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.