TM
THE IPT JOURNAL
Issue 01 - Fall 2010
IPT tells the story of their first field test and 10 day trip to Zacapa, Guatemala.
The contents of this magazine were created solely by the members of IPT, NFP and intended for free online distribution.
Jon Naber President
Adam Booher Vice President
Ehsan Noursalehi Director of Product Development
Hari Vigneswaran Director of Patient Relations
Richard Kesler Luke Jungles
ipt www.SupportIPT.com
Contents 4 | Introduction 6 | The Journey Begins 8 | Back Story 12 | Creative Process 22 | The Story 34 | Prototype Testing 40 | Patient Profiles 72 | The Future 74 | IPT Profiles 76 | Guatemala Gallery
A stockpile of prosthetic feet in the backroom of the ROMP clinic in Zacapa, Guatemala.
Introduction Hello! I wanted to take this opportunity to welcome you to the first issue of The IPT Journal. Thank you for showing interest in IPT and taking the time to read about our work. I sincerely hope that you enjoy the contents of this magazine. -Ehsan Noursalehi Director of Product Development
4 | The IPT Journal | Fall 2010
Sponsors
The recent success of IPT would not be possible without the sponsorship and support of the following organizations.
Enterprise Works
Shell Oil Company
IPT flies over Mexico City, on their way to Guatemala.
The Journey begins
At 7:20 am, on July 9th, 2010, Jon Naber, Adam Booher, Ehsan Noursalehi, & Hari Vigneswaran, boarded an A320 Mexicana Airbus headed to Mexico City, Mexico. This would become the first stretch of their journey to Zacapa, Guatemala.
The Back Story A story of what led to Guatemala.
IPT was founded in August 2008 on the idea of providing affordable prosthetic limbs to people in the developing world. Since that time, a team of fellow engineering students was assembled and has proven to be a powerful force in solving the technical problems surrounding amputation in the developing world. Important milestones leading to this trip include the winning of the 2008 Idea Bounce Competition, the launch of a well-visited website (www.supportIPT.com), the deployment of a prosthetic finger prototype to a patient in Ecuador, the winning of the 2010 Lemelson MIT-Illinois Student Prize of $30,000, and the winning of a Clinton Global Initiative Grant to fund our work in Guatemala.
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The two main objectives we aimed to achieve during our trip to Guatemala in collaboration with ROMP are as follows:
1.
To gain a greater unders-
tanding of the lives of amputees in Guatemala through a thorough and personal interaction with volunteer patients. This understanding includes insight into each patient’s history, current situation, anatomy, sociology, and psychology through an interaction consisting of open-ended and close-ended questions, as well as additional net observations made during each interaction. This data would be collected through the use of a patient survey and by photographic, video, and sound recordings, as well as through detailed chronological and freestyle note taking.
2. To gain a greater understanding of the interaction between amputees and the three different concept prosthetic arms produced by IPT. This data would be collected through the fitting and adjustment process, as well as through the observation of the amputees performing a battery of activities considered important for daily living.
"winning of the 2010 Lemelson MIT-Illinois Student Prize of $30,000, and the winning of a Clinton Global Initiative Grant to fund our work in Guatemala"
The Partnership A collaborative effort for now and the future.
ROMP & IPT Range of Motion Project
Adam Booher and Jon Naber (Champaign, IL) have their first Skype chat with David Krupa (Quito, Ecuador).
Learn more about ROMP at www.ROMPglobal.org
In September of 2009, IPT made first contact with ROMP, the Range of Motion Project, via email, proposing collaboration in Guatemala during the 2009-2010 winter break. ROMP CEO David Krupa quickly responded with an interest in collaborating with a team of engineers from his alma mater. The correspondence evoved as Jon began translating for a prosthetics drive in Germany and sought to set up a summer time testing session for IPT’s prototypes. This summer time collaboration, which took place between July 9th and the 18th and is retold in this Journal, proved to be a great success for both organizations and has laid an excellent foundation for future collaborative efforts between ROMP and IPT.
In January of 2010, IPT also took up a side project of
Incorporated
A document from Singleton Law Firm, the firm which assisted IPT through the incorporation process.
After much internal preparation and working with an attorney, IPT was incorporated in August 2010 as a notfor-profit organization in the State of Illinois. We are also registered as a Charitable Organization, and we are currently pursuing 501(c)(3) TaxExempt Status. These give us the legal structure necessary to continue working towards our vision. Our current plan is to eventually provide our prosthetic devices to the non-governmental organizations (NGOs), international aid organizations, and governments working with amputees in the developing world. With these steps, we are becoming part of the growing field of social enterprise - businesses setting out to change the world through sustainable programs. Jon Naber takes notes during a conference call regarding incorporation and intellectual property.
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Thank You
Jon Naber holds an OttoBock prosthetic terminal device donated to IPT for use in Guatemala.
