While many people and organizations that work in developing countries
are aware that appropriate and sustainable technology is needed in
places such as Haiti, I think many prosthetic facilities, while well
intentioned, may be donating components that are not appropriate.
Heather Mills was on Larry King live and showed her gel liner and pin
suspension prosthesis which is not something that is sustainable or
affordable, not to mention the potential hygiene problems involved. No
doubt she means well.
A local facility that is collecting contributions is receiving gel
liners, which is one of the reasons I am writing this.
Perhaps I am wrong and would like to be corrected by people currently
working in developing countries , but my
understanding is that the most appropriate prescription for BK’s
consists of hard sockets (polypro or laminated), Pelite or Keasy liners
if possible, and SACH feet for cost and availability from a variety of
sources,( although the Niagara foot out of Canada is a very low cost
dynamic response foot.)
Donating carbon fiber feet could work but there
might be a problem replacing them when they wear out
Perhaps even Jaipur feet could be used if they were available/obtainable
Cuff strap suspension is the easiest to maintain and repair on a local
level. Nylon socks for a sheath and athletic tube socks can be used for
an interface. Used with a Keasy or Pelite liner it would be even better.
My personal experience is that the Keasy from Proteor is
sturdier and I believe you can heat it up again and pull it over a new
model when the pt loses volume. It is more expensive. (I have no financial interest in
Proteor)
Alimco in India makes a very low cost functional hand and elbow as well
as other parts. Can these be brought to Haiti? I don’t know.
So, I would suggest that a discussion be opened up so that people who
work in developing countries can discuss what might be the most needed
in donated parts.
I think it would be helpful if others more familiar with working in
conditions such as Haiti, would let the list know what would be
appropriate in terms of typical prescriptions as well as
components and materials for AK prostheses that are appropriate and sustainable.
Mark Benveniste CP
VA Med Center
Houston TX
