RICHLAND -- Motorcycles are one of the most affordable ways to travel in Third World countries, but they're also the cause of the most serious, and common, injuries in those countries.
All too often a single accident produces multiple patients because it's not uncommon to see three, five, or even eight people atop a single motorcycle.
"They weld extensions on the back and sides," said Dr. Jacky Jean, an orthopedic surgeon at the Haiti University and Educational Hospital. He's one of more than 150 orthopedic surgeons attending the 12th annual four-day SIGN Fracture Care International Orthopedic Conference in Richland this week.
"And motorcycles aren't just used to transport people," said Dr. Chertoute Getho, an orthopedic surgeon at Haiti's St. Nicholas Hospital. He shared a photo taken with his mobile phone with several colleagues.
His photo showed a motorcycle carrying two large sacks of food, about 50 pounds each, likely rice or beans. One sack was balanced on the handlebars, the other on the back luggage rack where a passenger -- all you can see are legs -- was holding a large barrel, about 20 gallons, in their lap.
"It's likely cooking oil," Getho said.
As the developing world transitions from pedestrian to motorized transportation, tens of thousands of people are using roads originally built for foot traffic and horse-drawn carts. Now, pedestrians, bicyclists, motorcycles and cars/buses/trucks all intermingle on the same streets.
"In a year, 1.5 million people (in developing countries) die from road traffic injuries mainly from fractures of the long bones," said Dr. Edmund Eliezer, an orthopedic surgeon practicing at the Muhimbili Orthopedic Institute in Tanzania.
Long bones are considered the femur, the thigh bone, the tibia, the larger of the two bones below the knee, and the three large bones of the arm.
"And if they don't die, many are permanently disabled because we lacked the proper implants -- a metal nail -- to insert in the break to stabilize it," Eliezer said.
SIGN -- Surgical Implant Generation Network -- a nonprofit based in Richland, is changing that by training hundreds of surgeons around the world how to use metal surgical implants, called nails, to repair severely broken arms and legs. SIGN also manufactures the metal implants, up to 50,000 a year, if it has the funding.
"But worldwide, 60,000 a day are injured. We are limited by money in our ability to help people," said Jeanne Dillner, CEO of SIGN.
Since SIGN was founded by Dr. Lewis Zirkle, a Richland orthopedic surgeon, in 1999, the nonprofit has donated the implants, and the equipment to install them to hospitals in more than 50 developing nations. To date, 103,000 patients have been treated at more than 200 hospitals worldwide.
Getho said that before he took the SIGN training four or five years ago, he was using an inferior nail made in Pakistan and India to repair fractures.
"The SIGN implant has nails and screws to hold it in place. The other nail is smooth, no screws to keep it from rotating. Even the Pakistani doctors call the SIGN implant the Magic Stick," he said.
Before taking the SIGN training, Getho said that to even find the Pakistani or Indian nails, he had to go from hospital to hospital to track them down. The only other option is traction, and patients would need to stay in bed for 45 days or even months. Even then, there was no guarantee they wouldn't be disabled.
Using the SIGN implant, doctors can discharge patients in two days.
"And they can walk with crutches. So, depending on their job, they can go back to work. If it's an office job, they can go back in days. Other jobs, a month or so," Getho said.
Which is important. Many times, the patient is the breadwinner for 10 or more people.
"They simply can not be in the hospital, not able to work for months," said Jean. "Their relatives are depending on them for support."
Dr. Billy Haonga of the Tanzanian Muhimbili Orthopedic Institute agreed that it's expensive for the surgeons to attend the annual conference in the Tri-Cities.
"But what we get here, the sharing of knowledge between surgeons from around the world, you can not put a monetary value on," he said.
While at the conference, the surgeons attend hours of seminars ranging from treating hip fractures to treating limb deformities using the nail implants to wound dressing techniques for open fractures.
"Then we take that knowledge back and share it with our colleagues," Haonga said.
To help raise money for training and manufacturing the implants, SIGN will hold a fundraiser, Revel the Magic, on Oct. 27 at the Three Rivers Convention Center in Kennewick.
There will be an auction, live music from the Master Singers and a magician. Tickets are $50.
For more information, or to buy a ticket, call 371-1107.