LOCALadk Magazine

Next, practitioners gave him a Namaste Liner, made a week earlier in Kathmandu by Amrita Lama, a member of ACT Nepal, a group whose goal is to provide easy access to quality rehabilitation services. Amrita and other members of ACT Nepal had just been trained to make liners by Operation Namaste's CPO and founder, Jeff Erenstone. Since the liner-making process utilizes low-cost, 3D-printed molds and medical-grade platinum-cured silicone, ACT Nepal is able to provide them at a small fraction of the cost of conventional liners. Once the liner was on, practitioners cast and measured Suraj's limb using the finished plaster cast to create a mold. Working together, Jeff Erenstone and Shovakanta Sharma modified the shape. While Shovakanta is very skilled at making older-style prostheses (PTB style), he had only made a modern prosthesis (total contact style) once. Jeff taught Shovakanta the process, and he will continue to learn under the guidance of Operation Namaste volunteers. Aer the plaster model was completed, an EVA foam inner liner was made and a plastic socket was created. GPH uses ICRC (International Committee of the Red Cross) methods and components, which were used in this prosthesis. (Erenstone and Operation Namaste believe that you should change as little as possible when introducing new technology. Since these components were already working, and practitioners at GPH were familiar with them, there was no need to change.) Four days later, Suraj returned and the prosthesis was trimmed, height-adjusted, and aligned. Aer some dynamic gait adjustments, Suraj began to walk extremely well. Results were measured using a two-minute walk test. On Monday, wearing his old prosthesis, Suraj logged 150 steps in two minutes, below normal for someone his age. On Friday, wearing his new prosthesis, he walked 180 steps, normal range for an able- bodied twenty-year-old. He came into the clinic using crutches and le without them. Suraj's prosthetic care was not expensive. e new prosthesis, clinical care, and Namaste Liner cost a total of $380. is level of care can be maintained throughout Nepal based on just three points: All the components come from normal supply chains, or are fabricated in Nepal and easily distributed. e quality of care was brought up to modern standards, but the cost has not increased significantly. Local clinicians now know how to provide that level of care themselves, and have been provided a mentor to answer any questions. What started out as an inspired idea during a mountain biking trip seven years ago has grown into a powerful reality, the reality of many Nepali who can now enjoy their lives with dignity and, perhaps most importantly, without pain. 57 LOCALadk

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