Earth is calling... Merel van der Stelt

“It all started when one of my supervisors, Lars Brouwers, drove to Sierra Leone in 2017 with a 3D printer in his trunk. In the hospital where a friend of his worked as a tropical doctor, he left the printer. In the following time, however, the printer was barely used. The doctors were too busy to investigate the possibilities of the printer. Lars realised help had to come from The Netherlands. He created the possibility for Technical Medicine UT students to do an internship at the Masanga Hospital. I was the first student to so do and I started digging into 3D printing. From December 2018 up to and including February 2019 I visited Sierra Leone to discover what the printer could be used for. The idea existed to make prostheses and other medical devices, so I printed a few splints and a brace for a boy with scoliosis. That turned out to be a bull's-eye; there was a great need for medical devices. In Sierra Leone there are small prosthetic clinics, but their prostheses are priceless for many citizens.

We continued to print prostheses. We aim to manufacture very simple prostheses so that the local population with limited knowledge of IT and prostheses can still make a good and cheap prosthesis. We collaborate with local physiotherapists and prosthetists. Our goal is that they can develop the prostheses themselves. This requires us to continue talking with patients. For example, we are now trying to set up a register of all patients that we gave a prosthesis. We have set moments to revisit patients to see how both they and their prostheses are doing. This allows us to adjust and improve the new models.

Sierra Leone may seem like a different world, but it is, in fact, a different planet. People end up in the hospital with very small problems, such as a bone fracture. In the Netherlands, patients would then get a cast and are recovered after a few weeks. In Sierra Leone, we noticed that such small problems could become big. People often call in a doctor late, or they approach a traditional healer. As an example, there was a 7-year-old boy who ended up in the hospital a few weeks after he fell from a tree. His parents were not educated and had done what they thought was best. They brought him to a traditional healer. According to customs, the traditional healer laid boiling hot leaves on his leg, causing blisters and ultimately, infections. The parents kept on waiting until they finally visited the hospital. At that point, the boy’s arm was dead. It was poignant to see, especially because I knew that the fracture was something that could have easily been solved. Eventually, the arm had to be amputated.

From the Netherlands, we do not always have a good view of what people elsewhere need. I came up with the current prosthesis design after a conversation with a local woman. There are functional prostheses in Sierra Leone that look like a hook, but the woman wanted a prosthesis that would not stand out. She was ashamed of her stump to such an extent that she always hid it under her clothes. She, therefore, did not use that arm at all. After I had spoken to several people about prostheses, I discovered that there was a great demand for aesthetic prostheses. Prostheses can be functional if we ensure that people gain more confidence and dare to show their prosthesis - simply because it looks like a regular limb. The woman in question did not use her arm because she was ashamed of it. Now that she has the prosthesis, she is not afraid to show her arm. She now uses her prosthetic arm, among other things, to support her other hand picking something up. The fingers on the prosthetic arm are bent, making them function as a sort of hook. The woman can now pick up a bag from the floor, and it also supports her cooking and lifting her children.  

The situation in Sierra Leone makes me want to make an effort for the people there. After consultation, the University of Twente has made the 3D lab in the Masanga Hospital a permanent location to do an internship. Three students have travelled to Sierra Leone in the meantime. The students alternate. Every ten weeks, a new student arrives with a personal research question, focused on the 3D printing of prostheses. This is how we maintain the project. The project requires money. Together with Lars and the Netherlands Albert Schweitzer Fund (NASF), I launched a crowdfunding campaign. We have raised almost 7 thousand euros. This money will be spent on equipment, materials and better electricity supply. Now, we would like to raise extra money to involve local people in the project. Among other things, we would use the money to pay their salaries. Finally, our dream is to purchase a mobile workplace that we can use together with the research department. The mobile workplace enables us to reach people in remote areas and benefits follow-up appointments. To make the best use of this car, it will be the hospital's research car.

In short, we want to make sure that people with few resources get better chances for a bright future. We may prevent them from having to live in difficult circumstances or even being excluded by their disability. By exchanging cultural, medicinal and technological knowledge, a collaboration has been established in which both the Dutch trainees and the local population learn from each other. Donations can be made via www.nasf.nl, and for additional information, as well as patient stories, you can go to www.3dsierraleone.com.

The crowdfunding campaign runs until October 10, 2019. After that, we will think of how to proceed. In the meantime, I am researching how we can make leg prostheses because leg amputations are common in Sierra Leone. For the past six months, I have been searching for materials that can be used to make simple, fast and cheap leg prostheses. I hope to return to Sierra Leone in January. I am now conducting research on Dutch patients, and if that goes well, I will go to Sierra Leone to continue my research.”

Continue reading here about solutions from Twente for global challenges.