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Senior prosthetist and orthotist Technician and Trainer - DPRK


Country Democratic People’s Republic of Korea (DPRK)
City/site Position based in Pyongyang, DPRK Capital but with frequent travel to Hamhung
Department / project Support of services and structures for persons with disabilities in the DPR Korea
Number of employees According to the particular context of DPRK, none of the staff is under HI contract. Nevertheless, the expatriate will work with a team working at physical rehabilitation centres and with KFPD project officers in Pyongyang. She / He will have a permanent translator.
Size of the team N/A
Title of the position Senior Prosthetist & Orthotist Trainer (P&O trainer)
N+1 Country Director based in Pyongyang N+2 N/A Direct team management No direct management but the P&O trainer will have to work with the staff of the orthopaedic centres in as well as with KFPD project officers Indirect team management N/A Budget responsibility No Contract Fixed-term contract of 8 months, full time Expected date of arrival March 2013 Duration of the mission 8 months International travel In / through china
Travel between sites yes Possibility of a couple No Possibility of children No
Description of the programme and the projects
HI commenced its activities in DPR Korea in March 2001, implementing projects jointly with the Korean Federation for the Protection of the Disabled People (KFPD) which is a quasi-civil society organisation under the umbrella of Ministry of Public Health.
Our partner, the Korean Federation for the Protection of Disabled People first requested our support to modernise the orthopaedic production in Hamhung orthopaedic centre and is now broadening its request to various disability sectors such as capacity-building, advocacy, education and livelihoods.
Since 2009, while pursuing its support to the rehabilitation sector, HI has been building the capacity of its national partners KFPD in the areas of Project Cycle Management, Organizational development, Disability Knowledge Management, Education and Livelihoods. The project also lead to the creation of the Korean Foundation for the Protection of the Disabled and Orphans (KFDO), a sub branch of KFPD, enabling the development of further projects as well as a representation office in Beijing with the double focus of networking in the disability field and being an interface with potential international donors outside the DPRK.
Please note that due to political reasons, HI does not officially exist in the DPRK and as such is known under the name of EUPS Unit 7 (European Union Program Support Unit 7). Expatriates are considered as technical experts from the EU delegated to the Ministry of Foreign Affairs.
For more information concerning the context of work in this country, please consult our internet sitewww.handicapinternational.be.
History, context and evolution of the job
HI starts its activities in DRP of Korea in March 2001. A prosthetics workshop using the PPP technology and a small physiotherapy section have been set up in the city of Hamhung within the compound of a large orthopaedic centre: the Hamhung Orthopaedic Factory (HOF). In late 2004, a totally new equipped workshop has been constructed in the compound of the HOF, the Hamhung Physical Rehabilitation Centre (HPRC).
About 18 technicians have received training for BK and AK prosthesis production while most of them have got further training in PFP, Upper limb Prosthetics, KAFO and Spinal orthotics. 4 other Korean staffs have been trained for basic rehabilitation treatments. Next to that, 4 Technicians have been trained as ISPO Cat II in VIETCOT School in Hanoi. 2 of them are employee of the HPRC and ensure regular training in Hamhung in order to complete the work done by the former expatriate. The 2 others are workers of the KFDO (Korean Foundation for the Disabled and the Orphans) and work as researcher and lecturers. They also sometimes practice: one in Hamhung PRC and one in Songrim PRC (PRC formally supported by ICRC). In 2009, in a perspective of ensuring sustainability, HI has decided to invest (in terms of human and material means) in the resin technology. However, up to now, HPRC has not yet shifted to the use of this technology.
Since 2007, HPRC has been involved in mobile camps in remote area consisting in two phases: assessment and then provision of orthopaedic devices. The team of the mobile camps is composed of 5 P&O, 1 physiotherapist from HPRC and 2 implementing staff from KFPD. It has to be noted that these mobile camps do not provide PPP devices but rather wood and leather devices.
In parallel, Pyongyang Rehabilitation Unit has been rebuilt thanks to the support of Handicap International. This unit is supposed to act as a repair unit. The technicians have been partially trained.
