Improving lives in three
WHO WE ARE
3D Sierra Leone is a Dutch project established in 2018 to improve prosthetic facilities in Low- and Middle-income Countries. In collaboration with the 3D-Lab at the Radboud University Medical Centre in Nijmegen, we set up a pilot 3D laboratory in Masanga Hospital in rural Sierra Leone. Exploring 3D-scanning and -printing techniques to locally manufacture affordable prosthetic aids that meet the necessary standard.
Access to 3D printing, even in its most basic form, can provide a useful and essential tool for manufacturing locally relevant medical aids, such as braces, splints, and prostheses. We can print both simple and more complex products when needed, decreasing transportation delay and lowering costs. Using only three steps – scanning, designing and printing – we can manufacture custom-fitted prosthetics for a wide variety of amputees.
Furthermore, the entire process can be automated; whereby the prosthetic fitting would become less dependent on the individual prosthetist’s skills and experience. This way, we can train more prosthetic specialists in a shorter time to help more people in need.
WHY WE DO IT
Many complex wounds and amputations occur in Sierra Leone due to traffic accidents and infections. A common problem is delayed patient presentation to the hospital, and a vast majority of patients consult traditional healers. Because of this combination of circumstances, an initially small medical problem often leads to amputation. Furthermore, many amputees lost their limbs because of acts of violence by the rebels during the civil war.
When people are missing limbs, they often feel incomplete, which can lead to insecurity, depression, and exclusion from society. With the help of 3D Sierra Leone, people have the opportunity to obtain affordable prosthesis. Having a prosthesis will allow them to feel a part of society again, giving them a huge confidence boost.
– Merel van der Stelt, Principal Researcher at 3D Sierra Leone, about her drive to keep doing what she does.
I am involved in this project for almost two years now. The first time I travelled to Sierra Leone, with a 3D scanner in my suitcase and a 3D printer on-site, was exciting. Soon it became clear that using 3D printers in remote areas with limited access to healthcare is not as misplaced as it initially seemed.
In 2018/2019, we performed a first feasibility study to investigate the use of a 3D printer in a resource-limited healthcare setting. We produced Low-cost 3D-printed arm prostheses and other medical aids. We conducted our next clinical research in 2020 to examine low-cost 3D-printed transtibial prostheses.
In Sierra Leone, they view me as some wizard who can make limbs appear out of thin air for people who need them. In a remote area like Masanga, people are not aware of technologies like 3D-printing. For many people, it is a remarkable device. It is just like a magic box. At first, patients have little confidence in the process. Flashing with some strange light, called a 3D scanner and making a prosthesis with rolled-up plastic that looks like electrical wires, seems unlikely to them. When they come to pick up their prosthesis within a few days, they are amazed. People who have not been able to walk for over 20 years suddenly take their first steps again.
A year later, I returned to Masanga. The first day I was walking around the surgical ward, where patients stay who undergo surgery or are recovering after surgery. Suddenly I heard from the back of the room, “Doctor Merel, we are happy to see you back!”. Frankly, I am not a doctor, but I still turned around. To my surprise, I recognized a patient who I met during my first trip a year earlier.
It excites and moves me to see how much impact the project has for the community and that people still recognize me. “How is the body? How is the family?” he asked me in Krio English. My visit had left quite an impression. I explained to him that rather than arms, we were going to make legs this time. He was delighted to mention a list of all the people he could think of that I could help.
Turns out in the small village of Masanga alone eight people needed a prosthetic leg.
For one patient it had been over ten years since his leg was amputated due to leprosy. A woman with the same condition and amputation was brought in a year ago. However, she had no family to take care of her, so the man did. Something has sparked between the two and now they are still taking care of each other. If you are an amputee without a family, your life is difficult in Sierra Leone. It feels amazing to bring these people together and literally help them back on their feet. These heart-warming stories are why I love what I do.
When I am in Masanga, I am myself, happy and excited. What you experience here sometimes feels unreal, but it is reality. Masanga has secured a place in my heart and makes me enjoy my work even more.
Masanga Medical Research Unit
In collaboration with the Masanga Medical Research Unit, we set up a pilot 3D lab at the hospital. The MMRU platform promotes medical research in Sierra Leone to bring healthcare professionals together with a network of international partners to perform medical research. They hope to improve access of Sierra Leonean researchers to academic degrees and to improve patient care at Masanga Hospital and beyond.
3D lab Radboud University Medical Centre (Radboudumc)
Much of the research takes place in the Netherlands. The 3D-Lab at the Radboudumc in Nijmegen facilitates the implementation of technological innovations in 3D imaging and printing into daily clinical practice. These new technologies help improve the care and treatment plans of patients while taking their specific individual needs and wishes into consideration. It has created a close collaboration between engineers, doctors, and patients. Our project is part of the 3D lab at Radboudumc.