We have been very fortunate to have the support of friends, family, and the larger UofI community. However, we have also been graced by the support of companies such as OttoBock, a leading German manufacturer of prosthetic devices, and SolidWorks, a major distributor of CAD software. OttoBock graciously helped IPT by donating two prosthetic hooks for use in Guatemala, while SolidWorks provided IPT with financial support and plenty of SolidWorks clothing for the journey. We wanted to take a moment and say thank you.
SolidWorks t-shirts and sweaters donated to IPT to wear while in Guatemala.
The Creative Process
Creativity The Fuel of Progress
UOCD
User Oriented Collaborative Design
During the Spring semester of 2010, IPT team member, Ehsan Noursalehi had the unique opportunity to take part in a pilot course offered at the University of Illinois Urbana-Champaign through a partnership with Olin College of Engineering. The knowledge, techniques, and experience gained from this course have been invaluable to the product development efforts of our team. The Course: Product Development for Engineers This pilot course was titled UOCD, or User Oriented Collaborative Design. The premise of the course is to teach engineers how to understand users, and to develop valuable products for the identified user group. As the title suggests, the course includes a team of three or four engineers focusing on one particular user group, collaborating with that user group, and creating a (non-functional) prototype from one refined product idea over the course of the semester.
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Photo Credit: Kevin Hsia
Why We Care
The Techniques
The lessons learned from UOCD have allowed us to increase our productivity, creativity, and understanding. The structured techniques allow us to take advantage of all six of our engineers' skill sets while allowing each individual to reach their full creative potential within a team environment. We wanted to give a special thanks to Olin College, IDEO, & iFoundry for making this learning experience possible.
There were many valuable techniques in UOCD but, here are five that stood out to us:
UOCD showed us that it is possible to structure our creativity and has effectively fueled our progress.
-Personas -User Values -Frameworks -ExpandContract -Voting We have adapted these techniques, and made them our own.
Richard Kesler (left) and Luke Jungles (right) brainstorm new ideas in a structured 10 min activity.
Photo Credit: Kevin Hsia
Ehsan Noursalehi (right) and Adam Booher (left) discuss potential challenges.
Photo Credit: Kevin Hsia
IPT works from Enterprise Works.
Richard Kesler shows something of interest to Hari Vigneswaran.
Jon Naber tries to figure out when everyone has free time for a meeting using Google Calendar.
Luke Jungles performs online research during a design session.
The Creative Process
Frameworks The structure of thought.
Effective Brainstorming Brainstorming as a group is often a natural process, however, turning a brainstorming meeting into a useful outcome can often be a challenge. We started to notice that we would have very exciting brainstorming sessions, yet the outcome would be difficult to turn into action. 16
So, we started to change our strategy. We set out to structure our thoughts from each brainstorming meeting into a meaningful framework. Above, you see the outcome of our first attempt at this technique. We first pushed ourselves to think of all the challenges we would face during an attempt to create a mass-producible prosthetic arm for below elbow amputees. We made use of this thought process by producing a structured framework of the challenges we identified, and then brainstormed solutions based upon this framework. Several concepts were eventually crystallized from this process, and led to the prototypes that we tested in Guatemala.
Ehsan Nouralehi (right) and Jon Naber (left) organize ideas in a meaningful way.
Jon Naber (left), Richard Kesler (middle), and Adam Booher (right) discuss their ideas.
Senior Design A University Project sponsored by the Shell Oil Company
Adam Booher generates a 3D scan of a terminal device using a Next Engine 3D Scanner.
During the Fall 2010 semester, several members of IPT had a unique opportunity to work on a related project for course credit. Most engineering students at the University of Illinois take some type of “senior design� course in their last year at the University. These courses are intended to allow the students to work on real word problems for existing companies. In general, a large corporation will approach the College of Engineering with a design problem, and some funding to work on addressing that problem. Students in a senior design course are divided into small teams and each team works to find a solution for one of these design problems. This year, Shell Oil Company approached the Mechanical Science and Engineering Department at the University of Illinois to sponsor a humanitarian senior design project.
20 | The IPT Journal | Fall 2010
The department approached IPT and asked for our involvement. As a result 3 of the 6 members of IPT are working on this project for their senior design class during the semester. While IPT is dedicated to the overarching vision of providing amputees access to affordable prosthetic arms, this senior design project is structured around designing and building an affordable prosthetic terminal device. The terminal device is the component of a prosthetic arm that directly replaces the function of the user’s hand. Since IPT has worked specifically with designing an adjustable socket component, the terminal device is a new frontier for us, and a chance to develop more components of a complete prosthetic arm.
Ehsan Noursalehi compares his hand to a typical Hosmer prosthetic hook.
Using Technic LEGOS to develop a proof of concept.
The Story 22
The story of our trip to Guatemala.