Finally, it has to be noted that by the end of 2010, HI has decided to shift its support in orthopaedics from a direct support to a more indirect one, at least, as far as the raw material is concerned. Apart from supporting KFPD in finding alternative sources of funding for the raw material, HI is facilitating discussion between KFPD and ICRC how is interested in supporting orthopaedic centre although the context does not ease the collaboration. The raw material order for 2013 will have to be made mainly in the region. Considering the fact that in China the raw material sold is mainly raw material for the production using resin technology and for the use of modular endoskeleton components, HPRC P&O technician need to be ready to produce using this technology in the beginning of 2013. However the technicians already produced sockets with resin. They did very few but they know the process and need practising. A problem is the use of modular components. At the moment, they use only CRE exoskeleton components and are not familiar with the others. The resin is a perishable product and a health hazard. It cannot be stored for many years (unlike polypropylene) and must be renewed regularly. At least a purchase for one year is reasonable. Concerning the conservation with low temperatures, advices have been given by the consultant who came in December 2012. Anyway, the problem of low temperature is not so critical; some precautions will be taken for that. Anyway, the PP technology and the conventional will remain in the workshop and the mix among them is strongly recommended according to the cases faced.
Responsibilities
Training:
Training of the 15 Prosthetists and Orthotists (P&O) in the use of modular components and resin technology for prosthesis.
Training of the 2 Category II ISPO Certified P&O technicians (Monitor and Vice-Monitor) and the other P&O technicians of HPRC with those technologies. The 15 technicians already know all the basics of orthopaedics (biomechanics, prosthetic alignment, correction, fitting ...), so it is more a question of providing additional training on the following technical points that are related specifically to this type of technology: - Manufacture of resin sockets - Assembly and alignment of prostheses with the use of different types of modular components (pyramid device, adapter for 4 screw pyramid, mono-axial and poly-axial prosthetic knees and disarticulation of the knee cap, tube, part of the ankle pyramid ...) - Settings of prosthetics - Creation of cosmetics - Finishing of resin prosthetics
Considering that each technician will have to manufacture in an autonomous way the following devices: - 2 trans tibial prosthesis with the use of 2 different components of connection to the socket (male four prong with pyramid + adjustable socket coupling) - 2 prosthesis trans femoral using two different types of knee joints (single axis knee joint with manual lock + four bar linkage knee joint) - 1 through knee prosthesis using a specific knee (knee disarticulation joint) If possible (if patient is available), in addition to the devices listed above, a hip disarticulation prosthesis will be manufactured as a demonstration.
Training in “hybrid” technology
The P&O trainer will also train technicians from the workshop of HPRC to manufacture "hybrid" prostheses (by making polypropylene sockets of any color (instead of the resin) mounted on components covered with cosmetic foam) by showing them how to mount the sockets on the polypropylene modular components. Same with the use of resin sockets on exoskeleton components.
Despite the technology that is implemented, the trainer will have to assess the quality of the component used (quality during production and during patient follow up) and give recommendations regarding the technical choices.
Follow-up of the training
The trainer would accompany/follow-up in particular the two technical managers at the HPRC (Monitor and Vice Monitor, who are the best ISPO Category II orthopedic technicians trained at VIETCOT) in order to ensure they have the capacity to monitor the production of the orthopedic technicians in this area. As for the other orthopedic technicians at the workshop, the monitoring during training will be conducted by the Monitor and Vice Monitor, who will themselves be supported / backed by the P&O trainer.
Refresher and complementary Training of the PRU technician for repair
The PRU is a repair unit situated in the center of Pyongyang City. Its aim is to provide repairs for prosthetic and orthotic devices and basic physiotherapy services. The unit has been completely rebuilt in 2010-2011 thanks to the support of the European Union, basic equipment has been provided and the technicians have received one month of training. While in Pyongyang, the P&O trainer will provide refresher training for the PRU technicians and upgrade their skills to enable them to repair device made with resin technology and modular endoskeleton components
NB: Being the last P&O support foreseen, the P&O trainer will ensure that all Corresponding training material is made available in English.
Support to consumable and material order:
As in 2013 the HPRC technicians will have to change the technology and use the resin one, the P&O trainer will support the HPRC monitor & vice-monitor and the KFPD rehabilitation project officer in identifying the correct needs for the next order for 2013. In order to be fully functional, the PRU, as well as the mobile Unit, needs some additional tools. The P&O trainer will support the identification and purchase of those additional small equipment.
