International Missions

Solomon Islands Project

Prosthetic and Orthotic Container Lab Project

In June 2021, Walking Free, the international division of Mission Gait, signed a Memorandum of Understanding with the Ministry of Health and Medical Services, Solomon Islands, to bring state-of-the-art prosthetic and orthotic care to amputees and other patients living in the country. Walking Free has a history with on-site production of such labs in a number of locations around the world. However, this project was very unique in its design as we produced our first fully replicable prosthetic and orthotic lab, inside of a 40’ shipping container, built completely in Virginia, and delivered it fully functional to the location in need, in this case the Solomon Islands, in the South Pacific. The container has all the equipment and tools needed to create artificial limbs and braces for anyone in need.

The Project

Before we delivered our portable container lab in the summer of 2023, patients suffering amputation or other disabilities were unable to receive prosthetic or orthotic devices, as there was no fabrication center in the country. Patients faced a life of severe limitations. Now with the P&O lab container built-out and the equipment installation completed in Richmond, Va., the container transported via ship to the Solomon Islands and installed on the grounds of Kilu’ufi Hospital on the island of Malaita, patients have hope!

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The Team

Developing and implementing this are David Lawrence, MSPT, ATC-ret, Founder of the original Walking Free project in 2000 and Founder and CEO of Mission Gait Foundation, est. 2016, Gil Mejia, CP, Coordinator of Prosthetics and Orthotics, and the late Gail Grisetti, EdD, PT, who served as Mission Gait’s Director of Walking Free, and for whom this project is dedicated. In addition, Jeff Allen is an integral part of the team, coordinating communications with the Solomon Islands, and supervising in-country activities. Mr. Allen has extensive experience working and living in the Solomon Islands, beginning in 2010. He and his family have lived there during various mission trips since that time. He has participated in multiple startups and small business development in conjunction with citizens of the country. Joining the team and bringing design experience are designers Carolyn Lawrence, ASID, CID and Sheila Gunst. Ms. Gunst is the owner of Rustic Global, specializing in the construction, build-out, and interiors to transform shipping containers into habitable dwellings.

David A. Lawrence, MSPT, ATC-ret

Founder, Chief Executive Officer
Mission Gait Foundation

Gil Mejia, CP

Coordinator of Prosthetics and Orthotics
Walking Free – Mission Gait Foundation

Gail Grisetti, MPT, Ed.D

Director of Walking Free
Mission Gait Foundation

Jeff Allen

In-Country Project Manager
Walking Free – Solomon Islands

Sheila Gunst

Owner and Interior Designer
Rustic Global

Carolyn M. Lawrence, CID, ASID

Certified Interior Designer
Co-Founder and Acting Director of Operations
Mission Gait Foundation

Location of Project Site

Kilu’ufi Hospital, Malaita Province is one of the three largest hospitals in the province, and was selected as the site for this project because of its location to the greatest population density. Malaita is the most populous island of the Solomon Islands, more than a third of the entire national population. 

The container has been placed on the hospital grounds where prosthetic and orthotic production began in October 2023. This new program will bring attention, and hopefully resources, to the hospital which, in the past, has been known for the treatment of psychiatric patients. 

April 2024 – the beginning of in-country training of personnel to provide rehabilitation support surrounding device fitting – including physical therapy for patients in the pre-prosthetic/pre-orthotic phase, progressing to gait and functional training once they have received their device. Physical therapy will be provided inside the hospital. 

2025 – Rehabilitation training will expand into a nation-wide effort with Walking Free leading an International Symposium. This event will bring together key players throughout the Solomon Islands and the South Pacific, to ensure true sustainability and foster further development throughout the region.

Prosthetic Fabrication

The Ministry of Health and the Rehabilitation Department previously identified the need to provide care to amputees and other disabled people living in the country. To achieve this goal, two people were identified and sent to Mobility India (mobility-india.org) for training in prosthetic and orthotic fabrication The program is located in Bangalore, India. Wilfred Aukwai completed the training, graduated, and returned to the Solomon Islands. (see Wilfred’s bio below) Since the arrival of our P&O Lab, he has received some additional guidance provided by Walking Free’s Gil Mejia and his team, and has begun making prosthetic and orthotic devices to meet the needs of the people living in the Solomon Islands.

Wilfred Aukwai, Lead Prosthetist - Bio

Wilfred grew up in Malaita, Solomon Islands, completing both primary and secondary school there. He was interested in becoming a teacher, but met a prosthetist, Steve Hughes from Australia, who was in the Solomon Islands trying to start a prosthetic program at Kilu’ufi Hospital. Wilfred started helping him as a technician – training locally from 2009-2010. He then worked with Motivation Australia and their wheelchair program. In 2010 he became a certified wheelchair technician in building basic and advanced chairs for disability and rehabilitation.  He still runs the wheelchair program at Kilu’ufi to this day.

In 2019, Wilfred went to school in India at Mobility India Rehabilitation and Training Center and completed his prosthetics certification in 2020 (18 months). After completion he was unable to return to the Solomon Islands due to Covid, so he remained in India and assisted on various prosthetic based projects at the University.  He was finally able to return to the Solomon Islands, and his family, in 2022.

Wilfred was hired by Kilu’ufi Hospital in 2022 as the lead prosthetist and the only Certified Prosthetist working in the Solomon Islands to this day.  From 2022 to present he has been working with the Mission Gait Foundation’s Walking Free project here at Kilu’ufi Hospital, which is the only prosthetic service and lab within the Solomon Islands.

