In Banja Luka, two workshops were presented to sixteen staff members of the ZFMR Rehabilitation Hospital through the cooperation of Dr. Natasa Tomic, ZFMR's Medical Director.

Banja Luka amputee using mirror

A workshop presented directly to amputees suffering phantom limb pain was held at the Organization of Amputees UDAS in Banja Luka, organized by Nikola Zec. The results were astounding and included the unfurling of phantom fingers by an amputee who had been experiencing a phantom clenched fist for twenty years after a device exploded in his hand.

Jasmin Avdovic, Physiotherapist/Occupational therapy practitioner, introduced Mirror Therapy training as an idea for future to 260 fellow physiotherapist members of UFFBiH in October, at their 1st Annual Congress. Participants from Bosnia, Serbia and Croatia responded to it with great interest due to high number of people with amputation, especially in Bosnia. He and others mentioned in this post plan to spread the benefits of Mirror Therapy through pan-Balkan workshops.

IASP Insight article by Moira Judith Mann: Vietnam Mirror Therapy Project Expands to Cambodia

The International Association for the Study of Pain's first issue of its printed member newsletter,  IASP Insight, includes Moira Judith Mann's Vietnam Mirror Therapy Project Expands to Cambodia. The full article, which appears on pages 16-17 in the June 2012 newsletter, can be read online at: http://www.iasp-pain.org/Content/NavigationMenu/Publications/IASPInsight/default.htm

HOE --AN INSPIRED AMPUTEE CALLIGRAPHER

Meet Hoe, whom I met on my recent trip to SE Asia to teach mirror therapy ... one of the most amazing people on the face of the earth. --Moira Judith Mann

Hoe, a 42-year old double upper limb amputee is a self-taught calligrapher who started practicing the art twenty years ago after an industrial accident in China severed her left arm and her right hand.

 Hoe straps a calligraphy brush to her right arm stub and then, as she reports, uses her phantom hand to guide her strokes.

 Hoe produces calligraphy by donation from a street stand in Malaka, Malaysia, supporting two daughters going to university in China with her earnings.

Even twenty years after her accident, Hoe experiences phantom limb pain, particularly in the remaining stub of her left arm. End The Pain Project has taken steps to relieve this pain through various methods, including Farabloc and an EMF band.

Hoe has great dignity and focuses on perfecting her calligraphy style. She hopes to inspire other amputees through her efforts.

Hoe explaining her calligraphy at her street stand in Melaka, Malaysia.

 Hoe and Moira Judith Mann, Co-Founder of End The Pain Project in December 2011, Melaka Malaysia.

 

In February, 2012, Shannon Nill, an upper arm amputee from Oregon, displays the calligraphy created for him by Hoe in gratitude for an EMF band donated by Nill that helps her sleep. Nill uses the EMF band for sounder sleep as well.

Mirror Therapy Training at Three (VIC) Veterans International Cambodia Physical Rehabilitation Centers - 12/2011 -01/2012

This is an account of a recent mirror therapy training trip taken by Moira Judith Mann, Co-Founder of End the Pain Project to Cambodia.  The results indicate that mirror therapy to alleviate phantom limb pain for the many amputees in Cambodia will be spread by the 29 physiotherapists who participated in the workshops.  ETPP Workshops in other third world countries with large amputee populations can be made possible with your support.

Khuonh Barang, 24, lost his leg above the knee six months ago in a road accident. He suffers phantom limb pain which he feels in the toes and sole of his phantom leg and most of the time he feels heat at the same places.

Physiotherapists at the Veterans International Cambodia Physical Rehabilitation Center in Kratie, Cambodia, prepare Khuong Barang for a Mirror Therapy session. They explain the purpose and instruct to Barang.

 Song Sit, PT Clinical Mentor instructs a Technical Coordinator at Kratie Physical  Rehabilitation Center with initial assisted Mirror Therapy movements.

Song Sit explains the suggested schedule for Barang for self-administered Mirror Therapy. Barang was given an instruction print-out with his native language to follow each day.