Jon Naber looks out of a window during the flight to Guatemala.
The Story
We started to experience the Guatemalan people, culture, and land during our first full day in Guatemala. We had arrived in Guatemala approximately one month after it had been ravaged by Tropical Storm Agatha, which killed hundreds of Guatemalans and destroyed a great deal of infrastructure. During our first day, we saw firsthand the effects of the storm at a tent city outside of Zacapa. game of marbles in the dirt while others crushed corn to make tamales in frying pans sitting on top of crude fire pits. Despite the sobering situation, the displaced people of the city were amazingly optimistic and happy to meet Americans who were bringing them aid. Karen ScheeringaParra, founder of HIM.
This establishment was comprised of the residents of a riverside town which was swept away by the rising water level of the river during the hurricane, and sported tents from the Rotary Club International and water reservoirs from UNICEF. As we walked through the closely-packed rows of tents and tin huts, some children played a
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Today, assistance was being supplied in the form of bags of raw corn courtesy of Hearts in Motion (HIM), a nongovernmental organization which assists impoverished Guatemalans in the department of Zacapa. Earlier in the day we had visited the HIM nutrition clinic in Gualan, where extremely malnourished children are brought back to health from starvation. In some cases of
A 10 year old girl (center) recovers from malnourishment at HIM House.
Children at the HIM house calmly sit at a table after enjoying some cake.
Two children at "Tent City" are excited to pose for a picture.
The Story
The ROMP staff and IPT gather to watch the 2010 World Cup finale.
malnutrition, however, such an intervention comes too late to fully revive the child. At the clinic we met a ten year old girl who, due to the starvation she had faced growing up, barely had hair covering her head, and had lost her ability to speak. Following our time with Hearts in Motion, we began to see the beautiful country where we have chosen to begin our work of providing prosthetic arms. Our guides, Luis Aragon and David Krupa, spoke of the waterfall we were going to visit that afternoon as our microbus creaked up the side of a mountain in the Sierra de las Minas Range. At some points during the upward climb, the foliage opened up, revealing a daunting drop of hundreds of feet over the ledge we were driving on. We eventually made it to the end of the road and disembarked on a steep, uphill climb to reach a waterfall which was so powerful that it had once been harnessed as a source of electrical power. After making our way 28
through the dense forest, we were refreshed by a plunge into a pool which was just one tier of the several hundred foot-tall waterfall. We enjoyed climbing around on the massive boulders, and slipping and sliding our way through the water. The next day, the final game of the 2010 World Cup was televised in the lobby of our hotel, where we cheered with our Guatemalan counterparts for the game taking place, literally on the other side of the world. We watched as Spain defeated the Netherlands, sipping Coca Cola made from natural cane sugar. The anecdote of soccer bringing the world together rang true.
Make-shift homes in "Tent City".
Jon, Hari and Adam pose for a picture on thier hike up to the waterfall.
The Story Slums around the outskirts of Guatemala City.
The next week was spent working with patients, as will be detailed throughout this magazine. Following this week of work, we had the opportunity to travel across Guatemala to Antigua, where we continued to absorb the Guatemalan culture and landscape. Sitting in the shadow of several ancient volcanoes, Antigua proved to be a vibrant hub of Guatemalan culture. We spent an afternoon walking through an open air market, seeing stands vending beautiful textiles and wooden carvings. Coffee, chocolate, and jade were additional specialties sold at the market and in the surrounding shops. The next day we arose early to travel to the peak of one of the local volcanoes, Mount Pacaya, which is still active and had erupted just a month before we set foot on it, killing most of its trees and destroying the tin-roofed huts near the base. We made our way up the desolate, black ashcovered mountain, looking out over the valley below as we ascended above the
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cloud line. The weather near the summit was quite cool, which was refreshing after a hot week of work in the clinic. During our time in Guatemala we saw many elements in addition to our patients. We found similarities between the United States and Guatemala, such as On-the-Run Gas Stations and Burger King, as well as differences such as the red tuk-tuks zooming passengers around the cobbled streets of Antigua and the heavy influence of narcotic traffickers. We started to understand the culture and environment of Guatemala, knowledge we hope to apply in our product development process as we seek a prosthetic arm which is appropriate for the patients we work with.
Hari takes a look at a hand-made souvenir.
Ehsan juggles a soccer ball with local Guatemalans.
David Krupa (left), Adam Booher, Hari Vigneswaran, Jon Naber, and Ehsan Noursalehi (right) take a picture in front of an active volcano.
Prototype Testing A
major focus of our time in Guatemala was the testing of our prototypes. The staff at the ROMP clinic had contacted 7 different patients and asked them to work with us during our trip. All of these patients were trans-radial amputees, meaning they were missing their arms below the elbow. Some of them already had prosthetic devices from the ROMP clinic, and others were waiting for one. Still others were trying to decide if they even wanted a prosthetic arm at all. For those patients, the arms we had developed would be the first they had ever worn.
