International Committee of the Red Cross (ICRC)
Prosthetics for the lower and the upper limbs manufactured via ICRC’s polypropylene technology.
Prosthetics for the lower and the upper limbs manufactured via ICRC’s polypropylene technology. The product was selected for inclusion in WHO’s 2013 Compendium of Innovative Health Technologies for Low-Resource Settings.
ICRC develops polypropylene technology and trains local professionals in the use of technology to establish local limb-fitting centers. The establishment of these local centers allows ICRC to transfer responsibility to a local government or partner NGOs. In certain circumstances, ICRC may substitute entirely for the authorities, but 90% of ICRC projects are managed in close cooperation with local partners, primarily government authorities.
Funds from ICRC Special Fund for the Disabled cover the full cost or subsidize prosthetics. The funding structure of prosthetic provision varies from program to program depending on the financial capabilities of implementation partners as well as other factors such as local access to health insurance or government subsidized health care.
Lower-limb prosthetic technologies in the developing world
SATHI prosthesis, Monolimb, Roto-molded prosthesis, ATLAS prosthesis, Jaipur HDPE prosthesis
Goal 3: Good health and well-being
Physically disabled in regions of conflict or war
Individually crafted by a prosthetic technician on location using ICRC manufacturing guidelines
Worldwide at ICRC sponsored limb-fitting centers. In 2011 ICRC-assisted centers produced 19,740 prostheses and fitted the following amount of new patients with prostheses: Africa (2,435), Asia (4,265), Europe and the Americas (393), Near and Middle East (1,527)
437,910 prostheses as of 2014.
Skilled/unskilled required ability or training necessary to construct and fit a product for a patient
% of users reporting being satisfied with the product as determined by independent patient studies
% of patients reporting daily use of the product as determined by independent patient studies
% of patients reporting comfortable use of product in independent patient studies
The core of the prosthetic system is made of polypropylene. The injection process is used for making the components. Other parts of the prosthetic device (sockets, cosmetic covers, etc) are made of polypropylene sheets using thermoforming.
For thorough design specifications: ICRC Resource Center, Manufacturing Guidelines. Design history
ICRC-assisted centers are established locally and can provide technical support.
Ordered from manufacturer’s website (CR Equipments Switzerland)
Adult prosthesis: 3-5 years. The child might expect to be fitted for a prosthesis 15-20 times in a lifetime.
Waste material from polypropylene technology is recycled in many countries to make components of walking aids.
ICRC’s Physical Rehabilitation Programme promotes the use of technology appropriate for the context in which it operates (primarily countries effected by war and low-income or developing countries). It lists the following guidelines for any technology it deploys for the physically disabled:
- Durable, comfortable, easy for patients to use and maintain
- Easy for technicians to learn, use and repair
- Standardized but compatible with the climate in different regions of the world
- Low-cost but modern and consistent with internationally accepted standards
- Easily available
A study by ISPO followed 32 trans-tibial amputees using ICRC designed and manufactured polypropylene prostheses. 28 users were satisfied with the ICRC prosthesis and 23 found it to be their preferred artificial limb when compared to others. In the same study, minor failures of the prostheses were encountered, such as small cracks in the hard socket (4 instances) and cracks in the cosmetic seam (3 instances). ISPO concluded at the end of the study that ICRC’s polypropylene technology can be recommended for trans-tibial prostheses.
A second study by ISPO comparing ICRC polypropylene design with a conventional wood-resign design found both systems to provide acceptable technical and clinical results.
ICRC’s Physical Rehabilitation Programme maintains close contact with International Society for Prosthetics (ISPO) for inspection and evaluation purposes.
Ill-fitting prosthetic can result in physical discomfort and pain to the patient
Jensen, J. S., Heim, S. Evaluation of polypropylene prostheses designed by the International Committee of the Red Cross for trans-tibial amputees. Prosthetics and Orthotics International. 2000 Apr; 2(1):47-54.
Jensen, J. S., Raabb, W. Clinical field testing of trans-femoral prosthetic technologies: resin-wood and ICRC polypropylene]. Prosthetics and Orthotics International. 2004; 28(2):141-151.
Unknown, but the following standards exist for orthotics and prosthetics:
- International Standards Organization (ISO) has a standards catalogue from their Prosthetics and Orthotics Technical Committee
- International Society for Prosthetics and Orthotics “Prosthetics and Orthotics Programme Guide: Implementing P&O Services in Low-Income Settings“
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