Artificial limbs

Growing demand opens up opportunities for local manufactures

The ambience of the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR)—popularly known as ‘Pongu Hospital’—in Sher-e-Bangla Nagar, has never been too pleasant. Dim lights, unpleasant odours, and the ghastly sight of limbless patients groaning in pain—a visit to the hospital could be quite a nightmarish experience. However, amid all the despair, there is something at the hospital that offers some comfort. It’s room no. 102 on the ground floor. At first glance, it may look a bit like a mannequin factory. But the artificial limbs that make it seem so, are what give the patients a ray of hope.
The world-famous Jaipur Foot is in Bangladesh once again, on a three-week campaign this time, courtesy the Moyeen Foundation, a Dhaka-based welfare foundation. Starting May 8, several prosthetic lower limbs have already been produced in room no. 102.
Incidentally, until only two years ago, the ‘artificial limb centre’ at NITOR had been dysfunctional. The supply of low-cost artificial limbs for the poor at NITOR had come to a halt for almost 12 years, as all the limb-makers had retired from service.
In 2013, Jaipur Foot first came to Dhaka to help the Rana Plaza-collapse victims. The Moyeen Foundation tied up with them and brought them back to Dhaka last year, for a camp at NITOR. New limb-makers were hired and the dysfunctional ‘artificial limb centre’ of NITOR was once again abuzz with activity.
So, this year, they are back again. Prakash Bhandari, who is leading the camp, told The Independent that 500 of Bangladesh’s poorest amputees will be fitted with artificial limbs, free of cost. The camp has been sponsored by Bangladesh Orthopaedic Society, NITOR, and Asif Moyeen and Sadia Moyeen of Far East Knitting and Dyeing Industries.
Bhandari explained that the beauty of the Jaipur Foot is its lightness and mobility. Those who use it can run, pedal bicycles, and even climb trees. One of Jaipur Foot’s knee replacements, developed in cooperation with Stanford University, costs a mere US$20 and was named one of the 50 best inventions in the world by Time magazine.
Bhandari said all Jaipur Foot limbs are custom-fitted. “At first, we take the amputee’s measurements and then our team produces the limb(s),” he said.
The Jaipur Foot is said to be superior to the Solid Ankle Cushion Heel in some ways, mainly in the range of movements it offers. It allows several crucial actions, like squatting, standing up from a prone position, etc., with ease. Also, the material used for the foot is waterproof and the model moderately mimics a real foot.
Bhandari said that around 25 patients are being treated daily at the 20-day camp. “From around 1,000 patients, NITOR will select around 500, on the basis of the medical criteria laid down by BMVSS (Bhagwan Mahaveer Viklang Sahayata Samiti in Jaipur),” said Bhandari.
Prof. Dr Iqbal Qavi, director of NITOR, said the demand for artificial limbs has been increasing in the country, because of a large number of road accidents. He said most of the artificial limbs are imported from India, Germany, China and Korea. However, some local manufacturers have started producing quality limbs, which are gaining popularity as well, Dr Qavi added.
More than 10 private limb centres have now sprung up in Shyamoli, close to NITOR. Besides artificial limbs, they sell surgical shoes, pelvic traction, orthopaedic belts, cervical collars, crutches, walkers, and other surgical items.
The largest of these private limb centres was set up by the NGO, BRAC. At the BRAC Limb and Brace Fitting Centre, 2,836 people have been fitted with artificial limbs since its inception in 2008.
Dr Md Shahinul Haque Ripon, senior programme manager of BRAC Limb and Brace Fitting Centre, said no study is available about the size of the artificial limb market in Bangladesh.
According to the World Health Organization, the country, with its chaotic traffic and poor safety standards, has 400,000 road accidents every year, he said. In addition, many poor people have deformities or musculoskeletal diseases, and they don’t get sufficient care.
“Because of the increasing demand for artificial limbs, manufacturing facilities are now being established here,” he said.
Another large private limb centre is Dynamic Limb Centre. Its showroom displays high-end products like the Proprio Foot, the C-walk, the Single Axis Foot, and the 3R45 knee joint, as well as regular plastic limbs and all sorts of artificial joints.
Abu Sayeed, director of marketing and sales at Dynamic Limb Centre, said that they have their own manufacturing facilities, which produce all kinds of artificial limbs and braces. It has the capacity to produce around 800 artificial limbs per month.
“The demand for artificial limbs is increasing. Every month, we sell around 400 to 500 units of artificial limbs. We also import high-end mechanised products like the Proprio Foot and the C-walk from Germany. Those are very costly, though,” he said. The cost of their products ranges between Tk 600 and Tk 400,000.
Sayeed said they have a number of internationally trained artificial limb makers as well as prosthetists and orthotists. “Very few people in the country are trained in these skills,” he said.
According to the Centre for the Rehabilitation of the Paralyzed (CRP), only 25 people in the country have international certification to produce artificial limbs, braces, and splints. Until recently, Bangladeshis had to go to schools in India or Vietnam to train in these skills. However, the situation is changing.
In 2014, CRP started the country’s first diploma course for clinicians. Ten students enrolled in the three-year programme, which is supported by the International Committee of the Red Cross (ICRC) and international donors. Another 10 have signed up for the course this year. All the students get a full scholarship and are employed by CRP after graduation.
Sohanur Rahman, head of the prosthetics and orthotics department of CRP, said that, last year, around 820 patients were fitted with prosthetic and orthotic devices at the two CRP clinics in Dhaka and Chittagong. Ninety percent of these patients received free treatment, thanks to CRP and the Red Cross. “The market for artificial limbs is growing. Local manufacturers are now coming forward to join the market, which is still dominated by imported materials,” he said.

