ROMANIA PROJECT “SMART BOYS”

Title: Project Romania “Guys on the ball”

Intervention area: Romania, Republic of Moldova

Promoting bodies: AUCI-ONG (University Association for International Cooperation) – A. Gemelli University Hospital Foundation, Rome and ROMANIAN ORTHODOX DIOCESE OF ITALY.

Partner ITALY: Centro Protesi INAIL, Vigorso di Budrio (BO), Branch of Rome, Romanian-Italian Cultural Association proPATRIA, Airline Blue Air, Ossur, OttoBock and OffCarr.

Partner ROMANIA: ARCA Association (city of Iasi), Prefecture (city of Iasi).

Staff

The project staff is composed of:

Coordinators

– Prof. Pasquale DE SOLE, AUCI-ONG contact person

– Dr. Massimo LIBERATORI, medical director of the A.Gemelli University Hospital Foundation

– Dr. Franco Loreto Mele, orthopedic technician Centro Protesi INAIL, fialiale of Rome

– Father Ilie URSACHI, councilor for the social department of the Romanian Orthodox Diocese of Italy

Collaborators

These are Romanian nationals who are amputees, resident in Romania and selected by AUCI within the beneficiaries of the project, who have the task, working closely with the partner structures in Romania (ARCA Association and Prefecture of the city of Iasi) to report to the AUCI staff cases of amputees requesting help in obtaining a prosthesis.

Project identification and description:

The project has a social-health purpose and aims to intervene on the high number of young subjects with amputation outcomes of one or more limbs present in Romania (no official statistical data available in this regard) and too often left to a fate of marginalization and poverty.

Targets:

General objective:

Improve the living conditions of disabled people in Romania, promoting the right to physical integrity of the person.

Specific objectives:

Health

Solving the physical problem of the amputee who is at the base of the serious social hardship. Improve the psychological health conditions of the disabled person.

Society

Promoting social and labor reintegration, with long-term benefits, contrasting as much as possible with the phenomenon of begging and exploitation of the disabled.

Beneficiaries:

The beneficiaries are disabled persons, aged between 20 and 45, disadvantaged from a social and economic point of view, who have suffered the amputation of one or more limbs due to a traumatic event. The application of prostheses will allow patients a remarkable change in terms of quality of life. Patients are totally assisted from an economic point of view. The AUCI provides for the payment of all expenses (travel, stay in Italy, prostheses, rehabilitation treatment, various). Accommodation in Rome is provided at the Residence of Protected Hospitality within the complex of the A.Gemelli University Hospital Foundation.

Project phases: The project is divided into four phases that take place between Italy and Romania.

PHASE 1: territorial analysis, identification of new clinical cases to be submitted to prosthetic treatment, collection of data by local collaborators. For each person who submits a request for help, the collaborators in Romania have the task of filling out a detailed form with personal and clinical data and accompanying photographic material on the basis of which the project coordinators in Italy carry out a first screening of suitability cases to be treated. Once the first selection has been made, the case considered most suitable and feasible from a clinical and technical point of view is subjected to a three-month observation period by the AUCI collaborator in Romania who proposed the case, with periodic meetings with the patient to evaluate, on the one hand, compliance with the acceptance of the prosthesis and, on the other, the real motivation to adhere to the long therapeutic and rehabilitative path.

PHASE 2: transfer of the patient to Italy for prosthetic and rehabilitation treatment. The construction of the prosthesis and the rehabilitation treatment are carried out at the Rome branch of the INAIL Prosthesis Center in Vigoroso di Budrio (BO).

PHASE 3: return of the prosthesis patient in Romania, patient follow-up, resolution of technical problems and scheduled prosthesis maintenance. The AUCI collaborators in Romania maintain close contact with the patients treated and returned to their country of origin, collecting information on the use and status of the prosthesis which are then carefully stored in a personal database. The follow-up also includes the resolution of technical problems (breakage, reset, modifications) and scheduled maintenance of the prostheses. The AUCI staff carries out missions in Romania four times a year to check the progress of the project, discuss with the local partners about any project developments and / or adjustments, organize training courses and perform patient checkups. On October 14th of each year, on the occasion of the religious festival of “Sfanta Parascheva”, a social meeting (“tabara”) is then organized between the former patients and those who are still on the waiting list and the staff (Italian and Romanian) of the project in the city of Iasi.

PHASE 4: the fourth and final phase involves the development of specific and targeted social inclusion projects. The AUCI collaborators evaluate job opportunities for people with motor disabilities, through direct contact with Romanian and foreign public and private companies operating in the local area and who have offered their availability by proposing tasks that are compatible with the state of disability.