Khuonh Barang reports that after 20 minutes of concentrating on the mirror image of his intact leg, he no longer feels hot in the sole of his phantom foot and that the pain was highly reduced.

The day after the initial Mirror Therapy, Khuonh Barang reported better sleep and seemed in higher spirits than the day before.

 

 Physiotherapists at Kratie VIC Physical Rehabilitation Center studying Mirror Therapy. Song Sit, a PT clinical mentor for the three clinics of Veterans International Cambodia, is a regional member of IASP.

Mrs, Em Poth, a diabetic who recently had her foot removed, learns about movements to use in Mirror Therapy.

 A positive response to Mirror Therapy was reported by the diabetic amputee to the clinical staff at Kratie Center.

 Physiotherapists at the Kien Khleang Physical Rehabilitation Center for the Disabled, practicing Mirror Therapy. The object is to experience the sensations that come up when concentrating on the mirror image for twenty minutes. This will enable them to understand the process that their clients will undergo.

Ms. Um Naikim, a Prosthetist and Orthotist, uses ETPP Table Top Mirror Tent for practice at Kien Khleang National Rehabilitation Center for the Disabled,.

 Mr. Wa Sarun, a bench technician  at the Kien Khleang Physical Rehabilitation Center for the Disabled and an amputee, was sceptical about the benefits of Mirror Therapy prior to working with a mirror.

 After one session, his experience convinced Mr. Wa that Mirror Therapy was effective in subduing an almost constant pain he has endured since stepping on a land mine.

 Mr. Mao Sophan, a prosthetist and Orthotiest in Kien Khleang Physical Rehabilitation Center, is practising mirror therapy using an inflated glove for slow movements in front of a mirror.

 Mr. Ull Meng Hour, Site Manager of the Prey Veng Physical Rehabiitation Center stepped on a land mine in 1984 and still suffers periodic bouts of phantom limb pain.

  
Mr. Ull had positive results from his first session of Mirror Therapy. He concentrates on the mirror image of his intact leg using a distortion-free unbreakable plastic donated by the non-profit charity, End The Pain Project.

 Prey Veng Physical Rehabilitation Center. clinical staff concentrating on mirror images.

 Physiotherapist, Prosthetist and Orthotist at Prey Veng concentrate on mirror images.

 Other Physiotherapists at Prey Veng concentrate on mirror images.

Bouth Vorn, 53 years old, stepped on a land mine in Prey Veng Province seven years ago. He received a small grant from VIC to establish his motor and bicycle repair shop.  At least two times a week his sleep is disrupted by severe tingling pain in his phantom large toe that spreads to his stump.

 Mr. Bouth’s eight-year-old daughter, who might be of some limited assistance when Mr. Bouth, a widower, practices Mirror Therapy at home.

 Mr. Bouth experienced some relief the first time practicing Mirror Therapy. Though he did not believe the method would work, at the end of the session he experienced some changes that convinced him to continue practising.





 

ETPP Co-Founder brings Mirror Therapy techniques to Vietnam and Cambodia

The focus of a December 2009 trip to Vietnam and Cambodia for Moira Judith Mann, ETPP Co-Founder, was to present mirror therapy techniques,  prototype unbreakable plastic mirror systems, ETPP ToolKits translated into Vietnamese and Khmer and PrismGlasses to the Vietnamese Training Centre for Orthopaedic Technologists (VIETCOT) in Hanoi, PeaceTrees Vietnam, an NGO based in Dong Ha that services over 600 landmine victims, The Cambodian School of Prosthetics & Orthotics (CSPO), Kien Khleang National Rehabilitation Center in Phnom Penh, CHA, an NGO in Phnom Penh, as well as two designated ETPP representatives who will bring mirror therapy to hill tribe villages in the former DMZ, Quang Tri Province. 

The mirror therapy information and the use of non-breakable plastic mirrors were enthusiastically accepted and will be incorporated into the VIETCOT curriculum, as well as becoming part of the treatment offered at the Kien Khieang National Rehabilitation Center and CHA.  In addition, an outreach connection was made with Catholic Charities of Sri Lanka.