Giving a second life to prostheses and orthoses
Since HI’s Liimba project was launched in 2006, HI teams have collected hundreds of used prostheses and orthoses from private individuals and professionals and reconditioned their components. The aim of this unique initiative deployed in Belgium, France and Luxembourg is to give people with disability access to high-quality orthopaedic devices to help them regain their mobility.
Once collected, the used prostheses are sent to a workshop in Vénissieux, near Lyon in France, where a team of volunteers dismantles them, cleans and sorts the components and identifies which ones are reusable and can be reconditioned.
‘We forget that what may seem to be no longer functional can in fact be reused, and prostheses and orthoses can also have a second life! We estimate that around 85% of the prostheses we recover can be reused,’ explains Victoire Hubert, Liimba project manager.
At the end of this reconditioning process, the components are sent to partner rehabilitation centres in countries such as Rwanda, Uganda, Madagascar and Togo, where they are used by orthoprosthetists to create prostheses tailored to the needs of the beneficiaries. The socket, i.e. the part moulded onto the stump, is made to measure in plastic, either using a plaster system or, more recently, 3D printing.
A project addressing a number of challenges
Around the world, the needs for rehabilitation are huge. It is estimated that one in three people is living with a health condition that requires this type of care, but that only 50% have access to it. Furthermore, over 3.5 billion people will need a mobility aid (wheelchair, crutch, prosthesis, etc.) by 20501.
The cost of a prosthesis remains high throughout the world. In France, a new prosthesis costs an average of €3,000 for a tibial prosthesis and €5,000 for a femoral prosthesis, costs that are generally covered by the healthcare system. However, these high costs limit access to prostheses for many people who do not benefit from reimbursement systems.
Prostheses and orthoses are an opportunity for people with disabilities to regain their mobility and autonomy. Whether they are amputees or living with a malformation, when fitted with one of these devices they are able to get around, go to work or school and realise their full potential.
And yet prostheses and orthoses are still inaccessible in many of the countries where HI operates only 15% to 25% of people who need an orthopaedic device can actually benefit from one2. There are several reasons for this:
- Lack of rehabilitation facilities: orthopaedic centres are scarce, and those that do exist often lack trained staff.
- Lack of procurement centres: components have to be imported at high cost, making them very expensive to distribute.
- Insufficient resources to manufacture prostheses or orthoses at a cost that local people can afford.
HI has identified 18 priority countries, including Rwanda, Uganda, Madagascar and Togo, where the needs are among the most pressing. In these countries alone, there are up to 44,500 new amputees each year3. HI selected these countries because of their significant need for functional mobility aids, but also with a view to introducing innovative solutions that consider the resources available in the country.
By targeting these countries, the Liimba project is helping to fill a medical gap while building local capacity for a sustainable impact.
Ambitious prospects and a promising future
Liimba is a fast-growing project based on an inclusive and collaborative model and supported by local and international partnerships. By 2024, 550 prostheses had been processed. The project is continuing to develop, with a view to providing wider support to a growing number of beneficiaries. By the end of 2028, HI aims to be supplying 30 Liimba partner rehabilitation centres with reconditioned orthopaedic components across the 18 target countries, enabling 10,000 lower-limb prostheses to be produced locally.
“Our Vénissieux workshop currently reconditions around 300 prostheses a year. Our ambition is to multiply this capacity by 10 to reach around 3000 prostheses!”
Lastly, once the activity has been developed sufficiently, HI's ambition is to create an inclusion unit within the workshop to support the professional inclusion of people with disabilities.
1 Rapport mondial sur les technologies d’assistance, Organisation Mondiale de la Santé et UNICEF, 2023
2 Organisation Africaine pour le Développement des Centres pour Personnes Handicapées (OADCPH)
3 Institute for health metrics and evaluation
