Erenstone.
Photograph courtesy of Jeff Erenstone.
The Range of Motion Project (ROMP) and Operation Namaste have partnered to establish in-country fabrication of prosthetic liners in Ecuador. The project uses local labor and production for a fraction of the cost of commercial liners.
The Namaste liners use a method of fabrication called SILC Solutions that was developed by Operation Namaste. Similar liners can cost several hundred dollars per patient. The new liners cost less than $50.
Eighteen months ago, Jeff Erenstone, CPO, Operation Namaste founder and owner of Mountain Orthotics and Prosthetics, Lake Placid, New York, started developing the system based on a request from a fellow prosthetist in Nepal, Amit Bajracharya. After a year of testing in Lake Placid and four versions later,
Erenstone had developed a system that worked well, and he planned to deploy the product to Nepal in May 2020. Unfortunately, the COVID-19 global pandemic halted those plans. The O&P EDGE reached out to Erenstone to learn a little more about how the project is moving forward.
In November 2020, Erenstone contacted ROMP Executive Director Dave Krupa, and together they put together a plan to quickly implement the liner system in Ecuador. Within a week, supplies were shipped, and Erenstone was soon on his way. While flying during a pandemic initially posed some anxiety,
Erenstone said, “I was amazed by how strict and serious the people of Ecuador were taking COVID. I felt totally safe in Ecuador. The only place I was nervous was in the North Carolina Airport, but since then I tested negative twice.”
Namaste liners are made with 3D-printed molds that are complex in design and make liner fabrication easier. ROMP’s facility houses a 3D printer so they can sustainably print their own molds. ROMP can get supplies nearby and the liners are designed with off-the shelf sizing, so the molds should last for several months,” Erenstone explained. “They should be able to make hundreds of liners per mold and be self-sufficient with their own printer.” He added that ROMP has experience acting as a distributor to help facilitate getting liners to patients.
While Erenstone was in Ecuador, he and Krupa fitted a patient named Sarah with a liner made there. “This liner is more comfortable than my other [mass-market] liner,” Sarah told them.
“This is a game changer,” said Krupa.
Erenstone agreed, “I have been working in 3D-printed prosthetics for years, and this is one of the most effective and scalable uses we have found.”
Operation Namaste’s mission is to help people achieve mobility by providing knowledge, technology, and support to O&P practitioners around the world. They achieve this through support of other organizations like ROMP, which provides clinical care in Ecuador and Guatemala.
Operation Namaste and ROMP are excited to continue their partnership and move into the next phase, Erenstone said. The feedback from their efforts will help improve the program and make better low-cost prostheses throughout Ecuador and eventually around the world.
When asked how he balances his humanitarian work with his practice, Erenstone said, “Good question, and it is a constant struggle. My role in my private practice has shifted because of COVID. The other five practitioners are doing most of the patient care, and I only take on special cases. Going forward, I plan on focusing on research (which should be flexible to schedule) and continue to work on the nongovernmental organization. It doesn’t pay as well, but it feels pretty damn good to work on solving these big problems.”