Artificial limbs

Growing demand opens up opportunities for local manufactures

The ambience of the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR)popularly known as Pongu Hospitalin Sher-e-Bangla Nagar, has never been too pleasant. Dim lights, unpleasant odours, and the ghastly sight of limbless patients groaning in paina visit to the hospital could be quite a nightmarish experience. However, amid all the despair, there is something at the hospital that offers some comfort. Its room no. 102 on the ground floor. At first glance, it may look a bit like a mannequin factory. But the artificial limbs that make it seem so, are what give the patients a ray of hope. The world-famous Jaipur Foot is in Bangladesh once again, on a three-week campaign this time, courtesy the Moyeen Foundation, a Dhaka-based welfare foundation. Starting May 8, several prosthetic lower limbs have already been produced in room no. 102. Incidentally, until only two years ago, the artificial limb centre at NITOR had been dysfunctional. The supply of low-cost artificial limbs for the poor at NITOR had come to a halt for almost 12 years, as all the limb-makers had retired from service. In 2013, Jaipur Foot first came to Dhaka to help the Rana Plaza-collapse victims. The Moyeen Foundation tied up with them and brought them back to Dhaka last year, for a camp at NITOR. New limb-makers were hired and the dysfunctional artificial limb centre of NITOR was once again abuzz with activity. So, this year, they are back again. Prakash Bhandari, who is leading the camp, told The Independent that 500 of Bangladeshs poorest amputees will be fitted with artificial limbs, free of cost. The camp has been sponsored by Bangladesh Orthopaedic Society, NITOR, and Asif Moyeen and Sadia Moyeen of Far East Knitting and Dyeing Industries. Bhandari explained that the beauty of the Jaipur Foot is its lightness and mobility. Those who use it can run, pedal bicycles, and even climb trees. One of Jaipur Foots knee replacements, developed in cooperation with Stanford University, costs a mere US$20 and was named one of the 50 best inventions in the world by Time magazine. Bhandari said all Jaipur Foot limbs are custom-fitted. At first, we take the amputees measurements and then our team produces the limb(s), he said. The Jaipur Foot is said to be superior to the Solid Ankle Cushion Heel in some ways, mainly in the range of movements it offers. It allows several crucial actions, like squatting, standing up from a prone position, etc., with ease. Also, the material used for the foot is waterproof and the model moderately mimics a real foot. Bhandari said that around 25 patients are being treated daily at the 20-day camp. From around 1,000 patients, NITOR will select around 500, on the basis of the medical criteria laid down by BMVSS (Bhagwan Mahaveer Viklang Sahayata Samiti in Jaipur), said Bhandari. Prof. Dr Iqbal Qavi, director of NITOR, said the demand for artificial limbs has been increasing in the country, because of a large number of road accidents. He said most of the artificial limbs are imported from India, Germany, China and Korea. However, some local manufacturers have started producing quality limbs, which are gaining popularity as well, Dr Qavi added. More than 10 private limb centres have now sprung up in Shyamoli, close to NITOR. Besides artificial limbs, they sell surgical shoes, pelvic traction, orthopaedic belts, cervical collars, crutches, walkers, and other surgical items. The largest of these private limb centres was set up by the NGO, BRAC. At the BRAC Limb and Brace Fitting Centre, 2,836 people have been fitted with artificial limbs since its inception in 2008. Dr Md Shahinul Haque Ripon, senior programme manager of BRAC Limb and Brace Fitting Centre, said no study is available about the size of the artificial limb market in Bangladesh. According to the World Health Organization, the country, with its chaotic traffic and poor safety standards, has 400,000 road accidents every year, he said. In addition, many poor people have deformities or musculoskeletal diseases, and they dont get sufficient care. Because of the increasing demand for artificial limbs, manufacturing facilities are now being established here, he said. Another large private limb centre is Dynamic Limb Centre. Its showroom displays high-end products like the Proprio Foot, the C-walk, the Single Axis Foot, and the 3R45 knee joint, as well as regular plastic limbs and all sorts of artificial joints. Abu Sayeed, director of marketing and sales at Dynamic Limb Centre, said that they have their own manufacturing facilities, which produce all kinds of artificial limbs and braces. It has the capacity to produce around 800 artificial limbs per month. The demand for artificial limbs is increasing. Every month, we sell around 400 to 500 units of artificial limbs. We also import high-end mechanised products like the Proprio Foot and the C-walk from Germany. Those are very costly, though, he said. The cost of their products ranges between Tk 600 and Tk 400,000. Sayeed said they have a number of internationally trained artificial limb makers as well as prosthetists and orthotists. Very few people in the country are trained in these skills, he said. According to the Centre for the Rehabilitation of the Paralyzed (CRP), only 25 people in the country have international certification to produce artificial limbs, braces, and splints. Until recently, Bangladeshis had to go to schools in India or Vietnam to train in these skills. However, the situation is changing. In 2014, CRP started the countrys first diploma course for clinicians. Ten students enrolled in the three-year programme, which is supported by the International Committee of the Red Cross (ICRC) and international donors. Another 10 have signed up for the course this year. All the students get a full scholarship and are employed by CRP after graduation. Sohanur Rahman, head of the prosthetics and orthotics department of CRP, said that, last year, around 820 patients were fitted with prosthetic and orthotic devices at the two CRP clinics in Dhaka and Chittagong. Ninety percent of these patients received free treatment, thanks to CRP and the Red Cross. The market for artificial limbs is growing. Local manufacturers are now coming forward to join the market, which is still dominated by imported materials, he said.