STAND recently funded training of The Gambia’s National Rehabilitation (NRC) Clinic team to make their own children’s prosthetic feet. Longini Mtalo, a Prosthetics and Orthotics educator formerly of the Tanzania Training School for Orthopedic Technologists, has been helping the team for a while. But this in-depth training lesson has been a little different. He was instructing the team to make feet from wood. 

STAND supplies the NRC with lots of refurbished, high quality legs; so why don’t we just supply children’s feet? Like all things with our work, the answer is never simple. But we have found locally-appropriate solutions like this can be the most impactful work we do at STAND.

Low supply means we need to get creative

For rehabilitation centres like the NRC, children can fall through the gap. A reliable and consistent supply chain is essential for keeping up with the changing needs of growing children who will need multiple replacements as they get older, and sourcing second hand components from donations cannot guarantee this level of consistency.  Used children’s prosthetic components are genuinely difficult to source. Unlike adult components, there is no reliable global supply chain. Demand is lower, parts are less standardised, and availability from international suppliers can change without warning.

Low tech, locally impactful solutions

Children grow, so prosthetic legs will need to be replaced. Wood is readily available in low income countries, so manufacturing feet is cheaper for the clinic, therefore making it cheaper and more accessible for patients.

Training is pivotal

The Gambia has no national programme for training in orthopedic technology. In fact, there is only one accredited programme in all of West Africa. Often further training means costly international travel and having to leave work for extended periods of time. This means that workshops like the NRC are staffed with a small number of skilled and dedicated staff, and there is little access to development opportunities. Ultimately this is a huge barrier to providing care to the disabled community. 

That’s why STAND brings the skilled practitioners to the workshop to provide in-country training which is appropriate to the local context and realities.

Sustainable impact

Training like this does more than solve an immediate supply problem. It is an investment that provides long lasting impact within The Gambia’s services:

• Technicians now have these skills, and will continue to have impact years after this training session.
• Less reliance on supply chains: when international supply of a component becomes unreliable, the team has a path forward that doesn’t depend on anyone else.

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