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Prototype #1
Some patients did not have enough time for us to test all three arms, while in other cases a specific prototype did not fit on a patient. Even so, with each patient we were able to gain valuable information and insights, and we returned to the United States with an immense amount of feedback on each of the designs. During our first day at the clinic, we tested prototypes 1 and 3 with our first patient Santos. A bilateral amputee, Santos could simultaneously try out both prototypes. After a careful fitting and adjustment process, Santos was able to pick up a chair, and write his name with a Sharpie marker. His father emphatically thanked us for the work we were doing, even though Santos already had a pair of prosthetic arms. This was the first example of the hope we would offer our amputee patients through our experimental
Prototype Testing
The three prototypes we developed last summer and brought to Guatemala for field testing each had distinct features. Prototype 1 was created to be adjustable and rugged. Prototype 2 was made to be rapidly fit, and could achieve an intimate fit with the user. Prototype 3 was designed to be light-weight and modular. All designs exemplified low cost via a mass producible design, breathable comfort via an open design, and long-term adjustability. We had hoped to test all three prototypes with every patient, but in many cases we had to adjust our strategy.
product development efforts. While working with Santos, we fitted another patient, Louisa, with prototype 2. While Louisa was very much interested in the cosmetic
Prototype #2
aspect of the prosthesis she already owned, she was interested and receptive toward the new design. Tuesday, our second day of working with patients, was very busy. During the course of the day we saw four different patients, which pushed us to work even more efficiently than the day before. Our first patient on Tuesday, Jorge G., lent his thoughts
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during an interview, and examined the three prototypes, giving us his feedback. While two of us interviewed Jorge G. with Dave, the other two teammates began fitting Heberto with prototypes 1 and 3. Heberto had school every day at noon, but volunteered to return Wednesday and Thursday so we could finish testing. Later on Tuesday, our youngest patient, Eidy, arrived. Being a small sevenyear-old, Eidy could not fit into any of our designs. We conducted the usual patient interview with the help of her mother who had traveled to the clinic with her. While the interview continued with Eidy, we also began fitting our last patient of the day, Jorge P. While working with Jorge, we were able to test all three prototypes and hear his thoughts. At the end of the second day in the clinic, Herman, a patient with a bilateral shoulder disarticulation, arrived. Herman had two highly functional prosthetic arms fashioned
people we have worked with in our lives. Our second patient on Wednesday was Erick. Erick spoke a few words in English, and gave us a lot of interesting thoughts during the
Prototype #3 how he now supports his family – by selling model houses made from Popsicle sticks. This is a true testament to the value of proper prosthetic care. On Wednesday Heberto returned for his second day working with us. Again, he had to leave at noon to head to school. We found Heberto’s commitment to assist us in our product development particularly moving, evidenced by his willingness to miss three days of morning work to come into the clinic at no obvious benefit to himself. The amputees we worked with were by far some of the most patient and accommodating
interview. Erick, being one of our larger patients, was only able to try on the 1st and 2nd prototypes. Herman also returned on Wednesday, and the team was able to observe the ROMP staff working with him, which we considered to be a very valuable experience. On our last day in the ROMP clinic Heberto returned for the 3rd time. As our only specific patient that day, we focused on the final fitting of all three prototypes for him, and hearing all he had to say about each one. When the time came for him to leave for school again, we thanked him for all of his help, and gave him a few
Prototype Testing
for him by ROMP a year ago, and he was back for a checkup. Herman was a truly amazing patient to meet. Since losing both of his arms at the shoulder, he recovered and was now playing with his children and feeding himself. Even more amazing was
parting gifts. After Heberto left, we helped the ROMP staff work with its other patients for the day. Even though we were no longer working with our patients and prototypes, this experience gave us more insight into the workings of a prosthetic clinic in the developing world. We learned a great deal from our interaction with the patients. Each one was able to give us distinct insights and feedback. We realized very quickly during our time in the clinic that the patient's residual limbs varied in size and geometry much more than we had expected. It also became apparent how important a close fit and force coupling are to transfer the rotational forces of the residual limb and maximize comfort. We also realized that our designs were much more functional than we could have initially hoped for. Seeing Santos write his name with one of our prototypes and seeing Heberto tie his shoe lace with another of the prototypes proved a great deal of functionality in our devices. There is still much work to be done in refining the prototypes to improve the fit with the patients, and the overall functionality. As we analyze the pages upon pages of notes, hours of video footage, and thousands of photographs we brought back from Guatemala, we will continue to derive more detailed conclusions and ideas, and rejoice in the hope that we created along the way of Iteration One.
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Prototype Testing
Adam, Ehsan, and Jon take a picture with the prototypes at Enterprise Works before heading off to Guatemala.
