Memorial Service for John Andrew Fixsen, FRCS, 1934-2014

The recent memorial service for John Fixsen, our urbane and distinguished consultant who carried the flag for SGAA in Afghanistan for many years, was a fitting tribute to a remarkable man. Modest, unassuming, and softly spoken, John bore his great medical knowledge lightly. There was often a mischievous twinkle in his eye, but he was deadly serious about his mission: for John the patient came first and last.

John FixsenJohn Fixsen

John Fixsen tests these baby boys for developmental dysplasia of the hip (DDH).

A pilot project in Samangan Province found 16 babies out of 80 sent for testing to have dislocated hips.

 

When we began working in Afghanistan in 1986, there were after years of revolution and war many hundreds of thousands of amputees and other disabled patients. Since then, year in year out, we have treated literally thousands of amputees, providing them with artificial limbs [prostheses]; and many more thousands of children suffering from polio, cerebral palsy, club foot and spina bifida - a disease of the spine. Our main activity now is to send out regularly our highly experienced consultants who were led by John. The work they have done, often in difficult conditions, without complaint, has been enormously valuable. We are immensely grateful to John, who would have been 80 this year. His companion on many trips, a leading physiotherapist, Mrs Jeanne Hartley, currently representing SGAA in Afghanistan, sent this moving tribute, read out at the service by her husband, Peter, in the 11th century St Bartholomew the Great church in the City.

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Chairman's Letter

December 2014

 

2014 has been one of the most challenging - but also rewarding - years SGAA has experienced since we started working for the disabled in Afghanistan in 1983. The row over the Presidential election results with both the Ashraf Ghani and Abdullah camps claiming victory, almost led to civil war, according to Dr Abdullah, and the resurgence of the Taliban in a spate of suicide bombings - made life even more difficult for the Afghans. Here at home, SGAA had to cope with its own bad news: the sudden death in August, shortly before his 80th birthday, of our senior orthopaedic consultant, John Fixsen, FRCS. John was a remarkable man: a brilliant surgeon, he was hugely knowledgeable, dedicated, energetic, modest - and talkative. As Jeanne Hartley said at the magnificent memorial service for John at St Bart's the Great in the City in September, her words relayed from Kabul and read out by her husband Peter, it was sometimes difficult to get a word in edgeways.

He was especially revered by his Afghan colleagues and pupils, and loved by his many grateful patients. His death came as a shock because he had always seemed so spry and fit, a keen sailor and indefatigable traveller. He and his equally tireless companion, Jeanne, another alumnus of the Great Ormond Street Hospital for Sick Children, made two trips a year for 11 years from 2003 to monitor, teach, encourage and inspire their Afghan colleagues. When I was reminded of that record by Jeanne - plus the fact that John had actually gone out as well the previous year and then wisely recruited Jeanne - I was hugely impressed. What a spectacular record of service surpassed only by that of John Lamb, who has been training Afghan prosthetists and orthotists for SGAA since 1993. Luckily, Philip Henman, another highly-skilled pediatric orthopaedic surgeon, despite being fully employed by the NHS in Newcastle, hopes to visit Afghanistan with Jeanne next spring. SGAA is, I am proud to say, extremely lucky in the high quality of its consultants.

I know they are rated highly by the Board of our partner, the Swedish Committee for Afghanistan [SCA], as Anders Fange, one of their senior Board members and a former Country Director told me in Kabul recently. I don't want to seem to be blowing our own trumpet vicariously, so I will let the facts speak for themselves. Next November it will be exactly ten years since SGAA [in the person of Philip Henman] introduced the then still revolutionary Ponseti method for treating Club Foot to Afghanistan. Since then, to quote Jeanne Hartley, 'thousands of babies and young children have had successful treatment in clinics run by SCA, ICRC [International Committee of the Red Cross] and other NGOs. It has been and continues to be a hugely successful programme enabling children to live productive lives without the stigma associated with disability.' It is also a source of pride that the outstanding practitioner of the technique is a brilliant Afghan, Ahmad Shah, trained by SGAA in our clinic in Jalalabad [now part of SCA] where he is still the resident maestro.

The other area in which SGAA has also pioneered successfully is the treatment of DDH [Developmental Dysplasia of the Hip]. Few newly-born infants in Afghanistan are given the routine check for displacement of the hip that all children born in the West receive. If they are not checked and any displacement corrected, and the child starts walking with a displaced hip, the result with all its negative consequences, will be a permanent limp - a limp for life. We are trying to prevent this by spreading the word - and teaching all midwives to make it a routine check.

Jeanne Hartley, in the report about her recent visit, says that in the year until October, 2014, for all the clinics we service in four Northern Provinces [Kunduz, Takhar, Baghlan and Badakhshan] '1188 babies were tested and 153 found to have DDH. Figures are much higher than would be expected in Europe.' Jeanne concludes that whereas we have given midwives training in the past, 'this should be repeated with each new cohort of trainee midwives,' a policy which we hope to see implemented as soon as possible.

In my view as a parent and grandparent, I would not want any of my children or grandchildren condemned to a lifetime of disability for want of a routine medical check.

 

With Very Best Wishes for a Happy Christmas and [as we say in Scotland] a Prosperous New Year!

 

From all at SGAA and the Gall family,

 

sgaa sig

Sandy Gall, Chairman SGAA

 

According to the 2005 National Disability Survey of Afghanistan, one in every five households in Afghanistan has at least one family member who is disabled. This is a result of 30 years of war, landmines, disease and poverty.

Since 1986 Sandy Gall's Afghanistan Appeal (SGAA) has trained Afghan professionals to provide artificial limbs and other mobility aids for more than 25,000 people with disabilities and provided physiotherapy treatment for over 60,000 patients with temporary and permanent disabilities.