Elsie Taloafiri

Director of Physiotherapy Rehabilitation
Ministry of Health and Medical Services
Solomon Islands

Elwin Taloimatakwa

Director of Training
Ministry of Health and Medical Services
Solomon Islands

Wilfred Aukwai

Lead Prosthetist
Kilu’ufi Hospital
Malaita, Solomon Islands

Rehabilitation Oversight

The rehabilitation program will be managed by Elsie Taloafiri, Director of Physiotherapy Rehabilitation, Ministry of Health and Medical Services. Her responsibilities include providing direction for the rehabilitation programs provided throughout the medical facilities in the country. She is assisted by Elwin Taloimatakwa, the Director of Training for the rehabilitation program.

The format for the physical rehabilitation program will be based on the approach designed by Mission Gait. The program is comprehensive and takes the patient from the pre-prosthetic/pre-orthotic period, before the device is received, through independent ambulation. Walking Free will provide training to the rehab team in the Solomons on this approach. In addition to our multiple on-site education and training missions, the Mission Gait website and Youtube channel (www.youtube.com/missiongait) provides access to education and training videos, which contain details on every aspect of the rehab program and can be accessed globally.

How did Mission Gait first learn of the issues faced by amputees living in the Solomon Islands?

Mission Gait and Walking Free first learned of the needs of amputees in the Solomon Islands when David Lawrence was asked to treat Hudson Sade at his Richmond, Virginia PT clinic. In 2019, Mr. Sade was brought to the Richmond area from the Solomon Islands after losing his limb due to diabetes. Hudson is the father-in-law of Jeff Allen, who now serves as our in-country project manager. Hudson was measured and fitted with a prosthesis through the Hanger Corp and Gil Mejia, CP, our lead prosthetist for Walking Free. He provided continued care throughout, adjusting and fine-tuning Hudson’s prosthesis as needed. The important physical rehabilitation program, which should accompany prosthetic use, was provided at The Gait Center clinic under the supervision of the owner, David Lawrence, MSPT, ATC-ret.

All services were donated and provided pro bono. It was during the physical therapy sessions that the need for amputee care in the Solomon Islands was uncovered through discussions with Mr. Sade and Mr. Allen. During the months that Hudson was receiving his physical therapy, it became clear that there was a role for Walking Free to play in the country. 

 

At the time, it was our understanding that Hudson was the only amputee in the country to have a professionally fabricated prosthetic device. We were told that other amputees in the country have “homemade” prosthetics created using metal rods and sticks. After completing physical therapy Hudson returned home, where he now lives independently and has returned to his previous occupation of fishing. Hudson has become the face of hope for the future of prosthetics/orthotics in the Solomon Islands.

Hudson also demonstrated the need for well-trained in-country services provided by the people of the country. One of the first prosthetics made in the new container lab in 2023 was a replacement for Hudson’s 4-year old device that no longer fit or functioned correctly. Prosthetic and orthotic devices do not last forever, and people’s bodies change over time, especially children. Sustainable in-country services are important to long term patient care and success. 

Background on the Solomon Islands
The Solomon Islands is a chain of islands located in Oceania, to the east of Papua New Guinea. There are six major islands as well as hundreds of smaller islands. It is a sovereign nation whose official language is English. The country is known for its pristine waters, its biodiversity, and the richness of its marine life. The capital of the country is Honiara on the island of Guadalcanal which has a rich history and connection to the United States during World War II when the US and its allies fought pivotal battles against Japan. Diplomatic relations between the two countries have continued over time, especially after the country achieved its independence in 1976. USAID has offered support to the Solomons over time. This support demonstrates the commitment of the United States to aid in the development of economic opportunity, trade, and infrastructure. The Solomon Islands is reported to be the second poorest country is the Pacific with the lowest GDP. In addition, the lack of infrastructure includes the absence of paved roads and sidewalks. In rural villages, this is especially true. Any rocky, hilly terrain makes it difficult if not impossible to use a wheelchair, and those who are physically challenged face many obstacles. The ability to walk is crucial to survival as many citizens use gardening and fishing as a way to provide food for their families.

A 2018 estimate of the population of the country is 652,857. It is believed that the islands were settled between 30,000 and 28,800 BC. Throughout its history, there has been influence from European countries including, Spain, Portugal, and England which defined it as a protectorate until 1975. Self-government was achieved in 1976.

Demographic Overview

Solomon Islands Population: 669,823 (2019)

Languages Spoken: English is the official language, but Solomon Islands pijin is the lingua franca. There are over 80 different local languages plus dialects.

Capital City: Honiara

RECAPPING THE MISSION OF WALKING FREE

Walking Free missions continue to focus on the importance of interdisciplinary care, with an emphasis on integrating prosthetic and orthotic services with physical therapy and other rehabilitative services. Throughout its involvement globally, Walking Free has conducted numerous research, education, and training missions, educating doctors, nurses, therapists, and other rehabilitation professionals in a number of countries; we have also provided in-kind contributions of prosthetic and orthotic, rehabilitation, and surgical supplies and equipment. In 2010, Walking Free worked with University Don Bosco (UDB) in El Salvador to provide Category II orthotic and prosthetic distance learning and certification program for trainees in the Caribbean. When students obtain a Category II certification, accredited by the International Society of Prosthetics and Orthotics, it is recognized internationally. (Mobility India provided Category II education for the Solomon Islands project.) Walking Free has increased the capacity of rehabilitation professionals throughout the world to treat patients with prosthetic and orthotic needs, returning patients to active and hopefully productive lives in their communities.