Read their stories. 40
Eidy
Erick
Jorge p
Heberto
Jorge G
Luisa
Santos
Patient Profiles
Read the stories of the 7 patients interviewed by IPT at the ROMP clinic in Guatemala
Santos
Luisa
Jorge G
Heberto
Jorge P
Erick
seven amputees
Patient Data 2 Females
Eidy
5 Males
Average Age of 28 6/7 used a bus to get to the clinic
6 missing left arm
1 missing both arms
KeepReading Please note that each of the following patients has provided IPT, NFP with explicit permission to reveal the following photographs and information about their lives as amputees.
Patient Profile
Santos A 20 year old law student
Santos Estanisiao Morales Choc
"...the shocked Santos fell unconscious and was taken to the hospital"
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is a 20-year-old law student who lives in the mountains of Coban. Santos is one of four children of the 80-yearold Sr. Choc, whose family of seven shares a one-floor cinder block home. The modest life of a law student gives Santos limited time for extracurricular activities, however he once enjoyed running, playing basketball, volleyball, and fútbol. His brother chose a less academic pathway, working in the town’s water plant, only five kilometers away from the Choc residence. This gave the Choc family the opportunity to obtain an expired radio antenna from the water company free of charge. Sr. Choc had offered to take the antenna down
from the roof, but aware of his father’s age, Santos volunteered. While on the rooftop, Santos struck an exposed power line with the antenna he was carrying, was shocked, and fell unconscious to the ground. He was taken to the hospital in Coban, where surgeons and emergency physicians attempted to return function to his upper limbs for seven days. Although a week of interventional surgery and medicine were performed, no function could be regained. Amputation of the right and left arms occurred twelve centimeters below his elbows. It has now been one year and one month since the accident and Santos is unable to use the bathroom, eat meals, and have basic independence without his arms.
Left to right: Hari Vigneswaran, David Krupa, Santos, Jon Naber.
Jon Naber & Adam Booher inspect Santos' prostheses.
Santos tries on Prototype #2.
Santos writes his name with a Sharpie. Jon inspects a tear in Santos' prosthesis.
Santos' family and friends watch closely as he uses the prototypes.
Santos, his family, IPT, and the ROMP Staff pose for a group photo.
Patient Profile
Luisa A mother of three
Luisa Ortiz Cortez is a 37-year-old mother of three, and a grandmother of one. Together the family lives in a village in the temperate mountains north of Zacapa, which makes travel to the city difficult. Throughout Luisa’s life, she has experienced a number of hardships. When she was fifteen she was hit by a pickup truck and at the young age of twenty-five she suffered a stroke. The stroke caused minor paralysis on the right side of her face and arm. Just last year she had a horrifying domestic dispute with her (now) former husband. Together with his
"Luisa’s husband attacked Luisa and her eldest daughter with a machete"
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mistress, Luisa’s husband attacked Luisa and her eldest daughter, Corina, with a machete. Corina survived with minor cuts and bruises, but Luisa sustained deep cuts across her nose and mouth, and lost her left eye and left arm. The attack also left Luisa with deep emotional trauma that is evident in simple conversation. Luisa’s poor self-image following the attack has made it difficult to be in public, spend time with friends, and rely on outside help. With the burden of caring for a family of four alone with only one arm, Luisa is struggling.
Luisa's granddaughter rubs her nose on Luisa's residual limb as two of her children watch.
David Krupa asks Luisa her thoughts on Prototype #2.
Jon Naber makes a balloon animal for Luisa's granddaughter.
Hari and Ehsan pose for a picture with Luisa and her youngest daughter.
Patient Profile
Jorge G. A father of three
Jorge Medez Garcia
"the truck lost control and Jorge was thrown from the cargo area"
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is married with three children, and lives in Huehuetenango, a village on the far west side of Guatemala. Jorge is 34-years-old and lives with his family in a one floor house with one room and one bathroom. While in his twenties, Jorge worked in an agricultural setting with his father and lived in an even more rural house, which required frequent vehicular transport from place to place. Although Jorge did not own a car, hitching rides was easy and when he travelled to visit his aunt, he hitchhiked. In June of 1999, Jorge took a ride in the bed of a truck that was also carrying heavy metal construction rods. Along the way the truck lost control and Jorge was thrown
from the cargo area along with the metal rods. Sadly, his arm became wedged between one of the rods and the road. After the accident Jorge was rushed to the hospital where he spent two months recovering, but amputation of his left arm was necessary just above his wrist. After the injury Jorge was unable to continue working in the farm fields and he began studying to become a professor while working as a janitor at the very same school. Ten years later, Jorge talked to someone in the Guatemalan First Lady’s association, SOSEP, where someone mentioned a prosthetic clinic in Zacapa, twelve hours away. This conversation was the first time Jorge had heard about prosthetic devices.
