City clinic offers Kenyan amputees first 3D printed legs

Twenty minutes of the tragic train ride felt like an hour. Hundreds of sweaty men hung dangerously on the carriages as the old train rambled from Dandora through Mutindwa.

On this day, March 23, 2011, operators of matatus in Eastlands were on strike and the train was the only means of transport to the city centre.

Stephen Ochieng' was already nauseated by the body smells.

He gripped the window rails tightly. But soon, the numbness and tingling in his fingers turned into unbearable pain that shot into his forearms and then he let go.                          

He fell onto the track and the moving carriages immediately crushed his legs, lower down.

“You know how maize is turned into four? That’s what happened, this was the worst pain I have ever felt in my life,” he said.

He woke up at the Kenyatta National Hospital where he stayed for the next six months. Ochieng', now 32 years old, has been wearing traditional prostheses on both his legs, which were cut off just below the knees.

Last week, he became among the first Kenyans to receive the first locally made, 3D-printed artificial legs.

“They are very light and flexible and the joints are moving, this means I can even drive a car or motorbike. It’s also easy to walk up on a hill,”  Ochieng', a cobbler in Dandora Phase 5 said.

This is one of the 21st century's most exciting breakthroughs, where a body part is easily made by pressing the print button. The technology is now available in Nairobi.

Ochieng' was fitted with new legs at the Stratus Medical Imaging Solutions, an orthopaedic clinic in Parklands, which has partnered with Prothea, a 3D prosthetics printing company, based at the same venue.

Dr Nicholas Okumu, the CEO of Stratus, said that traditional prosthetics  – usually made from wood or plastic – are falling out of favour.

“If you were to look at the production time of a [traditional] prosthesis, like a lower limb prosthesis, it takes about three to four weeks to make,” he explained.

“And after you manufacture it, you still have to come back to the patient, fit it, and adjust it. So that whole time period can be up to a month and a half. And then you still have to follow up that patient for maybe three months to make sure they're not having any challenges.”

They are also costly. For example, a good quality traditional prosthetic for the lower limb (from the knee downwards) would cost about Sh350,000.

“With the 3D printed one, you can go down to Sh100,000. So you are lowering the cost by over 50 per cent. And it takes only about three days to make and it’s a perfect match, most of the time,” he said.

Dr Okumu said the conventional prosthetics need to be replaced about every four years.

“And this one, they're giving you a guarantee that the socket they make for you will last 10 years. All you need to replace are the moving parts, which are like a bearing or screw," he said.

The number of Kenyans who need prosthetics is rising, mostly due to road crashes, vascular diseases and diabetes.

Dr Okumu said, for instance, the Kenyatta National Hospital last year served about 4,000 victims of road crashes.

“Of those maybe 30 per cent lost a limb. So imagine just for Kenyatta alone, you have about 1,200, 1,300 patients who need prosthetics. Now, extrapolate that to the rest of the country, and you can see that the burden is significant," Dr Okumu said.

"And many of those patients are in wheelchairs because they cannot afford prosthetics. And if they do, they will go for cheaper quality."

Mercy Kawira, an education student at African Nazarene University, also received a 3D-printed prosthesis on both legs last month.

She was born with a congenital limb defect. Her legs were poorly formed. They were amputated at about ten years, one below and the other one above the knee.

She has been on prosthetics all her life. Kawira can therefore make a good comparison between the old types and the 3D-printed ones.

“They are not heavy. They are comfortable and durable,” she explains. The other ones also used to take a long time to be made,” she said.

Kawira has never used a wheelchair, which shows how much artificial legs improve life. “Unfortunately, no insurance, including the NHIF (National Health Insurance Fund) pays for artificial limbs,” she said.

Early this year, Florian Vallaeys, a Belgian engineer, co-founded the company known as Prothea to produce low-cost 3D printed prosthetics and orthotics in Kenya.

Florian told the Star the firm has hired Kenya specialists to make the prosthetics using its equipment.

Prothea, which last month partnered with Stratus Imaging Centre in Parklands, is a Sh5 million investment.

When a client comes, the specialists take a 3D picture of the stump using a mobile phone.

“We use a very simple application on a smartphone that takes 3D measuring points and transforms an object into a 3D image on the computer file,” Florian said.

The 3D scan will then be modelled on a computer and slowly printed. 3D printing is actually simple.

A 3D printer works by producing molten plastic through a tiny nozzle that moves around precisely under computer control.

It prints one layer, waits for it to dry, and then prints the next layer on top until a full artificial limb is formed.

And the possibilities are without limit.

Florian says, for now, they only print transtibial, that is, below-knee, prosthetics. “We are working on a solution for the above knee, it will probably be available by the end of next month. And then, in the next five, six months, we'll also have a solution for arm amputations,” he said.

“The reception has been quite good. Of course, we still need to spread our wings and show people that we exist.”