The World in His Arms

by Kristina
Rolfes
August 2, 2013
For a 14-year-old boy who lost his arms in a landmine explosion in Yemen, new prosthetic arms and rehabilitative therapy from Kennedy Krieger’s Limb Differences Clinic open up a world of possibilities for his future.

Mohammed KarimFour years ago, Abdul Karim heard an explosion just outside his house in Yemen. When he opened his door, his ten-year-old son, Mohammed, was standing in the doorway, covered in blood. Mohammed had spent that morning playing outside near his village. As the sun cast its light over the nearby mosque, Mohammed noticed a shiny object on the ground. He picked it up, thinking it was a toy, and put it in his pocket, intending to bring it home and show his father. When he neared home, he took out the object and tried to crush it, causing it to explode in his hands. “I’m okay,” he told his father when he reached the doorway, but he was not. Both his arms were later amputated, and he lost vision in one eye.

Mohammed is one of thousands of victims of landmine explosions in war-torn countries like Yemen. Many victims are children, and those who survive suffer stigma in their community and often grow up unable to find a vocation due to their disabilities. But Mohammed is one of the fortunate ones. He was given the gift of new prosthetic arms, courtesy of Kennedy Krieger Institute’s Limb Differences Clinic and the Marshall Legacy Institute, an organization in Arlington, Virginia, dedicated to helping landmine survivors.

The two organizations teamed up to provide Mohammed new prosthetic arms with the help of prosthetic manufacturer Dankmeyer, Inc., and Kennedy Krieger also offered to provide complimentary rehabilitative therapy for Mohammed, whose family had no means to pay for care.

A Team Approach to Addressing All of a Child’s Needs

Although Mohammed’s circumstances for arriving at the Limb Differences Clinic are unique, his rehabilitative needs are much the same as any other patient’s. “The goal of our clinic is to help children with limb anomalies or deficiencies be independent and live fulfilling lives,” says Dr. Stacy Suskauer, director of the Limb Differences Clinic. To help address this goal, the clinic has an orthopedist, a rehabilitation physician, a prosthetist, a physical therapist, and an occupational therapist, all working together to provide coordinated care for the patient. “Together, we come up with a cohesive plan to help children with all of their needs,” says Dr. Suskauer.

For children with limb differences, helping them improve function in their limbs and providing prostheses is only part of the battle. The team is also concerned with how families are doing socially and emotionally. The Limb Differences Clinic encourages patients and families to interact with others facing similar challenges during clinic visits. Families can also take advantage of a support group for families of children with limb differences offered through the Institute. Some of these children may never have met anyone else with a limb difference, explains Dr. Suskauer. “We help a child understand: You are not alone.”

Forty percent of children with limb differences have amputations resulting from cancer, infection, or trauma, as in Mohammed’s case. Most children with limb differences were born with them—limb differences occur in about 5 out of 1,000 births, and can be caused by vascular diseases during pregnancy or genetic disorders. About a third of the time, the cause is unknown. Genetic counseling may be helpful for some families in determining any genetic risk factors they may carry.

The clinic treats most patients throughout childhood, addressing therapy and prosthetic needs as they grow. For children who live far away, the clinic can evaluate a child’s therapy needs and coordinate with the patient’s home therapist.

Hope for a Brighter Future

In November, members of the Limb Differences Clinic team—Dr. Suskauer, prosthetist Mark Hopkins, and occupational therapist Chrissy Gallion—met with Mohammed and his guardian for an assessment of his needs. Dr. Suskauer explained through an interpreter that they would like to provide him with arms that will help him be as independent as possible. Mohammed told the group he would like to be able to pick up and put on his backpack, button his shirt, and eat with a fork, things he has been unable to do for the past four years.

The clinic’s prosthetist, Mark Hopkins, carefully measured Mohammed for his new prostheses and designed fully functional artificial arms, specially made for Mohammed. The new prostheses allow him to rotate his arms, grasp objects, and bring his hands to his mouth or chest, which he was unable to do before.

Mohammed practices grasping objects during occupational therapy.

At 14, Mohammed is receiving the prostheses at a fairly young age, so he has a good chance of successfully adjusting to them. “The earlier you fit somebody for upper limb loss, the more likely they are to integrate [the prostheses] into their lifestyle and use them successfully,” says Hopkins.

Mohammed came back to the Institute for an occupational therapy session to help him practice eating, drinking, writing, buttoning a shirt, and picking up objects with his new arms. “His new prostheses will give him the ability to do all of his daily activities, go to school, write, do computer activities, and pretty much everything that he needs to do,” says Gallion.

Mohammed seems to take his disability in stride, saying he is not sad about what happened to him. He says he is excited about using his new arms, and he looks forward to his future. “I want to be an engineer when I grow up,” he says. “And I want to help other landmine survivors.”

“He has a great attitude,” observes Gallion. Mohammed Karim practices writing with his new arms.Like Mohammed, a lot of kids she has worked with are very determined, very tough, and have strong spirits that allow them to make it through traumatic events and persevere. One of the reasons she loves working with kids like Mohammed is their ability to bounce back quickly and remain the fun, playful kids they always were.

Mohammed returned to his family in Yemen in January with a new set of arms and a whole new world of possibilities. “We hope his new arms will help him succeed in school and gain an increase in independence,” says Lauren Demeter, program coordinator at Marshall Legacy Institute. “His future is really up to him now,” she says. “We don’t want to tell him where to go from here, but we know he’s going to go somewhere with this.”