Limb loss and recovery: Innovative solutions to counter the effects of Sri Lanka’s civil war

“Most children have two whole legs and two whole arms but this little six-year-old that Dinesh was carrying had already lost one leg, the right one from the lower thigh down, and was now about to lose his right arm.”- A Story of A Very Brief Marriage

These are the haunting opening lines of Anuk Arudpragasam’s novel set during Sri Lanka’s civil war which describes, in painfully raw detail, the devastating effects of this conflict on the most innocent of victims. While the novel is fictional, the consequences of this 30-year war are acutely real.

Workers handcrafting prostheses at the Jaffna-Jaipur Clinic in Sri Lanka.

Anti-personnel land mines were responsible for more than 160,000 lower limb amputees in the country. Many of these individuals now struggle to live normal lives and reestablish themselves in a highly disrupted society.

In July 2016, Baylor College of Medicine Global Initiatives had the privilege of visiting the north-central provinces of Sri Lanka and many of the areas where the war took place. Today, the green fields of high grass and banana trees are rimmed with barbed wire and interspersed with demining vehicles, deployed by multinational aid agencies.

In Jaffna, the capital of Sri Lanka’s Northern Province, the Jaffna-Jaipur Centre for Disability and Rehabilitation manages, those injured by these mines. Currently, it is the only center providing prosthetic, orthotic, orthopedic and rehabilitative services in the region, serving a large population with limited resources and technical support.

The completed prosthesis, which is made of mostly rubber.

A visit to Jaffna-Jaipur provided the opportunity to view the prostheses being constructed by technicians using molds and local materials to hand craft the different components. The team at Jaffna-Jaipur does remarkable work given the significant resource constraints in the region. Nevertheless, there is great potential to magnify their capabilities using modern material science, and 3D printing.

This type of an automated approach would require significant local investment in 3D scanners, printers, and training of the local staff. Nevertheless, the benefits of this approach would be considerable: lightweight, comfortable, maneuverable prostheses that are quickly, reliably and cost effectively reproduced.

Over the next few months, Caroline Soyars, Baylor Global Initiatives fellow, and Jared Howell, director of orthotics and prosthetics at Baylor, will be partnering with non-governmental organizations and the Ministry of Health in Sri Lanka to develop local capacity to create these innovative prostheses. We are hopeful that creative collaboration around this tragic issue can reduce the devastating medical, social, and occupational impacts of these injuries, in Sri Lanka and other war-torn regions.

-By Dr. Sharmila Anandasabapathy, professor of medicine-gastroenterology and director of Baylor Global Initiatives

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