Numerous organizations now offer prosthetic, orthotic, and mobility assistance to communities in developing countries. Assistance ranges from direct fittings, donations of materials, supplies, used prostheses, wheelchairs, and shoes, to building clinics and training local practitioners.
Many non-governmental organizations (NGOs) claim to be humanitarian and may have the best of intentions but are in fact disruptive to the communities they serve, according to Jonathan Batzdorff, chair of U.S. ISPO’s international outreach committee. Some provide free services that drive local prosthetists out of business, and some introduce new techniques that require components or materials that are difficult to obtain locally and thereby encourage dependency.
Borrowing from the efforts and ideas of the International Committee of the Red Cross (ICRC), which developed a code of conduct for disaster relief, the U.S. Member Society of the International Society for Prosthetics and Orthotics (U.S. ISPO) developed a “Code of Conduct for International Non-Governmental Prosthetics, Orthotics, and Mobility Assistance.”
The code generally suggests that aid should not have political or religious strings attached, that building and supporting local capacity is valued over handing out direct services or materials without first evaluating local capacity, making every attempt to avoid creating dependence.
“The Code of Conduct is strictly voluntary,” Batzdorff explained. “Organizations are asked to look at the code and to adopt and abide by its principles. We are not trying to police the activities of NGOs, only to maintain the high integrity and reputation of the prosthetics and orthotics assistance community and to codify our ethical standards.”
Code of Conduct for Prosthetic and Orthotic Nongovernmental Humanitarian and Development Assistance
- An organization providing prosthetic/orthotic/mobility aid shall not discriminate on the basis of race, religion, nationality, or political party in the selection of its projects or in the conduct of its operations.
- Assistance shall not require any political or religious endorsements or behavior in order to receive benefits.
- Assistance organizations shall respect the local customs and culture of the communities it serves.
- When possible, all attempts shall be made to encourage and support local capacity for providing prosthetic and orthotic and mobility services, including evaluations, fabrication, follow-up, and replacement.
- When possible, attempts shall be made to avoid creating dependence of the local community on the NGO for future follow up, adjustments, replacements, or for additional materials and supplies.
- In order to avoid creating ongoing dependence, when possible, materials will be used which can be found or acquired locally.
- Attempts will be made to assure that existing local service providers are not adversely affected by the organization’s activities, such as when the organization provides services to recipients who would otherwise be served by local service providers.
- When possible, attempts will be made to coordinate efforts, planning, and delivering of services with the local community, with local service providers and with the recipients of the service.
- Though humanitarian assistance responds to emergency needs and may not consider developing local capacity as its primary goal, the organization should, when possible, include development efforts in its programming.
For more information, contact Jonathan Batzdorff, CPO, at jon@prosthetika.org
