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My name is Dr. Moses deGraft-Johnson.

The term “assistive technology” is defined

by the World Health Organization (WHO)

as an umbrella term that covers

systems and services that are related to

the delivery of assistive products and

services, and the whole purpose

of this is to aid an individual by giving

them independence and promoting their

overall well-being.

Now, as my colleague here just showed us

some very cool innovations,

some of the innovations that we

are very familiar with are the simplest

things such as the hearing aids,

wheelchairs, and the prosthesis. Even

something as simple as pill organizers,

because this is something even people

without a true disability utilize, you

know? My mother utilizes pill organizers.

So we find that there are certain

assistive technologies that even

individuals who do not have a true

disability also utilize in their daily

lives. And we’re seeing more and more

of that globally; more than

one billion people need one or more

assistive products.

Now this is the part that I really want to

get into, because this really talks about

what I do for a living,

and recently what we’ve seen is that the

World Health Organization released some

data, and what we see is a rise in

non-communicable diseases that are

causing persons with disability.

And one of the most common ones that was

mentioned was diabetes. But also, along

with diabetes was hypertension and

hyperlipidemia, also known simply

as high cholesterol, obesity, and smoking.

Now what’s interesting is that these five

variables are also known in cardiovascular

medicine as the five major risk factors

for a major cardiovascular event

They lead to something called
atheromatous plaque.

This is plaque formation of buildup in

our blood vessels. This is an example of a

normal coronary artery in the heart,

and as we see, over time we get damages,

buildups, and eventually we have lack of

perfusion, or lack of blood flow.

And that’s what eventually leads to heart

attacks, strokes, and poor circulation,

commonly known as “P-A-D.”

Now, at the Heart and Vascular Institute,

what we have done is we have an

initiative called the
"Save a Limb Initiative."

One of the things that my goal was was to

at least limit the amount of amputations

that were occurring in that community.

When we see patients who have these

sorts of problems, the first thing we

do after we’ve assessed them is called

acute limb ischemia. We take them

into the operating room and utilize a

GE system called a C-ARM.

What it does is it’s an X-ray that takes

pictures of the legs from the bellybutton

all the way down to the feet.

We use contrast dye to inject into the

patients so it will allow us to give us an

image, sort of like this.

So this first picture here… clearly you

don’t need to be a doctor to see there’s a

significant problem here. This is called

This is called the superficial femoral

artery. this is the big vessel that lies

between your hip and your knee.

It’s like a highway that’s not complete

because there’s something missing here,

right in the middle.

So this individual has developed a

blockage in that blood vessel that has

definitely caused a total occlusion of

blood flow flowing from this part,

which is coming from the belly button area

going down to the knee.

So once we take that picture with that GE

system, I’m able to see this and initial,

and right here I’m able to, just like a

plumber does, you know, you
snake the pipes.

So here you have a specific type of water

system that I use to cross the artery.

And once I cross the water system, on this

side… I’m going to show you this picture

here… I use a system called

a jetstream atherectomy device.

Now this system is a system that is made

by a company called Boston Scientific.

Boston Scientific is a medical device

company based out of

Maple Grove Minneapolis, in Minnesota.

And what it is is that basically we use

this device, it’s like a drilling system.

Just like in the oil fields, they drill

the ground. We use this system over that

wire that I’ve put into the system and

we’re able to go over the wire and clean

out the plaques that have formed.

Once that plaque is cleaned out, we use a

balloon system to stretch out the

blood vessels to really give it a wide

opening, and sometimes once it stays open,

if it stays open it’s fine but if it

doesn’t stay open, it has a tendency

to constrict again, and that’s when

we have a tendency to put in a stent

to keep it open. So in this picture right

here, this diagram, you see that we were

successful opening up this total occlusion

here, and opening it up and restoring

blood flow back to the limb.

This is an actual photograph of one of my

patients. Unfortunately, this was a

gentleman that we were not able to save

his leg. So this is six weeks

after surgery after I amputated.

This is called a BKA, a below the knee

amputation. And I often say that if

you’re not fortunate enough for me to save

the limb, I’d rather you have a

below the knee amputation versus

above the knee amputation, because

functionality-wise it’s better for the

individual because we’re able to really

fit him very well with a good prosthesis,

that they can go back and handle it and

walk as if nothing ever happened.

But it becomes a huge challenge once you

go above the knee. It’s very hard to fit

someone for any good prosthesis,

for them to bear weight.

We call this the “stump line.”

And we have a tendency to have a lot of

breakdown on this stump line.

So it just makes things a little bit

difficult. So unfortunately, I was not

able to save this man’s leg sine we had

the surgery, and this is him and his wife

after surgery.

So this is the sort of assistive

technology we’re used to seeing.

And in the past, I have to admit,

I have to be clear and be honest with you,

I never really paid attention to a lot of

this stuff until I met Chet Cooper.

That’s when I started to really focus and

pay attention to these things.

They’re right in front of us, they’re

right around us, but we’re so busy with

our daily lives we don’t pay attention to

things that are happening.

But this is now a big problem and a part

of my practice right now, of what I do.

So once we have saved the limb,

the question is then how do you prevent

them from ending up like this gentleman.

So we have a technology called the SPY.

The SPY was developed by a company

called Novadaq and then they sold it off

to a company called Stryker.

Stryker is a big medical device company

that does a lot of spine surgery for

people with back problems and this sort

of thing. So it’s kind of shocking why

they got into the vascular business. But

anyway, with SPY technology, what it does

is that it utilizes a fluorescent agent

that we inject into the patient, so after

the patient has had the
revascularization procedure,

they follow up at the office, we inject

them with the fluorescent agent,

and what it does is that we’re able to put

this camera right on their feet, right

overhead, and it gives us
this thermal imaging.

So when you see this right here, that’s

good news. Actually the redder, the more

red it is, the better it is. It means you

have really good flow.

And as the area gets a little bit blue,

that means you have diminishing blood

flow in that area. And when it gets to be

like this, you know you have a serious

problem. So this type of stuff is what

we’ve been doing for people in Miami,

for people in the Florida region.

And so I started to take this type of

practice back to Ghana.

Ghana is very interesting to me, not only

because I’m from Ghana,

but I’ve been very impressed with the

government of Ghana in terms of their

initiatives, which is a little bit

surprising to me because in those parts

of the world there’s a stigma that is

associated with individuals or persons

with disability.

Ghana is a small country in West Africa,

the population is about 28 million.

The GDP is about $130 billion. That puts

them at number 12 out of 52 of African

countries, and it’s actually the blueprint

for African democracy. It’s a

constitutional republic.

And English is the official language
of the country.

About 15 percent of the Ghana population

are persons with disability.

In 2006, the country passed a disability

law, and the purpose for this was to end

discrimination against individuals with

disability in the country.

The country has been working very very

hard to improve the living conditions

of individuals that live there.

My foundation, what we’ve done is that,

we’re really focusing on, because

disabilities, there are so many causes of

disabilities, from congenital diseases to

hereditary diseases and also acquired

diseases. With the acquired diseases,

my focus is really on the

noncommunicable diseases, because it

really falls in line with something we

have knowledge on. So what I've done is

that I’ve invested my own money into

building a hospital. This is a rendering,

a rendition, of the hospital,
the deGraft Research Hospital,

and the purpose of this hospital

is to facilitate the work that we

have done very successfully in Florida.

This is more images, and this is the

current progress of the hospital.

So hopefully by the end of next year

we will complete this project,

and then we will be able to offer the same

things we offer the people of Florida,

in Ghana. Thank you.