David Lawrence, MSPT, GRS, ATC | Elsie Taloafiri | Hunter Bogert, PT, DPT, GRS | Chris Stokesbary, CPO | Bethany Russell, PT, DPT, GRS
Mission Gait Foundation, Virginia, USA | Ministry of Health and Medical Services Solomon Islands
BACKGROUND
Diabetes-related complications, including amputation, have a high prevalence in Pacific Island countries [1]. Mission Gait Foundation’s (MGF) Walking Free Project in the Solomon Islands demonstrates a sustainable approach to prosthetic care implementation. It includes strategies to introduce capacity for prosthetic fabrication and training in less resourced regions, aiming for true sustainability (2).
AIM
Describe the role of each stakeholder and the innovations employed to establish a permanent multidisciplinary prosthetic and orthotic production and rehabilitation program at the Kilu’ufi Hospital in Malaita, Solomon Islands.
METHOD
The portable prosthetic & orthotic container lab is a 12-meter shipping container, fully equipped with state-of-the-art equipment purchased by MGF. It was constructed in Richmond, Virginia, then shipped to Malaita. The Kilu’ufi Hospital supplied the foundation for the lab as well as utility hookups, and committed to ongoing administrative and professional oversight. The Solomon Islands Ministry of Health and Medical Services provided governmental support, including funding for two citizens to attend ISPO CAT II prosthetist training with Mobility India in Bangalore, India, as well as funding for supplies on a continuous basis.
RESULTS
The container lab provided immediate, fully equipped fabrication capacity. MGF has provided two follow up trips, one provided practical mentorship supporting initial prosthetic production, and a second focused on training and education of in-country physiotherapists, technicians, and prosthetist, including prosthetic assessments, residual limb care, pre-prosthetic physical therapy, device selection, casting, production, wear schedule, prosthetic gait training, and follow-up on fit. Local certified staff have completed lower limb prosthetic fabrication and comprehensive rehabilitation for a “start-up average” of seven patients per month since the initiation of the lab. This project required three years to complete from the memorandum of understanding to full functioning of the lab because of delays during the COVID19 pandemic, however in the absence of this complication, it could be completed within 18 months, allowing time for prosthetist certification.
DISCUSSION AND CONCLUSION
The use of portable container labs and strong local collaborations were shown to be effective strategies for capacity building in less resourced regions. This method contrasts with Walking Free’s 20+ year history of developing in-country P&O labs, demonstrating increased efficiency and replicable production. The Walking Free Project in the Solomon Islands exemplifies how adaptability, cost-effectiveness, and community collaboration can foster long-term independence and productivity in prosthetic rehabilitation.
REFERENCES
- Si Thu Win Tin; 2015 Diabetes Res Clin Pract.107(2):233-246
- Md Shapin Ibne Sayeed; 2024 Disab & Rehab;46:10:2097-2116