Jorge tries on a cosmetic glove over his amputated hand.
Jorge talks about his life as an amputee and his aspirations to be a teacher.
Jorge and David Krupa take a look at Jorge's prosthetic glove in front of a mirror.
Patient Profile
Heberto
Farmer by morning, student by night
Heberto Alvaro Garcia Lopez
"... was born with a genetic disorder that left him without part of his left arm"
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is a young man who lives in the town of Santa Lucia, just outside the Department of Zacapa. Heberto was born with a genetic disorder that left him without part of his left arm. This congenital defect has been with him for 19 years and has caused significant muscle atrophy in his deltoids, biceps, triceps, brachialis, and other muscles in his left arm. Heberto studies as a student at a university in Zacapa during the afternoons, but works in a peanut and corn farm in the morning to make enough money to pay for school. His job consists of covering the crops to insulate them in cold weather and chopping wood using a machete. Heberto explained that living without one of his arms has been difficult throughout his life, especially at
a younger age. When he was a young boy his classmates would point out his misfortune, lowering his self-esteem. In 2009, when Heberto was eighteen years old, a nurse in the city of Santa Lucia suggested he visit the Range of Motion Project. So in August of 2009 Heberto contacted ROMP and he was first fit for a prosthetic arm in December. Heberto recieved the arm in March of 2010. Although Heberto uses a state-of-the-art Otto Bock prosthesis that was donated from the United States, the atrophied muscles in his arm do not allow for a sophisticated range of motion. Because early prosthetic intervention in the rehabilitation process did not occur, Heberto’s operation of the voluntary closing mechanism of the prosthetic hand requires a significant amount of effort.
Ehsan Noursalehi asks Heberto what he thinks of Prototype #3.
Heberto uses Prototype #2 to secure his belt.
Heberto poses with Prototype #2, as David Krupa adjusts the fit.
Patient Profile
Jorge P. A construction worker
Jorge Audelvo Perez
Jorge P. requested that we not reveal photographs of his face.
"... he spent 17 days in intensive care where doctors attempted to salvage function"
is a 36-year-old man who has stayed close to home throughout his life. As a young boy Jorge grew up in a village just outside of Guatemala City, where he developed a network of friends that would eventually help him to start his career in construction. Jorge lives in his own two-bedroom house, which is central to the village in which he grew up. He began his time in the construction sector working on projects like roofing, building walls, installing light fixtures, and plumbing. The versatility of skills that Jorge possessed allowed him to work on many projects and to live a comfortable lifestyle. One day in late fall, however, Jorge was working on electrical components of a project and managed to
contact some power lines. The high voltage lines shocked Jorge, who quickly travelled to the public hospital. At the hospital he spent 17 days in intensive care where doctors attempted to salvage function in his arm and repair his damaged body. Jorge survived the traumatic accident, but due to the electrical burns and tissue damage on his left arm, it was amputated. Currently Jorge cannot operate as a full-time construction worker and instead does about four welding jobs per month to support himself. Jorge needs help when holding tools and lifting objects. When Jorge visited the ROMP clinic, it was his first time trying on a prosthetic device and learning about the functional advantages that a prosthetic hook could provide.
David Krupa adjusts a harness on Jorge P.
Jorge P. holds his left arm against a sheet of graph paper.
David Krupa observes as Jorge lifts a tank using Prototype #2.
Patient Profile
Erick
An unemployed, middle-aged man
Erick Madriz Caballeros
" the two attackers had a gun and machetes ready to kill Erick"
is a middle-aged man of 43 years who has two teenage children from a former wife. Erick previously lived in Nicaragua near his sister, working as a salesman to sell televisions and clothes. Erick, his sister, and other siblings, were raised by their single mother. Erick’s father died only 6 months after Erick’s birth. The lifestyle Erick lived as a businessman was one his envious brotherin-law sought to usurp. In July of 2008, Erick was visiting his brother-in-law’s residence when he found his sister’s husband and his friend ready to attack him. The two attackers had a gun and machetes ready to kill Erick when he arrived. Erick escaped with a gunshot wound to his left clavicle area, a laceration to his left torso, a fractured right arm, and serious injuries to his left arm below the elbow. To
flee the attack, Eric had to run one kilometer to the nearest hospital. He stayed at the the hospital in Nicaragua for 28 days, where doctors performed seven surgeries, six of which were surgeries on his left arm. Regrettably after weeks of care, the severe nerve and muscle damage that had been done to Erick’s left arm necessitated an amputation. After the hospitalization Erick moved in with his uncle and mother in Guatemala City, Guatemala for further support and care. Erick is currently unemployed and survives economically from his mother’s funds, and thus visiting with friends is a rare occurrence. Since he initiated the process with the Range of Motion Project in November of 2008, Eric has been patiently waiting for parts to arrive, and only recently received a prosthetic arm in July of 2010.