Activities were initially based in Peshawar, Pakistan where there were over 1 million Afghans living in refugee camps in the 1980s and 1990s. SGAA gradually moved its activities inside Afghanistan from 1991 onwards and set up two main centres in Jalalabad in 1993 and Kabul in 1996.

Since 2006 SGAA has signed a partnership agreement with Swedish Committee for Afghanistan and its activities are now merged in a community based disability programme which works in 13 provinces.

This programme both treats people with different types of disability and offers them a range of services including home-based training, physical rehabilitation, education, skills training and business loans.
 

Physiotherapy Consultant’s Report. April 2013

The Chairman and Mrs Gall visit Kabul and Jalalabad March 2013

MahpekaiSGAA staff from the Component and Orthopaedic WorkshopsSGAA staff from the Component and Orthopaedic Workshops
Malek swimming raceMalek swimming race

Photos:

Top left: Mahpekai, senior prosthetist-orthotist, and double amputee, showing a drop hand splint she has fabricated.

Top middle, top right: SGAA staff from the Component and Orthopaedic Workshops

Bottom: Malek, who is a double amputee, winning his race in Kabul.

 

Hashmatullah’s story

The boy in the picture is Hashmatullah. He and his father were walking through Darulaman (a suburb of kabul), Hashmatullah in front, when the father shouted: 'Look out, there's a mine !'

Hashmatullah

The words were no sooner out of his mouth then there was a terrific explosion right beside Hasmatullah, wounding him in both legs and seriously injuring his father who died two days later. By some miracle, Hasmatullah survived but he lost almost the whole of his leg. It was amputated just below the hip and half of his leg, amputated above the knee in what is known as an AK.

Click here for more patient stories

2014 has been one of the most challenging - but also rewarding - years SGAA has experienced since we started working for the disabled in Afghanistan in 1983. The row over the Presidential election results with both the Ashraf Ghani and Abdullah camps claiming victory, almost led to civil war, according to Dr Abdullah, and the resurgence of the Taliban in a spate of suicide bombings - made life even more difficult for the Afghans. Here at home, SGAA had to cope with its own bad news: the sudden death in August, shortly before his 80th birthday, of our senior orthopaedic consultant, John Fixsen, FRCS. John was a remarkable man: a brilliant surgeon, he was hugely knowledgeable, dedicated, energetic, modest - and talkative. As Jeanne Hartley said at the magnificent memorial service for John at St Bart's the Great in the City in September, her words relayed from Kabul and read out by her husband Peter, it was sometimes difficult to get a word in edgeways.

 

He was especially revered by his Afghan colleagues and pupils, and loved by his many grateful patients. His death came as a shock because he had always seemed so spry and fit, a keen sailor and indefatigable traveller. He and his equally tireless companion, Jeanne, another alumnus of the Great Ormond Street Hospital for Sick Children, made two trips a year for 11 years from 2003 to monitor, teach, encourage and inspire their Afghan colleagues. When I was reminded of that record by Jeanne - plus the fact that John had actually gone out as well the previous year and then wisely recruited Jeanne - I was hugely impressed. What a spectacular record of service surpassed only by that of John Lamb, who has been training Afghan prosthetists and orthotists for SGAA since 1993. Luckily, Philip Henman, another highly-skilled pediatric orthopaedic surgeon, despite being fully employed by the NHS in Newcastle, hopes to visit Afghanistan with Jeanne next spring. SGAA is, I am proud to say, extremely lucky in the high quality of its consultants.

 

I know they are rated highly by the Board of our partner, the Swedish Committee for Afghanistan [SCA], as Anders Fange, one of their senior Board members and a former Country Director told me in Kabul recently. I don't want to seem to be blowing our own trumpet vicariously, so I will let the facts speak for themselves. Next November it will be exactly ten years since SGAA [in the person of Philip Henman] introduced the then still revolutionary Ponseti method for treating Club Foot to Afghanistan. Since then, to quote Jeanne Hartley, 'thousands of babies and young children have had successful treatment in clinics run by SCA, ICRC [International Committee of the Red Cross] and other NGOs. It has been and continues to be a hugely successful programme enabling children to live productive lives without the stigma associated with disability.' It is also a source of pride that the outstanding practitioner of the technique is a brilliant Afghan, Ahmad Shah, trained by SGAA in our clinic in Jalalabad [now part of SCA] where he is still the resident maestro.

 

The other area in which SGAA has also pioneered successfully is the treatment of DDH [Developmental Dysplasia of the Hip]. Few newly-born infants in Afghanistan are given the routine check for displacement of the hip that all children born in the West receive. If they are not checked and any displacement corrected, and the child starts walking with a displaced hip, the result with all its negative consequences, will be a permanent limp - a limp for life. We are trying to prevent this by spreading the word - and teaching all midwives to make it a routine check.

 

Jeanne Hartley, in the report about her recent visit, says that in the year until October, 2014, for all the clinics we service in four Northern Provinces [Kunduz, Takhar, Baghlan and Badakhshan] '1188 babies were tested and 153 found to have DDH. Figures are much higher than would be expected in Europe.' Jeanne concludes that whereas we have given midwives training in the past, 'this should be repeated with each new cohort of trainee midwives,' a policy which we hope to see implemented as soon as possible.

 

In my view as a parent and grandparent, I would not want any of my children or grandchildren condemned to a lifetime of disability for want of a routine medical check.

 

With Very Best Wishes for a Happy Christmas and [as we say in Scotland] a Prosperous New Year!

 

From all at SGAA and the Gall family,

2015 Calendar

Giles Duley photographs an amputee trying out his new leg at the ICRC hospital, Kabul

Our 2015 calendar featuring images by award winning photographers is now available. Click here to order

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