CIR Brings Prosthetic Services to Developing Nations

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By Mary Stanton, Elise Moylan, and Laura Frankel
Photo courtesy of Center for International Rehabilitation
Photo courtesy of Center for International Rehabilitation

The Center for International Rehabilitation (CIR) is a Chicago-based nonprofit organization committed to assisting landmine survivors and people with disabilities worldwide in achieving their full potential. Through innovative engineering projects, capacity-building education programs, interactive online tools, and disability rights advocacy, the CIR reaches out to individuals and communities across the Americas, Europe, and Asia.

The CIR is an outgrowth of Physicians Against Land Mines (PALM), a nongovernmental organization (NGO) devoted to ending the death, dismemberment, and disability caused by landmines. In 1998, PALM opened the CIR and expanded its activities in order to have a greater impact on the lives of people with disabilities around the globe.

Engineering for Developing Nations

The Rehabilitation Engineering Research Center (RERC) was the first program implemented at the CIR and remains a core initiative. Through the RERC, the CIR develops technologies to improve the quality and accessibility of care for landmine survivors and people with disabilities in low-income countries. The CIR's products are designed to meet the long-term economical, cultural, environmental, and functional needs of people with disabilities in the communities where they live, and can be made locally, using materials that are inexpensive and widely available.

The CIR Sand Casting system is an innovative, cost-effective system that uses vacuum-packed sand to fabricate a mold of an amputee's residual limb for fabrication of prosthetic sockets. This revolutionary process significantly improves the production rate and quality of prostheses, offering a new alternative to traditional methods. The system reduces prod­uction time for socket fabrication from eight hours to one hour and relies on recyclable materials, allowing for easier service in the remote areas that the CIR serves.

Additionally, the CIR has developed anatomically based alignment systems and a prosthetic foot that mimics natural movement. Research is being completed on the Anatomically Based Axis (ABA) and Vertical Alignment Axis (VAA) methods in Nicaragua, and the protocol for field testing of the Shape&Roll Prosthetic Foot is in development.

Education

In 2001, the CIR piloted a distance learning program designed to train prosthetic technicians working in clinics and hospitals serving landmine survivors, war-wounded, and other people with disabilities in post-conflict countries. The CIR's courses were developed in conjunction with the renowned Northwestern University Prosthetics and Orthotics Center (NUPOC) and fulfill International Society for Prosthetics and Orthotics (ISPO) Category II Prosthetist requirements.

The CIR distance learning program in prosthetics is now being taught to more than 70 students from 30 rehabilitation centers in six countries. These centers treat an estimated 8,600 war-wounded and other amputees each year. In January 2006, the CIR's distance education students in Bosnia became the first in the region to receive ISPO Category II certification. In addition, CIR staff members conduct technology transfer and training workshops at rehabilitation clinics and centers throughout the developing world.

Interactive Online Tools

In 2006, the CIR launched the International Disability Educational Alliance Network (IDEAnet). IDEAnet is an interactive website that provides information, communication tools, and social spaces designed to enable people from around the world to work together on issues of importance to people with disabilities. The site is designed around two communities. The Rehabilitation Services Community works to improve services for people with disabilities through the development and distribution of improved assistive technologies and through the delivery of distance education programs for service providers. The Disability Rights Community is dedicated to promoting and protecting the human rights of people with disabilities by building the capacity of grassroots disability organizations and promoting the implementation and monitoring of legal protections.

Advocacy

Disability rights advocacy efforts are an important component of the CIR's efforts to assist people with disabilities worldwide in achieving their full potential. Since 2001, the International Disability Rights Monitor (IDRM) project has trained more than 40 disability advocates to document the progress, problems and barriers experienced by people with disabilities. The IDRM has published regional reports on the Americas and Asia, as well as various thematic reports, including Disability and Early Tsunami Relief Efforts in India, Indonesia and Thailand (2005) and The International Disability Rights Compendium (2003). The CIR continues to develop and expand its innovative programs, services and technologies in order to better meet the needs of people with disabilities worldwide.

For more information, visit www.cirnetwork.org