Unfortunately for amputees in developing countries, poverty and disability go hand-in-hand. Limb loss can make it extremely difficult for victims to provide for themselves and their families. From this reality came the inspiration for Sudanpro, an inexpensive and durable prosthetic developed by the author, an orthotist and prosthetist working with Project Hope Sudan

Ismail, Mohammad

English

James Madison University

Journal of Conventional Weapons Destruction Volume 15 Issue 2 The Journal of ERW and Mine Action Article 9 July 2011 New Prosthetics Offer Hope in Sudan Mohammad Ismail Project Hope Sudan Follow this and additional works at: https://commons.lib.jmu.edu/cisr-journal  Part of the Other Public Affairs, Public Policy and Public Administration Commons, and the Peace and Conflict Studies Commons Recommended Citation Ismail, Mohammad (2011) "New Prosthetics Offer Hope in Sudan," The Journal of ERW and Mine Action : Vol. 15 : Iss. 2 , Article 9. Available at: https://commons.lib.jmu.edu/cisr-journal/vol15/iss2/9 This Article is brought to you for free and open access by the Center for International Stabilization and Recovery at JMU Scholarly Commons. It has been accepted for inclusion in Journal of Conventional Weapons Destruction by an authorized editor of JMU Scholarly Commons. For more information, please contact dc_admin@jmu.edu. 9/4/15, 12:35 PMNew Prosthetics Offer Hope in Sudan, by Mohammed Ismail (15.2 online only)Page 1 of 4http://www.jmu.edu/cisr/journal/15.2/focus/Ismail/ismail.shtmlThe total cost of the SACH foot per leg is less than US$100. Morethan 1,400 people have been fitted with this kind of prosthesis.All photos courtesy of the author. Table ofContentsEditorial Focus Feature SpecialReportNotes Obituaries BookReviewsBriefs R & DNew Prosthetics Offer Hope in Sudanby Mohammad Ismail [ Project Hope Sudan ]Unfortunately for amputees in developing countries, poverty and disability go hand-in-hand. Limb loss can make itextremely difficult for victims to provide for themselves and their families. From this reality came the inspiration forSudanpro, an inexpensive and durable prosthetic developed by the author, an orthotist and prosthetist working withProject Hope Sudan.In many developing countries, orthotic and prosthetic practitioners are without the resources to meet amputees’needs. According to many estimates, there are around 60 million amputees. Often the high cost of prosthetics and theintense labor required to produce these devices limits organizations in the number of people they can serve. A lack ofresources availability further hinders efforts in the field, as Western prosthetics often require materials unavailable indeveloping countries. Available resources are also often too costly for wide distribution.Training personnel to manufacture, fit and adjust prosthetics is anexpensive and time-consuming process, and many organizationsin the developing world cannot afford to expand their staff or theirarea of operation. In addition, the time and effort required toconduct a fitting is great, which reduces the amount of assistancethe limited number of trained practitioners can provide toamputees. Consequently, many service providers are unable tomeet the high demand for prosthetics. Sudanpro: A New Approach to ProstheticsFirst conceived in 1995, the Sudanpro prosthetic leg was designedto alleviate some of the issues associated with prosthetic-limbprovision. Using lighter, lower-cost and readily available materials,the Sudanpro prosthetic leg allows for faster fitting, casting andtraining at a lower cost. The Sudanpro prosthetic leg has not yetbeen copyrighted. Hope Sudan manufactures, fits and services theSudanpro prosthetics. For less than US$150, it can give an amputee a new leg and subsequently new opportunities tomove, work and thrive in their community.1 Without the high manufacturing and materials cost, organizations are freeto expand their staff and provide service to more amputees.Sudanpro technology also offers opportunities for organizations using Sudanpro technology to service more remoteregions, where access to prosthetics may be limited. Unlike other prosthetics in use, casting and fitting of theSudanpro mold requires no special equipment, and enables practitioners to conduct fittings in more isolated areas.1Ismail: New Prosthetics Offer Hope in SudanPublished by JMU Scholarly Commons, 20119/4/15, 12:35 PMNew Prosthetics Offer Hope in Sudan, by Mohammed Ismail (15.2 online only)Page 2 of 4http://www.jmu.edu/cisr/journal/15.2/focus/Ismail/ismail.shtmlThe SACH foot looks like a real foot, is less expensive than the Flexfoot and is easy to fit and use.The SACH foot easily fits in a shoe. Materials. Often the West conceives and designs prosthetics, and then the technology is transferred to the developingworld. The problem with this situation is that many of the materials available to Western prosthetists are scarce andexpensive in the developing world. Sudanpro technology, however, was engineered with special consideration for thematerials actually available to prosthetists in the field.One such material, central to the design of Sudanpro, is polypropylene, which is a plastic used in a variety of contexts,such as food packaging, plastic hinges and rods, textiles, and automotive components. Because of its extensive use,polypropylene can be found throughout the developing world, including in Sudan, where it takes the form of PP rods.The physical properties of polypropylene plastic make it ideal for use in prosthetics, as it is tough yet flexible and has ahigh melting point, making it resistant to warping in heat.Sudanpro also uses a copolymer pylon, which contains 20 percent polyethylene. Polyethylene increases the workinglife of the prosthesis, allowing for flexibility in the pylon. This flexibility is crucial for the patientâ€™s mobility becauseit allows the patient to retain energy during the stance phase and release it in the swing phase of their stride. In arecent study, researchers concluded that pylon flexibility in prosthetics