FAQ: Rescuing and Recycling Prosthetic Legs
How do we check devices are safe for reuse?
Devices, new or used, always carry the risk of failure. To reduce this risk:
- We do not send out any complex products such as microprocessor knees, preferring simple mechanical knees, feet, pylons, and adaptors.
- Components are visually inspected for damage, and any moving parts are mechanically checked. Additionally, they undergo a second inspection when received by a partner clinic before being fitted to a patient.
- Partner clinics and their staff, being aware that components have already been used, will perform further checks before fitting prosthetics to a patient.
- Patients are informed that components are used and require more frequent durability checks.
- Partner hospitals and clinics have at least one fully trained prosthetist with several qualified technicians. In addition, we provide information on industry standards, opportunities for in-person training, and links to online events and webinars.
- Most prosthetic devices are engineered to a limited number of steps to warrant durability and performance. However, practically speaking the number of steps an amputee takes on a device is not and cannot be precisely limited. As such, there are doubtless many prosthetic users that are walking on prosthetics that have exceeded recommended step count. This is a risk that has always been managed in the prosthetics industry by prosthetists.
How do we mitigate the risks of using devices designed for single users on multiple users?
We, and those that receive components from us, believe the benefits greatly outweigh the risk, that said we mitigate the risks of reusing prosthetics by doing the following:
- We dismantle the devices we rescue and thoroughly inspect their components. This ensures the product has serviceable life remaining before our partner clinics receive them for reuse.
- Components are sprayed and wiped with isopropyl alcohol before being shipped to partner clinics.
- We do not send used liners
- We check they are safe (see “How do we check devices are safe for reuse?” above)
How do we manage donors’ liability?
Rescued legs arriving in our collection hubs are dismantled, and everything is organised by component type or size, leaving no way for us to know where the components originally came from. We have a ‘hold harmless’ agreement in place with our downstream partner clinics as well as donor suppliers so that no liability can be transferred up the supply chain.
How can we ensure devices are fitted correctly?
Partner hospitals and clinics have at least one trained prosthetist to ISPO standards with several qualified technicians. In addition, we provide information on industry standards, opportunities for in-person training, and links to online events and webinars.
Is there a risk of reselling and profit-making?
Reselling and profit-making are high up in the risk register. We do everything we can to mitigate these activities. We work closely with trusted partners in sub-Saharan Africa to ensure donated components are accounted for by:
- Requiring inventory tracking: Our partners are required to have sufficient secure storage, take regular stock checks, and record who receives the components.
- Assuring cost transparency: We also require transparency around the costs passed on to patients and enforce that only labour costs be charged. Labour costs vary from clinic to clinic, and we work closely with each clinic to decrease costs passed onto the patient. Our partner clinics are very transparent about their expenses and non-sensitive patient data, helping us see the bigger picture and understand where more work needs to be done.
- Providing whistleblowing pathways: We actively promote accessible methods for patients, staff, or the general public to whistleblow and report suspicious activities. Part of the vetting process and annual MOU assessment explains that the components we donate are strictly not for sale. Partners understand that their agreement will be swiftly terminated should anything like this be realised. We also provide clinics with patient information posters for waiting rooms, all of which include whistleblowing directions should patients believe they are being sold components provided by Legs4Africa. Finally, we are building networks within the amputee community and advocacy and sports groups in our partner clinic countries to broaden the reach of communications for whistleblowing.
Is there sustainability in donating legs?
The demand for prosthetic legs across sub-Saharan Africa overshadows the supply, and thousands of perfectly serviceable components are disposed of worldwide every year. So rather than filling landfills, we’ve chosen to address this problem by extending the serviceable lives of these valuable resources.
We are actively talking to inventors, university groups, and startups to pool together tested solutions that we would like to see address employment issues for people with disabilities, ideally contributing to manufacturing robust components from locally-sourced or even recycled materials.
Why is it important?
We believe in a fairer world where people are not discriminated against and have access to resources that enable them to walk, work, go to school, and dance. Used components with serviceable lives ahead reasonably address this while reducing landfill waste and eliminating the need for further raw materials to be extracted.