Support to National rehabilitation strategy development and implementation:
Draft a framework (ToR) for conducting the mobiles units (goals and limits) It is important to note that the activities carried out by the mobile teams have limits and they can never be a substitute for rehabilitation centre which have all the necessary means and equipment to provide quality treatment. The P&O trainer, in collaboration with the physiotherapist will support KFDP rehabilitation department to write an explanatory document setting forth firstly the objectives of the mobile teams, as well as activities that they can carry out, in order to lay a framework and to define precisely the boundaries of these actions. This document would as well capture the precise impact of these outreach sessions in order to increase its needed strength in number and quality. The role of each professional (physiotherapist, P1O technician, bench worker) and its prescription capacity should be described in order to model this activity in the future and ensure efficient use of human resources for this outreach activity.
Standardization of rehabilitation education programs: Several technicians are working in the country with different expertise, coming from the training process, the activity in their workshop, their education background… In order to start an organization of the profession, the P&O trainer will work on curricula and process of validation with the partner of KFPD. It could be possible to include in the reflection the Education Board Committee of ISPO for a more formal and international result. This work on education program will also take in account a global education strategy based on a multidisciplinary approach with the collaboration the physiotherapist.
Global strategy regarding the technology use in DPRK: One challenge of the Physical rehabilitation center sector in DPRK consists in the sustainability of the consumable and material supply. The P&O trainer will assist KFDP rehabilitation department to analyzing the distribution network; the potential alternative supplies (ex. Testing quality of resin other than the one from the “prosthetic suppliers”) and supplier in the region as well the corresponding need of equipment.
ICRC collaboration ICRC is interested to collaborate with KFPD in the field of rehabilitation. Even if the DPRK context does not at all facilitate this type of collaboration, there are some possibilities. HI having decided to gradually step out of the rehabilitation sector, there might be interesting area of collaboration with ICRC. The P&O trainer would be requested to further discuss the possibilities with ICRC, keeping in mind the limitations due to the context. Those discussions will have to be made together with the Country Representative of EUPS Unit 7.
Contribution to the general management of the DPRK program
As part of Unit 7 team, the P&O trainer will contribute to the general management of the project by: - participating to coordination meeting and providing input to the monthly reports; - Provide input into the Country Review framework. - Providing technical inputs regarding donor reporting and identification, formulation of new projects or re-orientation of existing projects. - Liaise with Technical Resources Department of HI federation.
Travel According to responsibilities listed above, the mission’s location will be spread between Pyongyang and Hamhung.
Profile required for the job
The candidate will have to demonstrate an ability to understand the context of the country, understand the political and logistics constraints, which will affect any project here. He/she will be able to integrate those realities in his/her recommendations. His/her analysis skills will enable him/her to translate all the information collected in practical and precise recommendations.
Secondly, he/she will be able to organize his/her time with efficiency and flexibility according to possible restrictions or administrative constraints/obligations.
Knowledge • Degree(s), diploma(s): degree in orthopaedic level 1 or level 2 senior (10 year experiences); good knowledge and practice in the resin technology. • Knowledge on logistic process & procedures. • Language(s): English is the working language, candidate must have a good written and spoken knowledge. Skills • Experience in teaching methodology • Experience in appropriate technologies (conventional, resin, PP and exoskeleton and endoskeleton components)
Personal qualities • The success of a mission in North Korea depends on both the personal and professional qualities. An ability to demonstrate tolerance, patience, flexibility and self-reliance are important personality traits and are the key factors in determining the success of the candidate. The candidate will need to be confident and comfortable with himself/herself and will need to adjust his/her expectations and aspirations for life and work in North Korea according to the local context. The candidate should be psychologically strong enough to cope with the environment, be calm, and have well-tempered character showing maturity and diplomacy in decision-making. • To adhere to Handicap International’s vision: a world in which all forms of disabilities can be prevented, cared for or integrated, and in which the rights of people with disabilities are respected and applied
How to apply:
Please send CV and cover letter to jobs@handicap.be