Carlos sat slumped over in his native land as the two Virginians approached him.
The 53-year-old Honduran man hadn’t stood unassisted in two years and he watched curiously as the pair attached $75 worth of materials to the stump that once was his right leg.
“We molded it to him, said a prayer and he walked around, just like that,” said Phil Johnson, a Blacksburg prosthetist and orthotist who crafted the limb.
Carlos was the first person that Johnson and Edward Via College of Osteopathic Medicine student Michael Mabry helped.
And Carlos was just the start.
Since helping Carlos in October 2014, the pair’s nonprofit, Hope to Walk, has equipped 61 Hondurans free of charge with one of the custom below-the-knee prosthesis Johnson engineered and can fit in less than an hour.
They’re currently working with two hospitals in Honduras, the Baxter Institute in the capital city Tegucigalpa and Hospital Evangelico in Siguatepeque, with more than 500 people on a waiting list for legs.
“It’s just amazing how it’s moving forward,” Mabry said.
Their work has drawn the attention of the United States Public Health Service, which gave Mabry an Excellence in Public Health Award last week.
In what the CIA World Factbook calls the second poorest country in Central America, the nonprofit’s having an unprecedented impact, said Dr. Xiomara Erazo of the Baxter Institute.
“I have never seen a face light up so instantly and their eyes shine so bright,” Erazo wrote in an email from Honduras.
Erazo said the high number of amputees in Honduras is mostly attributed to the country’s high rate of diabetes. Accidents are another cause, including those resulting from people attempting to sneak into the United States on what is known as “The Death Train” or “La Bestia.”
According to the Migration Policy Institute’s website, as many as half a million Central Americans hop aboard the freight train that runs through Central America to the U.S.-Mexico border annually.
“As there are no passenger railcars, migrants must ride atop the moving trains, facing physical dangers that range from amputation to death if they fall or are pushed,” the site says.
Dr. Gabriela Osorio of Hospital Evangelico, about two hours by car from the Baxter Institute, wrote in an email that landmines along the Nicaraguan border also cause many lost limbs.
Erazo said she didn’t have up-to-date figures on amputees in the country, but many public hospitals perform as many as 20 surgical amputations a month, many on people with no means of obtaining a prosthetic limb.
“Those patients return to their homes with no hope to ever be productive again … Hope to Walk is seen as an answer to their prayers, as angels that have come to provide an option for the poor,” Erazo said.
Johnson said he thought of helping amputees in developing countries for more than a decade, but it took a chance encounter with Mabry to make the project a reality.
In 2004, Johnson, who owns New River Valley Orthotics and Prosthetics in Blacksburg, traveled to Guatemala to deliver a prosthetic leg to a young boy he’d heard about from a woman in Floyd.
He said the day he arrived it was too late to examine the child, so they decided to sleep and regroup the next morning.
“And there were 18 amputated children standing in line. They had heard over the night. I didn’t know what to do,” Johnson said.
The experience haunted Johnson during the next 10 years.
“It was like we’ve got to come up with an idea we can take there. Build the leg right there on the person,” Johnson said.
Occasionally he would start to tinker with an idea, but each time the complex nature of missions work would overwhelm him, and his life and business would eventually occupy Johnson’s time.
In 2012, Johnson’s passion for the idea was briefly rekindled when a group from Blacksburg Church of Christ brought a Honduran man to Johnson to have a prosthetic leg built and fitted.
In working with the man, Johnson began pondering the idea of teaching native people in developing countries how to assemble and maintain prosthetic legs. He began to dream of setting up a prosthetic workshop in Honduras so the people could be completely self-reliant.
But his ideas continued to lay dormant until Mabry, who was in his first year at VCOM, visited Johnson’s basement shop in Blacksburg in search of custom insoles.
The two men quickly hit it off.
Like Johnson, Mabry had done missions work, both at home and abroad. So his interest was sparked a few months later when the doctor finally shared his dream of developing an affordable leg for amputees in developing countries.
“Do you really think you can do it?” Mabry said he asked Johnson.
“I know I can do it. It’s a no-brainer. I just never had anybody walk it out with me,” Johnson replied.
“Well, I’ll do it,” Mabry said.
Within three months of their first conversation about prosthetic legs, Johnson and Mabry found themselves on a self-funded trip to the Baxter Institute in Honduras, which maintains an ongoing partnership with VCOM.
From the man who pushed his wife in a wheelchair for a day and a half to reach them, to the multiple people who slept outside the institute’s gate, they saw more than 50 people in five days.
“People were wheeling them in from all over the place to get there,” Mabry said.
The pair of Americans returned home, and while Johnson developed the leg, Mabry, who was in his second year of medical school, worked tirelessly to complete the paperwork to found Hope to Walk .
