By David South, Development Challenges, South-South Solutions

3D printing is rapidly going mainstream and is now starting to make a big impact in health care. One innovative solution is using the technology to manufacture artificial arms for amputees harmed by war in Africa.
While large-scale manufacturers use the machines to fabricate products and parts, from aircraft components to furniture, it is the smaller-scale use of 3D printing machines that has been getting many working in development excited.
3D printing (http://en.wikipedia.org/wiki/3D_printing) usually involves a desktop-sized fabrication machine that builds a three-dimensional object following instructions from a digital computer file. It is an additive process, in which material is laid down in successive layers to create an object. The technology has been around since the 1980s but only became affordable for the general public in the past five years. Typically, 3D printers are used to make prototypes — for example architectural models or machine parts — or to manufacture one-off objects without the need to turn to mass production methods. But the technology is evolving quickly and, according to The Guardian, “20% of the output of 3D printers is now final products rather than prototypes.”
For international development, 3D printing offers the potential to close the gap between what is available in developed and developing countries. Just as the Internet has closed the knowledge gap, and enabled people around the world to access news and knowledge at the same time, so 3D printing could make it possible for technological innovations to be available everywhere. Just upload the digital plans for an object, and people can download them and print the item, wherever they are.
Some of the more enthusiastic proponents of 3D manufacturing see it as a game-changer in access to technology. They argue it could eliminate material want and place the power of manufacturing in the hands of billions, in the same way the rapid proliferation of mobile phones and the Internet transformed access to information. That is the dreamers’ dream, but it is closer than many think.
The conflict in the new nation of South Sudan, which separated from the Republic of the Sudan in 2011, continues and involves UN peacekeeping forces (http://unmiss.unmissions.org). The violence has killed over 10,000 (International Crisis Group) and injured many more, ruining lives through lost limbs and capabilities. One young boy, Daniel Omar, 16, lost both his hands while trying to use a tree trunk to shield himself from an exploding bomb. Losing his hands was devastating enough, but he was also so depressed at not being of full use to his family that he wished he had died that day.
He is not alone in being harmed by the conflict. In total, an estimated 50,000 people in South Sudan are physically disabled, according to the International Committee of the Red Cross (ICRC).
Prosthetic limbs are very expensive and so far are not a priority for medical services in the country. Saving lives is the priority, with rehabilitation an expensive luxury.
This is where Not Impossible Labs (notimpossiblelabs.com), based in Los Angeles, California, came in. The non-profit startup founded by Mick Ebeling specializes in “crowd-sourcing to crowd-solve previously insurmountable healthcare issues.” The solutions are then made public on the Internet and explained in online media to help innovators either replicate the solutions or be inspired to come up with their own ideas.
The lab’s ingenious solutions include BrainWriter – a way to draw using brainwaves and a computer mouse that can allow disabled artists to carry on creating. Not Impossible Labs also developed a high-tech cane for the blind that draws on sonar technology and a laser to navigate the terrain and foresee upcoming obstacles.
Emotionally touched after learning about Daniel’s plight, Ebeling decided to act.
“I’ve got three little boys,” Ebeling told The Guardian newspaper. “It was hard for me to read a story about a young boy who had lost his arms.”
Project Daniel (http://www.notimpossiblelabs.com/#!project-daniel/c1imu) set out to manufacture artificial hands for Daniel without him having to leave his country and his family. Daniel was living between the Yida refugee camp in South Sudan and his home in the Nuba Mountains.
A team from Not Impossible Labs set up the 3D printing lab in the Nuba Mountains and trained and supervised the local team to print two prosthetic arms. The design for the arm was done in the U.S. at its headquarters in Venice, California and is available for free and is open source (http://en.wikipedia.org/wiki/Open_source). A “dream team of innovators” were assembled – including the South African inventor of the Robohand (http://www.robohand.net/), an Australian MIT (Massachusetts Institute of Technology) neuroscientist and a 3D printing company owner from Northern California – to crowd-solve the challenge of making a 3D-printable prostheses. A precision engineering company, Precipart (precipart.com/home), and Intel were also drafted in to support the project.
