Ghana's National Prosthetic and Orthotic Centre Experience; An Attachment to Attachment

Ghana’s National Prosthetic and Orthotic Centre Experience; An Attachment to Attachment
6 min read

Have you ever been in the situation where as a student you watched YouTube tutorial videos and felt that all your academic scales have fallen off your eyes? And that you finally fully understood what your lecturer was going on and on about in class? My internship at Ghana’s National Prosthetic and Orthotic Centre made me feel more than that. It sharpened my thinking skills. It generated a burning interest and appreciation for Biomedical Engineering. It generated an attachment. An attachment that would never permit me deserting the field.

The National Prosthetic and Orthotic Centre

The National Prosthetic and Orthotic Centre, which falls under the Institutional Care Division of the Ghana Health Service, is responsible for the design and fixation of prosthetic and orthotic devices for patients. Some of their products include conventional knee-ankle-foot orthoses (KAFO), cervical collars, orthotic splints and braces, spinal orthoses (corsets), trans-tibial prostheses, trans-femural prostheses, partial hand prostheses, Syme’s prostheses and many more.

NPOC Products (Knee-Ankle-Foot Orthoses (KAFO), Lower Extremity Prosthetic Limb)

NPOC is one facility in Ghana that is greatly undermined due to lack of publicity and mainly poor infrastructure. The centre typically paints the picture of the clichéd notion that the Government of Ghana does not adequately support governmental institutions.

NPOC's Office

NPOC Office

NPOC Workspace

As at now, the centre relies heavily on the use of human strength to cut metals and other materials using hand saws. This is a ‘koko’ (easy) task for grown able-built ‘calloused-palms-as-a-result-of-constant-physical-work’ men, but for ‘slim-macho’ ‘almost-underweight-due-to-engineering young ladies’ like me, it is a Herculean task. We may try to be torch-bearers of the women-empowerment movement by a polite “Oh, I will cut it myself’’ but after three cutting strokes, we are tempted to think that male chauvinists were not too wrong in their assertion that some things are for men only. This scenario applies to other devices and machines as well because anytime I use the oscillating saw, I feel like my very osteoblasts have been induced to vibrate at their natural frequency. It is therefore of no surprise that there are no female prosthetists and orthotists currently at the centre.

Women who work at the orthotic centre have specialty in the fabrication and fixation of particular devices such as braces or corsets, and hence are not qualified to be addressed as orthotists. The making of braces and corsets is considered easy as compared to making prostheses and more complicated orthoses. This is mainly attributed to the manual and strenuous nature of the job, therefore calling for serious consideration on the use of automated and digital equipment at the centre not only to encourage the participation of women, but for easy production, increased safety and the manufacture of better orthoses and prostheses. This setback, however, does not deter me as a woman. It rather challenges me as engineer-in-the-making to design and come up with better equipment that would assist females in such or similar physically-engaging fields.

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My job as an intern there was to gain in-depth knowledge on the application and fixation of prostheses and orthoses, and to have an idea about their design. I was therefore challenged as a Biomedical Engineering student, to find solutions to problems encountered in the fabrication of these devices.

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One problem is the use of thermosetting polypropylene plastic in moulding casts instead of thermoplastics. Polypropylene, typical of thermosetting plastics, is not reusable and leads to incurred costs when the moulding goes wrong. There should also be a way of making Plaster of Paris (POP) (used for casting) recyclable since a great amount is used and wasted during casting. Concerning the issue of materials wastage, it would be of great advantage if majority of prostheses and orthoses made at the centre were pre-fabricated instead of custom-made.

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Plaster of Paris (POP) Casting

Plaster of Paris (POP) Cast

The centre also runs at a loss for every prosthetic or orthotic device made due to highly subsidized charge rates. This problem may be solved if the benevolence of philanthropists and sponsorship of poor amputees and the construction of an ultra-modern workshop is anything to go by.

Despite the numerous challenges faced by the centre, it offers one of the most excellent learning environments any Biomedical Engineering student can come across. The centre is one of the few institutions in Ghana that have workers structuring an organized internship program for interns. Every week, a mini-seminar on issues in Biomedical Engineering, prostheses and orthoses is organized for interns where resource personnel enlighten us on certain tit bits we need for a successful career. We are also given projects to undertake throughout the internship period. This year’s project involves the fabrication of solid-ankle cushioned heel (SACH) feet and prosthetic lamination adapters.

Through this experience, I have learned to apply Biomechanics, Engineering Design and Human Biology studied as part of the Biomedical Engineering curriculum. I strongly recommend the National Centre for Prosthetics and Orthotics to engineering students seeking a thorough application of engineering coursework and the acquisition of mechanical workshop skills. Indeed, there will certainly be an attachment to this attachment.

Tracey Ayebea Obeng

 

Tracy is a final year student of the Department of Biomedical Engineering at the University of Ghana. She has strong interest in STEM fields, particularly in Prosthetic Design & Engineering, because she believes it provides innovative solutions to problems, and enlightens the world on diverse capabilities in improved healthcare. Tracy also has a knack for writing, and this she believes, could spearhead her combined interests in STEM, and the issues concerning career women in these fields.