allows patients quicker, more comfortablestrides.2Because of this increased flexibility in the leg’s shaft, Sudanpro does not require the expensive Flex foot used in otherprosthetics to achieve the same flexibility. Instead, Sudanpro replaces the Flex foot with a much cheaper SACH foot,manufactured by the Chinese government.Depending on taxes, price fluctuations and the facility’s location,the materials necessary to produce a Sudanpro prosthetic leg costanywhere from US$50 to US$100. In many cases, the materialsare exempt from import taxes, allowing the cost of materials to beless than US$100.Production. The production of a Sudanpro prosthetic limb canbegin as soon as the amputee is healthy enough for evaluation.Prosthetists analyze the stump and develop a plan for theprosthetic’s construction and alignment. This initial alignment plansaves production time because, having already sketched thealignment, the prosthetists do not have to conduct extensive trialsin the fitting’s last stage. The development of a plan early in theprocess also allows for a better fit, because prosthetists canmanufacture the leg from the beginning with the final alignment inmind.The leg has fewer parts than commonly used in prosthetics, whichreduces joint stress and increases the prosthetic’s weighttolerance, making Sudanpro a more durable prosthetic. Having fewer parts also reduces the overall weight of theprosthesis by about 30 percent. Taking into consideration lost momentum, this decreased weight saves patientsenergy in their strides.Although the casting process requires a well-trained practitioner toproperly anticipate the weight distribution lines, it does not requireany specialized equipment and can as much as doublepractitioners’ efficiency. Casting only requires power and a flat-bedoven with an even distribution of heat capable of reaching 300degrees Celsius (570 degrees Fahrenheit). Within three to fourhours, a prosthesis can be cast, aligned and fitted for a patient,and within six hours, the patient can begin training with the newleg.Because the process requires no specialized equipment,practitioners can also conduct fittings in the field. Sudanproprosthetists can cast a new leg anywhere with an oven andelectricity. This is an important advantage, as they normally wouldbe unable to cast limbs outside of their facility. If implementedproperly, this mobility allows organizations to expand their2Journal of Conventional Weapons Destruction, Vol. 15, Iss. 2 [2011], Art. 9https://commons.lib.jmu.edu/cisr-journal/vol15/iss2/99/4/15, 12:35 PMNew Prosthetics Offer Hope in Sudan, by Mohammed Ismail (15.2 online only)Page 3 of 4http://www.jmu.edu/cisr/journal/15.2/focus/Ismail/ismail.shtmloperations to previously unreachable areas. ResultsSudanpro technology has the potential to help victims and the organizations assisting them, giving new vitality to theprosthetics field. Since 2006 when it was first implemented, Sudanpro technology has fitted 678 amputees with 682prostheses, at very low costs. Victims who previously could not afford more expensive prostheses were given renewedhope that they, too, can comfortably stand, walk and run with the help of Sudanpro technology. In the future,Sudanpro’s makers hope to extend the technology to other countries where victims are without access to inexpensiveprostheses. Organizations working in Brazil, Ecuador, Egypt, India, Kenya, Liberia, Nigeria, Pakistan and South Sudanare exploring the technology, but even with the help of these organizations, millions will remain without access toprosthetics. However, with further interest and effort, Sudanpro technology will someday reach these victims, andgrant them the freedom of mobility. CISR staff member Jeremiah Smith assisted in the research and writing of this article. Â BiographyMohammad Ismail is the ortho-prosthetist who designed the Sudanpro technology and hasheaded Project Hope Sudan since April 2005. He is pursuing a master’s degree in advanced studiesin humanitarian logistics and management at the University of Lugano, Switzerland USI (Univesitadella Svizzera Italiana), and expects to graduate in October 2011.Mohammad IsmailOrtho-prosthetist/Manager Project Hope SudanTawsol Al Amal Charity OrganizationBuilding #3, Hope Medical CityJabal Awlayia, Khartoum State / SudanTel: +00249 91 82 38 104E-mail: mshlash2002(at)yahoo.com Endnotes1. Coleman, K.L., D.A. Boone, D.G. Smith and J.M. Czerneiki. “Effect of trans-tibial prosthesis pylon flexibility onground reaction forces during gait.” Prosthetics and Orthotics International, Vol. 25: 195-201 (2001).http://poi.sagepub.com/content/25/3/195.abstract. Accessed 9 February 2011.2. Mohammad Ismail runs Project Hope Sudan. The Project is funded by several providers: the government ofSudan, the State of Khartoum government, private donors and the beneficiaries. It employs about 120 people.They offer state-of-the-art service in limb fitting. TOP OF PAGE 3Ismail: New Prosthetics Offer Hope in SudanPublished by JMU Scholarly Commons, 20119/4/15, 12:35 PMNew Prosthetics Offer Hope in Sudan, by Mohammed Ismail (15.2 online only)Page 4 of 4http://www.jmu.edu/cisr/journal/15.2/focus/Ismail/ismail.shtml The Journal of ERW & Mine Action is sponsored by:     © 2011 All rights reserved. The Journal of ERW and Mine Action, Center for International Stabilization and Recovery at James Madison University. MSC 4902 Harrisonburg, VA / USA 22807 | Email: cisr@jmu.eduIf cited properly, short sections (a sentence or two) can be used without permission. Written Journal of ERW and Mine Action approval is required,however, before longer sections of content published in The Journal may be used by another source or publication. ISSN 2154-1485 Past Issues * CISR Home * Subscribe4Journal of Conventional Weapons Destruction, Vol. 15, Iss. 2 [2011], Art. 9https://commons.lib.jmu.edu/cisr-journal/vol15/iss2/9

New Prosthetics Offer Hope in Sudan

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New Prosthetics Offer Hope in Sudan

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