What I want to do with the rest of my life...

This semester in my Majors-only Writing Intensive Yoga class (yes, I know that it sounds really weird!) we're learning to write funding proposals. The semester's assignment was to write a proposal for a program that we wanted to implement after we finished college/grad school. 

Others chose to write about afterschool sports programs, mobile therapy clinics, or playgrounds for pediatric hospitals, and I chose to write about something that I really am passionate about. I hope that as you read this, you'll catch a glimpse of what I want to do with my life and where I feel God leading me!

Hope for Nigerian Amputees: Manually-Powered Prosthetic Fitment

Katherine E. Farr – Final Paper - Wednesday, April 7

Introduction

The African civil wars and conflicts of recent decades have left thousands of people injured; rural land mines that continue to explode injure people and often leave them with lower limb amputations (Arya and Klenerman, 2008). Although a prosthetic was created in 1975 to suit the unique lifestyles of third-world patients, and several organizations now provide them at no cost (Tuli, 1981), many of these amputees will never receive one because they cannot afford to take the time to travel and be fitted.

Some of these non-governmental organizations also face the problems of overwhelming need, insufficient funds, inadequate facilities, and unreliable electricity. New techniques have been developed to resolve some of the issues, but all of the techniques still rely on electricity. Current donors to the Evangel Missions Hospital in Jos, Nigeria, will receive a copy of this proposal along with the quarterly newsletter, and they will be asked to consider sending an additional donation or to earmark their next regular donation to a fund to purchase a manually-powered fitment device.

Target Population

There are approximately 7,000 physically handicapped people in Nigeria’s capital city of Jos (Ardill, 2006), and many of them support themselves by begging. Evangel Hospital's prosthetic facility has been able to provide lower limb prosthetics to many amputees who live in Jos, but many patients who live in remote areas of Nigeria cannot afford the time or money to travel to Jos even to receive prosthetics free of charge. There is a great need to increase process efficiency and mobility so as to serve the maximum number of people.

Project Description/Rationale

The current fitment procedure is very inefficient. First, the entire casting, fabricating, and fitting process takes 2-3 days—an amount of time that most low-income families and subsistence farmers cannot spare. Secondly, the process requires a large amount of plaster of Paris (approximately 8 lbs (3 kg) per fitment), which means that all plaster must be transported with the machine for field services in more undeveloped areas of Nigeria (Garcia, 2008).

A vacuum-casting procedure has been newly developed to increase efficiency by reducing the entire fitting and fabrication time to an hour and a half and eliminating the need for plaster. However, the vacuum machine is expensive and relies on electricity to provide the negative sand mold of the patient’s stump. Philip Garcia, an undergraduate student at MIT, worked with a team of 20 interdisciplinary students to explore the idea of a manually-powered vacuum machine to be used with the sand-casting technique (Chandler, 2008). The vacuum-casting procedure coupled with the MIT team’s design would provide an effective solution for Evangel Hospital.

The team’s design utilizes four bicycle pumps and 10 other readily available parts. Some of the parts could be replaced with more native materials to further reduce the cost from USD147 to approximately USD50 per machine. The device is lightweight, requires very little setup, and can easily sit on a tabletop; these features allow for extreme portability. Technicians using the machine would not need intensive training, as many of them would be familiar with hand-crank machines common to local water wells. Since the devices are simple, local tradesmen or mechanics could make any necessary repairs.

Expected Outcome

The entire procedure has several huge possible positive outcomes. First, the vacuum-casting procedure has the potential to increase Evangel’s patient load fivefold (Garcia, 2008). Secondly, eliminating the need for plaster will reduce the cost per prosthetic limb. Thirdly, the manually-powered machine will allow the Evangel workshop to operate at all hours, independent of the hospital’s generator and its erratic running time. Fourthly, since the machines do not require electricity, the workshop technicians would be able to organize mobile prosthetic teams to travel into rural Nigeria and serve those amputees who cannot travel to Jos. As a result, many Nigerians would hear about Evangel Hospital, and word would spread about their free or low-cost medical and treatment programs and facilities. Lastly, donors from around the world will have the unique opportunity to make a difference in the lives of many Nigerians by restoring their dignity and livelihood providing them a lower-limb prosthetics.

  

Conclusion

The number of amputees can seem overwhelming, the recent economic situation that reduced Evangel’s donations can be disheartening, and the challenges of serving in a third-world country can be daunting, but the new fitment technique and device offers incredible prospects. With rural prosthetic fitment and fabrication teams many more amputees can learn to walk again, work again, and be a part of society again. Truly, advancements in medicine, engineering, and science—coupled with faithful financial partners—can offer hope for Nigerian amputees.

Works Cited

Arya, A. P., and Klenerman, L. (2008). The jaipur foot. Journal of Bone & Joint Surgery, British Volume, 90B(11), 1414-1416.

Tuli, J. (1981). The jaipur limb. World Health, 2-5.

Ardill, B. (2006). Prosthetics project. Retrieved 3/30/2010, from http://www.ecwaevangel.org/mambo/content/view/248/70/

Garcia, P. (2008). Optimization of vacuum pump device for use in rapid fitment of prosthetic limbs.  Retrieved 2/22/2010, from http://dspace.mit.edu/handle/1721.1/45794

Chandler, D. (2008). A leg to stand on. MIT News, March 5, 2008.  Retrieved 2/20/2010, from http://web.mit.edu/newsoffice/2008/itw-jaipur-tt0305.html