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By Doris Retfalvi
Using low-temperature re-moldable thermoplastic, the Amparo prosthetic socket is designed to fit on an amputee's residual limb in a matter of hours, without the need for a trained prosthetist or any return visits to the clinic. Doris Retfalvi learns the story behind this international student collaboration
There are more than one million amputations happening around the world annually - that's one every 30 seconds. In the developed world, this is most often caused by peripheral vascular disease (the blockage of blood flow to a limb) or diabetes, but in the developing world it is external risk factors like land mine injuries, factory accidents and poor sanitation that claim the limbs of those affected. According to the Journal of Orthopaedic Surgery and Research, patients in the developing world are more susceptible to amputations because they often seek medical attention when it is too late to salvage the limb and amputation is the only option.

Around 80 per cent of the world's lower limb amputees don't have access to modern prostheses, and those who do have to make frequent visits to the clinic to assure their prosthesis is always well adjusted. On top of this, materials used in the manufacture of prosthetics are usually exported from developed countries and may cost over six times the average income of a family living from a developing country, the American Academy of Orthotists and Prosthetists reveals.

Solving a real-world problem

Addressing this global issue was the topic assigned to Lucas Paes de Melo, Wesley Teerlink, Jessica Menold, Matthew Dion and Isabel Bahiana Wotzasek - a team of five students taking part in a 2014 multidisciplinary project of design-thinking, led by the Global Engineering Teams in Berlin. The aim of the project was to take students specialised in healthcare, engineering and design out of the academic environment and face them with the problems and demands of the real world. So the team decided to travel to South Africa and Brazil to speak with underprivileged amputees to learn about their struggles trying to obtain a prosthetic leg. Here they found out that after an amputation, the residual limb changes volume throughout the day and high temperatures can cause it to swell to the point it cannot fit into the prosthetic socket.

Matching their findings with the available solutions on the prosthetics market, the students decided to design a re-moldable prosthetic socket made from low temperature thermoplastic that could be fitted directly to an amputee's residual limb, instead of using the casting method required by traditional sockets. The socket would not require the intervention of a trained prosthetist, thus reducing the time and number of visits the amputee would have to make to the rehabilitation clinic. They named it Amparo, which is Portuguese for support and protection.

But their solution had too much potential to be limited to a university project. So the students decided to turn their idea into a business. 'We had an idea of how the prototype would be built but we had no money to research different materials or do fittings with amputees. We needed funding before we could actually build the product,' says Lucas Paes de Melo, now CEO of Amparo. 'So in 2015 we wrote the business plan, putting the whole product idea and development into a business concept to help us in our application for a government grant.'

Six months later, Amparo received the EXIST Business Start-Up Grant of €200,000 from the German Federal Ministry of Economic Affairs and Energy that helped them run clinical trials and develop the socket. In the summer of 2016 Amparo was officially launched as a Berlin-based startup.

Small steps

' Many clinics we had run trials with in Berlin believed our product could be applied in the interim phase of an amputation,' says Paes de Melo. 'Every time a person has an amputation there's an initial six-month phase where they are still adapting to their life as an amputee. In this period the residual limb is really swollen so it changes quite a lot in volume.

'So to have a product like ours which is re-moldable means you can reshape the socket as the amputee goes through the recovery process. Last year we went to India and Brazil and we realised there was a need in those markets. But being a very small and new company, to start to sell your products overseas would pose a lot of challenges. So we have readapted the business model to start serving amputees in Germany. We plan to expand to Europe by the end of this year, after which we would go to developing countries.'

To launch a prosthetic device in a highly regulated German market that's already filled with established industry players isn't easy. But Paes de Melo is optimistic. 'We have just started the regulation process which should be finalised by the end of April this year. Our case is quite privileged because that product is really low-risk so you don't have to go through so many tests to regulate it as it is non-invasive. If we get into the German market we can get into any market.

'What is more challenging is the fact that healthcare is so consolidated with big firms that it makes it hard for a startup like ours to join the circle,' Paes de Melo adds. 'You have to be really, really impressive because not many people give credit to small firms. We've been quite successful in that sense because we've created a technology that is user-centred and did a lot of research before developing the product. So the end result was something that was really needed.'

A welcome solution

Amparo will also be setting up partnerships with a number of orthopaedic clinics around Berlin, including Koch Orthopaedie run by prosthetist Daniel Koch, who has already assisted the team in their initial research. These partnerships will help Amparo run a few months of pilot projects before hitting the market by mid-2017.

The end-user response to the Amparo socket has been widely positive, with clinical trial participants even requesting to use it outside the clinical environment, says Paes de Melo. 'We have done over 20 fittings so far but since we don't have the product certification we don't feel comfortable legally to let people even voluntarily take home the device. We're actually starting to do pre-sales but we want to deliver the first devices after we finish the pilot projects.'

With three awards won already, including the ASME Innovation Showcase USA award in 2016, Amparo's proudest moment was when they saw the first amputee walk with the help of their innovation. 'Her name is Melissa and she liked our project from the beginning. She kept volunteering to come back and help us out with our trials. I think that for people from the developed world to know that there are others less privileged that go through the same problems but don't have access to the same help, it really strikes a chord with them. Melissa was one of these people and I think this is why she kept coming back.'

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Designing a real solution for third-world amputees

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By Doris Retfalvi Using low-temperature re-moldable thermoplastic, the Amparo prosthetic socket is designed to fit on an amputee's residual limb in a matter of hours, without the need for a trained prosthetist or any return visits to the clinic.