Not Impossible believe the spirit behind the project will be globally transformative.
“We are on the precipice of a can do maker community that is reaching critical mass,” said Elliot V. Kotek, Not Impossible’s content chief and co-founder. “There is no shortage of knowledge, and we are linking the brightest technical minds and creative problem-solvers around the globe. Project Daniel is just the tip of the proverbial iceberg.”
Daniel’s new artificial arm and hand took a 3D printer several days to make and cost around US $100.
In November 2013, Ebeling travelled to South Sudan with all the equipment required to “print” Daniel a new arm: 3D printers, spools of plastic and cables.
The plastic arm printed by the 3D printer works by allowing the wearer to flex what remains of their arm to pull various cables that act as ligaments, like in a real limb. When the user flexes and bends, the cables pull back and in turn make the fingers close and open.
It is not a solution for every amputee. “With the technology we currently have it’s hard to help people with no arm left,” said Kotek. “There needs to be at least a little bit of a stump.”
Shy at first, once Daniel saw the arm, he was transformed. “It was a pretty amazing thing to see this boy come out of his shell,” said Ebeling. “Getting Daniel to feed himself was a highlight that was right up there with watching my kids being born.”
Even more impressive has been the quick adoption of the technology by the local doctor, Dr. Tom Catena, who performs all the amputations in the area.
With two 3D printing machines left behind by Ebeling, Dr. Catena has been able to print a prosthetic arm a week.
The machines mostly work at night when it is cool. The printer parts are then assembled by eight local people trained to operate the machines and build the arms.
But how do they ensure, over time, this 21st-century technology doesn’t just fall into disrepair and neglect as has been seen time and again with other attempts at technology transfer? Weekly phone calls are made to check on the project and the plastic used to make the arms is sent directly from Not Impossible Labs.
And then there is community buy-in.
“At first these kids wanted arms that matched their skin tone, because they didn’t want to stand out,” said Kotek.
But in time the youths have been decorating the arms in many colors and customizing them. And the arms have been given a name: the Daniel Arm.
Published: May 2014
Resources
1) The pioneer behind developing 3D technology has been the Massachusetts Institute of Technology’s Fab Labs based in the United States. It has been running experimental “Fab Labs” across the global South for the past few years, experimenting with ways to apply this technology to the challenges of development and to use this technology to turn people on to the power of technology to solve problems. These experiments have explored how a 3D printer could print everything a small community could require but would otherwise be expensive or difficult to purchase through normal markets. Fab Lab is the educational outreach component of MIT’s Center for Bits and Atoms (CBA), an extension of its research into digital fabrication and computation. Website: http://fab.cba.mit.edu/
2) 3D Systems: 3D Systems envisions a future in which 3D printing will return humanity to a heritage of personalized, localized craftsmanship and improve quality of life. A new industrial revolution changing the human experience from health care to entertainment. Website: 3dsystems.com
3) MakerBot: MakerBot makes a range of 3D printers for consumers. Website: makerbot.com
4) Stratasys: Stratasys manufactures 3D printing equipment and materials that create physical objects directly from digital data. Its systems range from affordable desktop 3D printers to large, advanced 3D production systems, making 3D printing more accessible than ever. Website: http://www.stratasys.com/
5) 3D Printing and Technology Fund: The Fund seeks long term capital appreciation through focused investment in global 3D printing and technology companies. Website: http://www.3dpfund.com/
6) Digital Revolution: An Immersive Exhibition of Art, Design, Film, Music and Video Games: Running from July to September 2014 at the Barbican Centre in London, UK. Website: https://www.barbican.org.uk/bie/upcoming-digital-revolution


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ORCID iD: https://orcid.org/0000-0001-5311-1052.
© David South Consulting 2022
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