Accomplished results:

Since 2004 (beginning of the project) to date, 118 people of Romanian nationality have been assisted with 132 prostheses of high functional and aesthetic quality. Fourteen patients required the provision of two prostheses as two limb amputees.

Future perspectives of the project:

After this first definitely incisive phase, the AUCI together with the Romanian Orthodox Diocese of Italy proposes a further development of the project and of the collaborations already in place, in order to enhance the respective competences, knowledge and experiences with the aim of realizing and extending in Romania a series of coordinated interventions, able to favor a more effective social and work integration of amputees.

Target

The general objective of the new project is to implement, in Romania, a series of interventions aimed at creating the conditions to improve the autonomy and quality of life of subjects suffering from serious disabilities, in this case amputees, thanks to their job placement .

The project, far from a welfare perspective, wants to build in perspective, with the supervision of the AUCI and its partners, a series of multidisciplinary skills in the technical and health fields, currently absent or seriously lacking in Romania, able to realize in the Country a first pole for the supply of personalized devices (prostheses, orthoses, orthopedic shoes) and for the rehabilitation of those who benefited from these devices.

In fact, due to the high costs of prosthesis and displacement, a large number of Romanian amputees could hardly access the supply of prosthetic devices in countries that have advanced skills in this field.

To achieve the objectives set out above, the future scenario of the project is believed to be articulated in the following technical and health activities.

Training activity

Technical training

In Italy, in the field of technical orthopedics and rehabilitation, the specific qualifications are the degree of orthopedic technician and that of physiotherapist. Both are three-year degrees which can be accessed if you are in possession of a high school diploma. In Romania, in the field of technical orthopedics, there seems to be no professional figure equivalent to the graduate orthopedic technician, as expected in Italy. Therefore, the quality level of the devices that can be supplied is certainly not high. Consequently, using the training capacities of the A. Gemelli University Polyclinic Foundation, one could hypothesize different types of training interventions for experienced technicians, with or without academic qualifications; or of technical training of people to be identified among the prosthetic patients and benefited from the “Smart Boys” project.

Health training

The health training activity will see the Foundation Aging, Orthopedics and Rehabilitation Area involved in both the rehabilitation (physiotherapists) and the medical-surgical (orthopedic) part.

This area is considered a center of high specialization, both nationally and in Europe, in the application of conservative surgical techniques in the treatment of tumors of the musculoskeletal system.

In most cases these are primitive tumors, both of pediatric and adult age, whose treatment involves the application of complex reconstructive techniques (prostheses, homeoplastic bone grafts, vascularized fibular grafts etc.) and which often require involvement of other surgical disciplines (plastic surgery, thoracic and general surgery, vascular surgery, microsurgery). The specialized skills and competences of this Area could be a reference point, on a national and European basis, in the ultra-specialist training in orthopedic oncological surgery of surgeons already specialists in orthopedics, from Romania.

The vastness of the cases of the oncological pathology of the musculoskeletal system is a phenomenon shared throughout the medical-scientific world, while the complexity of the commonly used surgical treatments is still today the heritage of a few specialist centers. The training capacities of the A. Gemelli University Polyclinic Foundation can therefore be used with excellent results in this training project, addressed to a country like Romania, which does not have specialized orthopedic traditions in the treatment of the oncological pathology of the musculoskeletal system . A further aim of the training project in partnership could be to create a university center highly specialized in orthopedic oncological surgery in the city of Iasi, with the ambition of becoming a pilot and reference center, in Romania, in the treatment of neoplastic bone disease, and in turn training center under the strict guidance and supervision of the Italian center. A university-training bridge will thus be created between the A. Gemelli University Polyclinic Foundation and the Faculty of Medicine and Surgery of the University of Iasi, structured so as to provide, on the one hand, theoretical-practical training on recent acquisitions in theme of musculoskeletal oncological pathology and, on the other, cultural interchange between specialized university centers.

Learning, in Italy, of conservative orthopedic surgical techniques, the correct application of the acquired knowledge and their routine use in the treatment of neoplastic pathology of the bone and soft tissues will result in a considerable reduction of limb amputation interventions for malignant tumor diseases of the musculoskeletal system.

In the health-rehabilitation field, training could also be envisaged – and this is another of the most innovative and important aspects of this intervention – by physiotherapists, to be held always at the Foundation’s facilities, understood as professional updating activities, of already trained physiotherapists; this training activity must be focused primarily on the upper and lower limb amputees. Finally, it is emphasized as an introduction to the training activity to be carried out in Italy, an insertion of the participants within a course of learning the Italian language to be held in Romania.

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