The leg makers at the Thai-Cambodian border step into unknown future

UBON RATCHATHANI – The rain is just letting up over the dense shrubbery of the mountains of the Thai-Cambodian border on the morning that Sai Lamek lost his right leg. Foraging for frogs and bamboo sprouts along a well-trodden path, an explosion erupted under his feet. Two years after the unfortunate step on a land mine, he became known as the “Leg Maker” in his home village of Thung Sadet in Ubon Ratchathani Province.

“Seeing people walk again makes me happy and proud, and I feel connected to them,” says 47-year-old Mr. Sai standing amid a muddle of artificial limbs at the Center for Prostheses of Dom Pradip Subdistrict in Nam Yuen District.

For twelve years Mr. Sai and his colleague, Harat Suthanang, have been helping people who lost their limbs to land mines be able to walk again, free of charge. But the future of the prosthesis technicians at the Thai-Cambodian border is uncertain as an important source of funding has been frozen.

For twelve years, Harat Suthanang, one of two prosthesis technicians at the center, has been making land mine victims walk again.

In Nam Yuen District, thousands of land mines and unexploded ordnance (UXOs) are believed to be scattered throughout an area of about 148 square miles, or more than a third of the district’s total area.

Responding to the high number of land mine accidents in the district, the Center for Prostheses was established in 2004 to provide victims with more direct access to prostheses services.

Communities in the border area with Cambodia depend on the forest as an important source of food. As a result, most land mine victims in Nam Yuen are foragers or farmers. Despite efforts by the government and international organizations to demine and mark hazardous areas, every year locals lose limbs after taking a wrong step.

In the early 1980s, Nam Yuen District became a battlefield between the Khmer Rouge, who were supported by the Thai government, and Vietnamese troops that had occupied Cambodia in 1979. When the conflict ended in 1989, thousands of explosive remnants were left behind in the Thai-Cambodian borderlands.

According to information from the Thailand Mine Action Centre, 16 of Thailand’s 76 provinces are still affected by mines. In the Northeast, areas in Buriram, Si Sa Ket, Surin and Ubon Ratchathani Province are listed as so-called confirmed hazardous areas but the precise extent of land mine areas is not known.

The Center for Prostheses in Nam Yuen is the only of its kind in the area. Before it was established, prostheses services were only available in the provincial capital of Ubon Ratchathani, about a two-hour drive from Nam Yuen.

Amputees usually come to the center two or three months after they have been released from medical facilities and their wounds have healed. Before Mr. Sai and Mr. Harat begin their work, they carefully examine the amputee’s stump and ask about areas of pain.

“Every amputee’s stump is different,” Mr. Sai says, adding that it takes only about one or two days to produce a prosthesis. Amputees usually receive two legs, he says: a sturdy “farming leg” and a more polished, regular one.

“Our customers are farmers and the prostheses are like their shoes,” explains Mr. Harat. “They need one to work their fields and one when they go to the city.”

Sai Lamek turned an accident with a land mine into a career as prosthesis technician at the Center for Prostheses of Dom Pradip Subdistrict in Nam Yuen District.

Since Mr. Sai and Mr. Harat learned the trade of leg making, they have produced more than 600 prostheses for over 200 people. As prostheses need to be fixed or replaced often, the two technicians have regular customers with whom they build close bonds over the years and who often bring small gifts in return for the free service.

Not only victims of land mines need prostheses. Accident victims and diabetics also come to see Mr. Sai and Mr. Harat. The center has a policy of non-discrimination and offers free services even to those outside the Thai health care system like foreigners from neighboring countries.

The center was set up by the General Chatichat Choonhavan Foundation, a non-profit organization working on humanitarian and environmental issues established by the former prime minister of the same name. The funds built the center but only provided salaries of 3,000 baht (about $85) for three staff per month for one year.

After the first year, Mr. Sai, Mr. Harat and three other prosthesis technicians worked for free until the Dom Pradip Subdistrict Administrative Organization created two paid positions at the center in 2009.

The center’s other important funder is the Prostheses Foundation of Her Royal Highness the Princess Mother which provided tools, materials, and training through its prosthesis center in Chiang Mai. Mr. Sai and Mr. Harat had also joined several training workshops in neighboring countries that were organized by the foundation.

But in the past year, shipments of tools and materials from the foundation have stopped, and the two prosthesis technicians are feeling the impact on their work.

Virat Phanphanit, Deputy Secretary-General of the Management Department at the royal foundation, told The Isaan Record that according to the Physical Therapy Act 2013 a physician needs to oversee the production of prostheses and amputees’ walking trainings.

“It is very dangerous if there is no doctor to oversee the process,” Mr. Virat says. “When a patient tries to walk with a prosthesis [for the first time], there is a risk of brain hemorrhage or heart failure.”

As the Subdistrict Administrative Organization of Dom Pradip has yet to name an overseeing doctor for Center for Prostheses, and to avoid a violation of the law, the royal foundation has stopped supplying tools and materials for the time being.

Without a doctor, it remains unclear if the center will be able to operate in compliance with law. The Subdistrict Administrative Organization of Dom Pradip was not available for immediate comment.

Apart from the uncertain supply of tools and materials that are crucial for the future of the prosthesis center in Nam Yuen, Mr. Sai and Mr. Harat also face the problem of recruiting a new generation of leg makers.

“Both of us are getting older and we won’t be here forever,” Mr. Sai says. “I would like to have trainees who continue our work here at the center.”