Ehsan Noursalehi helps Eric try on Prototype #2.
Erick holds his arm against graph paper while it is photographed for documentation.
Hari interviews Erick in Spanish as Adam and Jon take notes.
Patient Profile
Eidy
A seven year old amputee
Eidy Jasmin Lopez
"Eidy was travelling with her family...to be baptized"
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At seven-years-old, Eidy Jasmin Lopez is the youngest child in a family of seven people. She has two older brothers and two older sisters. The family lives in the Gualan Union of Guatemala, high in the mountains. Their residence, surrounded by mango and orange trees, lies on the steep incline of the mountains, which makes it especially dangerous when landslides occur. The nearest city is about an hour away, making market visits infrequent. To support themselves the members of the Lopez family grow beans and corn in the fields outside their house, however during the recent rainy season, Hurricane Agatha made cultivation difficult. To travel from place to place the members of the Lopez family hitch rides. One Sunday, Eidy was travelling
with her family in the bed of a pickup truck to a church to be baptized. Along with Eidy and her family there were 24 people in the truck, which began to lose control as it climbed a hill, expelling the passengers. Eidy’s arm was smashed by a rock, and she spent the next 26 days in the hospital where the general surgeon tried to salvage her arm. The surgeon was inexperienced in upper extremity trauma, and Eidy had to return to a hospital in Zacapa where the orthopedic specialist corrected the surgical mistakes caused by the amputation. Eidy is currently without a prosthesis and has not returned to school since the accident. Eidy is constantly worried about falling and cannot continue most hobbies she had before, like playing fútbol with her friends.
Eidy's father sits patiently in the ROMP waiting room.
Eidy and her mother pose for a picture.
Eidy's mother talks about the amputation.
Dear ROMP, Thank you! We felt very welcome in your home. We look forward to continual collaboration as we design new solutions for your patients. -IPT
Jon, Adam, Hari, and Ehsan pose for a picture outside of the ROMP clinic.
The Future The future of IPT holds much hope for the amputees of the developing world. As we conclude the analysis of our prototype testing in Guatemala, we are preparing for the next iteration of product development, which will include developing a new generation of prototypes, testing them with patients, and analyzing the results. Our iterative process will continue to be executed in partnership with the Range of Motion Project (ROMP), with whom we are currently writing a threeyear plan for future collaboration. This partnership will include IPT developing the new technology, ROMP devising a distribution strategy for the prosthetic arms and facilitating their testing, and both IPT and ROMP fundraising to support the ongoing partnership. Our hope is to one day produce the devices to supply to the nongovernmental organization (NGOs) and aid organizations working with the amputee populations of Latin America, and eventually, the rest of the world.
72 | The IPT Journal | Fall 2010
Make your Impact IPT is a Not-For-Profit and Charitable Organization in the State of Illinois. As we continue to expand the scope of our work, our financial needs are growing. In partnership with ROMP we will be writing grants, holding fundraising events, and soliciting corporate and individual donor support. The funds we raise are greatly needed for the following areas:  Product development and testing, both domestically and abroad, to best serve the needs of amputees.  Support of IPT staff, as several of us commit the next years of our life postgraduation to continue our non-profit work. If you or your organization is able to help us in our effort to provide the amputees of the world with prosthetic arms, please contact us and we would be happy to speak in more detail. Donations can also be made through our website at www.SupportIPT.com/donate Email us at contact@supportIPT.com
IPT Profiles
Jon
Adam
Ehsan
Naber
Booher
Noursalehi
President
Director of Engineering, Vice President
Director of Product Development
Hi there! My name is Jonathan and I am the President of IPT. I am currently finishing my last year of studying Materials Science and Engineering at the University of Illinois at Urbana-Champaign where I also study International Engineering. I help IPT to develop our business strategy and network of contacts. I am particularly interested in social entrepreneurship and startup management. When I’m not working with IPT, I enjoy to travel internationally, run long distances, and tie balloons into animal shapes.
Hey, my name is Adam and I am the Director of Engineering for IPT. I will graduate in May of 2011 with a B.S. in Engineering Mechanics, and a secondary field in Mechanical Design. I have worked with IPT since its inception producing Computer Aided Design (CAD) models, and optimize our designs to be inexpensively manufactured. I am also involved with the Society for Experimental Mechanics, where I am a Projects Chair and former President. I am a member of the Orange Krush (the best basketball fan section in the country!) and I am active at my campus church, serving on our student council. During my free time (little of it there is) you can find me at the ARC playing basketball, or out for a run. I am also trying to improve my skills with electronics through some small side projects.
