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In Togo, hi-tech orthopaedic care goes through crucial test
LOME, June 23, 2018 (BSS/AFP) – In a consulting room in Togo’s capital,
Lome, Geraldo Emmanuel — handicapped since birth six years ago — waits
patiently on a bed while a digital scan is taken of his right leg.
Thanks to new 3D technology, he may be able to walk normally within a few
months.
“The child walks on his toes so I’m scanning his leg so we can make him an
orthotic using a 3D printer,” said Enyonam Ekpoh, from Togo’s national
orthopaedic device and physiotherapy centre (CNAO).
A few hours later, Adjovi Koudahe, 46, has tests to receive a 3D brace for
her right leg, which has been paralysed since a car accident in 2012.
“I’ve stopped doing anything because I’m in pain. I can’t walk properly
anymore,” said the former trader, who limps heavily, aided by a crutch.
“Despite all the treatment I’ve had, my leg won’t respond and drags along
the ground. But with the brace they want to make here, I’ve got high hopes.”
Three-dimensional printing is a fast-track way to make individually-
tailored prosthetics and orthopaedic supports that compensate for a lack of a
limb, deformity or paralysis.
The technology, initiated by a charity called Handicap International,
allows the bespoke devices to be produced faster and reach a larger number of
patients.
But if it is familiar to orthopaedic clinics in rich countries, it has yet
to be introduced to poorer countries where needs are greater and the social
safety net much smaller.
Only five to 15 percent of people in low income countries who need a
prosthetic limb or orthopaedic brace get one, according to the non-profit
organisation based in France.
Handicap International — recently renamed Humanity & Inclusion — is
pushing ahead with research and clinical trials to see how the technology can
be used in poor settings.
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In 2016, it carried out clinical trials of three types of lower limb
prosthetics in Madagascar, Syria and Togo, the results of which were highly
encouraging.
A more ambitious project called “3D Impact” has been running in Togo, Mali
and Niger since November last year, where 100 patients are getting made-to-
measure 3D devices for free.
The project is backed by 700,000 euros ($816,000) of funding from the
Belgian Development Agency.
Fifty of the 100 patients will be in Togo, where many handicaps affecting
mobility are linked to strokes or infectious diseases such as polio, said
Impact 3D manager Simon Miriel.
– Saving time –
3D printing is revolutionary for doctors working in conflict zones or even
just hard-to-reach areas: the scanner is the size of about two mobile phones
and very easy to transport.
One has been tested at a regional orthopaedic centre in Dapaong, some 620
kilometres (390 miles) by road north of the capital.
Normally, patients far from hospitals would have had to travel to have
casts taken.
“It saves us a lot of time,” said Miriel.
“As need be, scans can be sent directly by telephone to the specialist in
charge of making the digital orthotic on a 3D printer.”
In all, four 3D scanners are being used in the three countries.
The project’s two printers are located in a laboratory in Avepozo, some 15
km from Lome, and work non-stop to produce all the orthopaedic devices.
Togo is a good choice, said Miriel. “It is one of the few countries in West
Africa which has a good structure for orthopaedic care.”
Specialists from across the region are trained at the national school of
medical auxiliaries (ENAM), which is a partner in the project.
The test phase is expected to finish before the end of the year, and will
be followed by a long evaluation about the successes and problems, costs and
benefits.
But, if all goes well, the cost of 3D orthopaedic devices will fall
dramatically, the charity hopes.
The devices that were tested in 2016 were printed overseas and cost between
1,500 and 2,000 euros each (from $1,745 to $2,330) — a huge sum in West
Africa, where the average wage often does not exceed $100 a month.
But once the devices are made in-country, they will become “a lot more
accessible”, said Miriel.
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