“I woke up early. I stayed up late. I prayed a lot,” Mabry said.
Johnson said the cheapest below-the-knee prosthetic leg in the U.S. cost $5,000.
Not only would such a leg be financially infeasible for the nonprofit, but it also could make its Honduran recipient a target for thieves.
“Sometimes the cost of that leg is the most expensive thing in the whole village,” Johnson said.
It also would leave the recipient with no way to repair the expensive parts if broken.
Johnson’s challenge: to engineer a cheaper leg, multiples of which could be easily transported to Honduras, constructed and fitted to patients. They also needed to consist of simple technology and common materials that people could repair on their own.
“I can make you a leg for $10,000, but making one for 80 bucks is a different bird,” he said.
By October 2014, Johnson had built the first prototype. The pair of men used raffle proceeds from a donated P. Buckley Moss watercolor to raise travel funds and headed to Honduras to test the prototype.
That first leg consisted of a fiberglass top that could be molded to the patient’s stump, much like a cast, a wooden leg and a foam foot.
Within 55 minutes of his fitting, Carlos began walking around and they had their results.
“That showed us that our idea was good,” Mabry said.
Hope to Walk became an official nonprofit in May 2015. Johnson recently made his seventh trip to Honduras, while Mabry has only made three because of his school commitments.
Johnson’s prosthetic limb has evolved to include a leg made of a combination of wood and PVC pipe and a crepe foam foot that propels the user forward with each step. Some of their patients have used these artificial legs for more than a year.
In June 2015, the group brought on Mabry’s friend, Charlotte businessman Ed Bellaire, to be Hope to Walk’s executive director and help navigate the group’s efforts.
Bellaire said Mabry had kept him informed about Hope to Walk’s progress. After a career of leading multiple businesses, he felt working with the nonprofit was a calling.
“I was strongly moved at the potential for what this really means for the human condition,” Bellaire said.
He’s since gone on multiple trips and witnessed the impact of Johnson’s creation.
“When they receive a prosthetic leg there’s the potential for them to be reborn in a sense. To have the potential to really live the way they were supposed to be,” Bellaire said.
In December, Bellaire helped Hope to Walk’s efforts expand to include Hospital Evangelico. According to Osorio, the impact was immediate.
Osorio said she’s seen the prosthetic donations give life back to many patients, including one blind and deaf woman who lost her leg below the knee.
“Now Aurelia has hope. She can stand and help in the kitchen and make tortillas … she can go by herself to the bathroom, things that we take for granted now make lots of difference in Aurelia’s self-esteem,” Osorio said.
The Baxter Institute has recently built a workshop at its campus just for Hope to Walk and has employed 13 single mothers from the city to sew the leather straps for the prosthetic legs.
Johnson said the space would play a key role in fulfilling the second part of his dream, helping train the Hondurans to create, fit and repair the legs themselves.
“Part of the vision is training the local people so they don’t have to be reliant on us,” he said.
That aspect of Hope to Walk drew the interest of the Charlotte branch of a nationwide ministry, The Barnabas Group, which is composed of Christian business leaders who aid ministries with their business savvy.
Branch managing partner Rocky Norkum said the group has helped more than 100 ministries in the past six years, most often by providing free strategic operations planning. He said what stood out about Hope to Walk was not only providing free legs, but training locals to help themselves.
“Actually creating a model that empowers those on the ground. … That’s not just helping the user, that’s helping families and communities,” Norkum said.
“It’s really got legs to it, and it’s moving and the Lord is working with it. I think you’re going to see great things,” he said.
Using Honduras as their pilot program, and with the assistance of the Baranas Group, Hope to Walk’s leaders aim to expand to other countries.
In January, Bellaire spent two weeks visiting with a missionary group and government officials in Da Nang, Vietnam, to assess the potential to help the country’s large population of child amputees.
Getting there is merely a matter of funding, Johnson said. Currently it costs about $1,000, travel included, for an individual to spend a week helping Hope to Walk in Honduras, but airfare alone to Vietnam is about $1,100.
In the meantime, Johnson is working to also expand Hope to Walk’s services to include an above-the-knee prosthetic.
The group recently found the San Francisco-based company D-Rev, which sells their “ReMotion Knee” joint for $80. The product has allowed Johnson to create his first above-the-knee prototype for slightly more than $170, which they plan to begin testing on next month.
Johnson said he was in the process of getting patents for his products, not in order to monetize the technology, but to prevent others from doing so.
The patent will simply ensure Hope to Walk can continue to produce the artificial leg and the life-changing stories that accompany it.
“To see the smiles on these people’s faces when they first stand up, there’s no money in the world worth it,” Johnson said.
By Travis Williams – firstname.lastname@example.org