When creating artificial limbs and braces, Humanity & Inclusion uses alternative, innovative solutions to limit negative environmental impacts.
Artificial limbs and braces can be life changing for many people. They open the door to countless opportunities and contribute to the invaluable autonomy and independence of their users. However, making these devices often requires an incredible amount of energy and materials.
“To make an orthopedic device, we need a lot of plastic, metals, water, plaster, carbon, resin, and more,” says Abder Banoune, rehabilitation specialist for Humanity & Inclusion.
“It takes a lot of energy, and a lot of people to make one simple device,” Banoune continues. “Each one is custom-made for the user, and new ones must be made as people grow or their bodies change. For example, many adults change prosthetics every five years, but amputation is for life. So you can imagine how many devices one person would have in their closet after 40 or 60 years. Children need to change even more frequently (every six months or a year) since they grow more. This results in a lot of waste.”
Humanity & Inclusion is committed to making quality rehabilitation care accessible to people all around the world, while remaining conscious of its ecological impact. Low-income countries, where Humanity & Inclusion primarily operates, are disproportionately affected by the negative consequences of waste, climate change and environmental neglect, all of which magnify humanitarian needs. As part of Humanity & Inclusion’s commitment to the communities it serves and to their environments, the organization takes a three-prong approach to limit waste and energy use in creating assistive devices: reuse, reduce, recycle.
After seeing old assistive devices going to waste, Humanity & Inclusion’s Rehabilitation Director Isabelle Urseau had the idea to reuse second-hand artificial limbs and braces. Banoune has seen the same thing.
“When I was working in Africa, the centers all had huge piles and containers full of destroyed or rusted devices that could not be re-used,” Banoune explains. “They are just dumped in the backyard where they would stay forever.”
In Lyon, France, Humanity & Inclusion operates a second-hand prosthetics workshop called “La Poudrette.” It’s run by retired prosthetics and orthotics professionals. The workshop receives used devices and dismantles them, conserving all of the re-usable components that can help construct new devices.
“About 50-60% of the device can be re-used,” Banoune explains. “Sometimes, if you need to repair a device, you only need one part. Instead of buying new components or having to make an entirely new prosthetic, we can still use the parts that are good quality from the old ones.”
La Poudrette has grown significantly since its creation and is now dismantling as many as 1,500 prosthetics each year, with plans to double or triple their actions in the near future.
In 2016, Humanity & Inclusion became the first NGO to use 3D printing to make braces in low-resource settings. In Uganda, the organization uses the innovative technology in refugee camps to scan individuals in need of orthopedic devices, and send the digital files off to be 3D printed in a separate location, without the recipient needing to travel to a rehabilitation center. By doing so, Humanity & Inclusion can reach more people in isolated areas while using less energy and fewer materials than the traditional method of making these devices.
When making devices the traditional way, a cast of the body is first made out of plaster, which is difficult to recycle. Plastic is then heated to 392 degrees Fahrenheit to be shaped onto the plaster cast, before later adding components such as metal joints, foam, resin laminate and others. The process requires thousands of gallons of fuel, a powerful generator, and a large center to house the equipment.
“3D printing is a unique approach to making orthopedic devices without needing huge equipment, lots of energy, or a lot of materials,” Banoune says. “It’s all virtual, so instead of using plaster, we can just scan the limbs. We don’t need a huge space and the printer only uses a small amount of energy—about three or four times less than the traditional method. In the future, I think we can power them by solar panels, which would not be possible traditionally. It’s ecological, and it is inexpensive.”
Though 3D printing is emerging as a possible solution, plaster-based creation is still the norm for most devices. The plaster required to make artificial limbs and braces is often shipped internationally and can only be used once before being thrown in the trash. Gypsum, from which plaster is made, makes up 400,000 tons of waste worldwide. Humanity & Inclusion alone creates 5 to 10 tons of gypsum waste per year through prosthetic creation, and is determined to find a solution.
Humanity & Inclusion has partnered with the National Institute of Applied Sciences, an engineering school in France, to conduct research to solve this problem. A program at the institute is performing experiments and studying efficient ways to re-use and recycle the plaster needed for the prosthetics process.
Another research program is looking at ways to locally source and recycle materials such as plastic bottles or vegetable fibers to create the filament used in 3D printing.
“It’s important to find adapted, local solutions,” explains Magdalena Szynkowska, Humanity & Inclusion’s Innovation Development Officer. “Every context might have different materials available, different vegetable fibers, and variety of types of plastic used in plastic bottles, so there may not be one single answer. It is complicated work, but I am confident that we will find solutions.”
GREEN Initiative: Humanity & Inclusion is committed to reducing the adverse effects of climate change on populations worldwide. We help communities prepare for and adapt to climate shocks and stresses, and we respond to crises magnified by environmental factors. Applying a disability, gender and age (DGA) inclusion lens across all our actions, we advocate for practitioners and policy-makers to embed DGA in their climate work as well. Humanity & Inclusion is also determined to reduce its own ecological footprint by adapting and implementing environmentally conscious approaches to humanitarian action.