Hi, I'm Ehsan. As the Director of Product Development, I focus on how we can turn our prosthetic technologies into successful products. I try to think about everything as a whole, considering Engineering, Industrial Design, Marketing, and Human Factors. I am also the all-around tech guy. I take lots of pictures, edit videos, manage the website, and produce most of our graphics. I plan on getting a B.S. in Materials Science and Engineering from UIUC in May of 2011. I also have past experience in the Product Innovation Research Laboratory, where I consulted for companies such as SC Johnson & Son. Last, but not least, I also run my own web development business at www.enworkshop.com.
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Hari Vigneswaran
Luke
Richard
Hi, my name is Luke. I plan on graduating from the University of Illinois at Urbana-Champaign with a B.S. in Mechanical Engineering in May of 2011. I am interested in mechanical design and analysis especially as they apply to prosthetics and other medical devices. I also do research through the Human Dynamics and Controls Lab at UIUC writing computer code to analyze gait performance data of individuals with Parkinson’s Disease. In my free time I enjoy playing basketball and ultimate frisbee and going running. I also enjoy playing piano and guitar.
Hi, my name is Richard. I plan on graduating from the University of Illinois at Urbana-Champaign in May 2011 with a B.S. in Bioengineering. My focus is in biomechanics, specifically orthodic and prosthetic devices. I’ve done (and continue to do) other research through the Human Dynamics and Control Lab at UIUC developing a portable powered ankle foot orthosis for patients with neuromuscular disorders of the lower legs. I’m also a member of Fighting Illini Triathlon, the university’s student triathlon club team, and enjoy spending any free time I have swimming, running and especially biking.
Jungles
Kesler
Director of Patient Relations
Hey hey! My name is Hari and I’m the Director of Patient Relations at IPT. I’m finishing up my last year of Materials Science and Engineering with concent-rations in biomaterials and chemistry at the University of Illinois at UrbanaChampaign, and I will be graduating in May 2011. I am very interested in medical innovations and medicinal practices especially in the developing world where there is so much opportunity for new solutions. I help IPT with some of my clinical experiences in both the United States and in Latin America. I am a certified emergency medical technician, and have background research in clinical medicine at the University of Chicago. Apart from my academic background I play tennis for Illinois’ USTA travelling tennis team and above all I enjoy a tasty meal!
The Guatemala Gallery
A bilateral amputee enters the ROMP clinic with his wife.
Jon and Adam pack their supplies in Naperville, IL.
Adam distributes supplies throughout the luggage.
Ehsan holds up his ticket to Mexico City, Mexico.
Hari fills out immigration paperwork before landing in Mexico on the connection flight.
Hotel Atlantico just outside Zacapa, Guatemala.
A breakfast of eggs, toast, beans, and fruit.
Ehsan Noursalehi enjoys his breakfast.
Hari, Adam, and Jon riding in a micro-bus.
A typical view from the roads outside Zacapa, Guatemala.
A bridge passing over the Atlantic river.
David Krupa gives a tour of the ROMP facility.
Hari takes a look at an example of one of ROMP's patient forms.
Hari and Jon watch as children play with marbles at "Tent City".
Children play in the dirt with marbles.
An outdoor "kitchen" at "Tent City".
A puppy at "Tent City".
David Krupa leads IPT up to a waterfall.
David and Hari pause for a picture during their hike up to the waterfall.
Adam climbs on some large rocks at the top of a waterfall.
Two men, no arms. Two bilateral amputees stare outside as the ROMP staff repairs their prosthetic arms.
An amputee with no arms waits patiently as the ROMP staff repairs his prosthetic arms.
A little girl looks for her amputee father inside of the ROMP clinic.
David Krupa talks with a patient's family.
A patient with two above the knee amputations walks around in the ROMP waiting room.
Adriana, an orphaned amputee, stands tall as she is fit with a prosthetic leg.
Adriana leans on her caretaker as Jon Naber makes her a balloon animal.
Hari Vigneswaran helps Adriana blow up a balloon.
Adriana practices walking with her newly fitted prosthetic leg.
Luis Aragon, the Clinic Director at ROMP, holds up the mold of a patients thigh.
Carlos, an amputee patient of ROMP and their newest technician, reveals his prosthetic leg.
Christian, a ROMP technician, and Jennifer Arnold, a HIM volunteer, observe as IPT interviews patients.
Christian with his daughter at the ROMP clinic.
Luis Aragon with his son and daughter who both work full-time for ROMP.
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Luis Aragon and Adam Booher work on modifying a prosthetic leg.
Adam Booher and Hari Vignewaran in the ROMP waiting room.
Hari laughs as David Krupa tells a joke.
Filling up on fuel for the microbus at a Texaco gas station.
David Krupa records a video on a Flip camera.
IPT with the ROMP staff.
hope for sale at the Illini Union Bookstore
ipt
Graphics and photos by Ehsan Noursalehi.
THE IPT JOURNAL Issue 01 - Fall 2010