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Published: 2009-05-30 (Revised/Updated 2018-03-27) : Author: Rhonda Turner, PhD

Synopsis: An amputee's residuum, age, daily activities, profession and certain health factors determine the specific materials and technologies used for each custom manufactured device.

Quote: "A prosthetic is device is made up of moving parts. Parts wear down; interfaces need replacement. Humans grow, gain or lose weight, change in shape. All of these factors contribute to need and cost."

Main Document

A lower extremity prosthesis (leg) can range in cost from $5,000.00 to $50,000. An upper extremity device (arm) can range from $3,000.00 to $30,000.

Prosthetics - An Explanation of Cost

Why pay for a Cadillac, when a Chevy will do?

How does the saying go? If I had a nickel..So it goes with this phrase; repeated by rehabilitation claims reviewers and insurance payers, demonstrating that there is a growing national trend towards evaluating the medical necessity of a claim simply for its overall cost.

Generally, an understanding exists between payer and beneficiary, that any catastrophic, illness or event involves an issue of financial responsibility. However, the expectation persists that insurance will provide for the purchased services.

How Much Does 'An Arm and a Leg' Really Cost?

A lower extremity prosthesis (leg) can range in cost from $5,000.00 to $50,000.

An upper extremity device (arm) can range from $3,000.00 to $30,000.

Why the difference and why not just give everyone the less expensive variation?

Cost does not define medical appropriateness. An amputee's residuum, age, daily activities, profession and certain health factors determine the specific materials and technologies used for each custom manufactured device.

A prosthetic is device is made up of moving parts. Parts wear down; interfaces need replacement. Humans grow, gain or lose weight, change in shape. All of these factors contribute to need and cost. A prosthetic device can be body powered or computerized, made of aluminum, stainless steel, titanium, plastics or carbon composites. Even the most expensive prosthetic limbs are built to withstand only 3 to 5 years of wear and tear, meaning they will need to be replaced over the course of a lifetime - and they're not a one-time cost.

What are the Costs of Denying Someone a Prosthetic Device?

The California Health Benefits Review Program determined the cost of California State parity would be approximately $.25 per insured member.

Additionally, a recent survey found that every $1 dollar spent on rehabilitation saves the economy $11 dollars in various welfare and disability benefits.

On the other hand, a person who does not receive a prosthetic within 2 years of amputation has a greater likelihood of social welfare, increased health concerns including obesity related diseases and conditions and is more likely to suffer depression.

The US amputee population is approximately 1.9 million persons and growing, however science and medicine provide the technology to restoring a person's dignity, self-reliance, productivity and ability to contribute to society.

In consideration, the benefits to the person and to the community far outweigh the cost of provision.

What is Prosthetic Parity?

It is state or federal legislation requiring insurance companies to pay for prosthetic devices on par with federal programs, payment rules and regulations. Federal Program could be Medicare, Medicaid, or programs such as the Federal Employee insurance held by Congress and other government employees. These programs provide reimbursement without capitation or exclusions for medically necessary services such as prosthetic devices for further information see our article What is Prosthetic Parity.

Discussion

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Prosthetics Costs: The High Price of Prosthetic Limbs

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Published: 2009-05-30 (Revised/Updated 2018-03-27) : Author: Rhonda Turner, PhD Synopsis: An amputee's residuum, age, daily activities, profession and certain health factors determine the specific materials and technologies used for each custom manufactured device. Quote: "A prosthetic is device is made up of moving parts. Parts wear down; interfaces need replacement.

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Centers for Disease Control and Prevention

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Upper and lower limb reduction defects occur when a part of or the entire arm (upper limb) or leg (lower limb) of a fetus fails to form completely during pregnancy. The defect is referred to as a "limb reduction" because a limb is reduced from its normal size or is missing.

How Many Babies are Born with Limb Reduction Defects?

Researchers estimate that about 1 in every 1,900 babies is born with a limb reduction defect in the United States. Some of these babies will have both upper and lower limb reduction defects.

What problems do children with limb reduction defects have?

Babies and children with limb reduction defects will face various issues and difficulties, but the extent of these will depend on the location and size of the reduction. Some potential difficulties and problems include:

Difficulties with normal development such as motor skills

Needing assistance with daily activities such as self-care

Limitations with certain movements, sports, or activities

Potential emotional and social issues because of physical appearance

Specific treatment for limb reduction defects will be determined by the child's doctor, based on things like the child's age, the extent and type of defect, and the child's tolerance for certain medications, procedures, and therapies.

The overall goal for treatment of limb reduction defects is to provide the child with a limb that has proper function and appearance. Treatment can vary for each child. Potential treatments include:

Prosthetics (artificial limbs)

Orthotics (splints or braces)

Surgery

Rehabilitation (physical or occupational therapy)

It is important to remember that some babies and children with limb reductions will have some difficulties and limitations throughout life, but with proper treatment and care they can live long, healthy, and productive lives.

What causes limb reduction defects?

The cause of limb reduction defects is unknown. However, research has shown that certain behaviors or exposures during pregnancy can increase the risk of having a baby with a limb reduction defect. These include:

Exposure of the mother to certain chemicals or viruses while she is pregnant

Exposure of the mother to certain medications

Possible exposure of the mother to tobacco smoking (although more research is needed)

CDC works with many researchers to study risk factors that can increase the chance of having a baby with limb reduction defects, as well as outcomes of babies with the defect. Following are examples of what this research has found:

A woman taking multivitamins before she gets pregnant might decrease her risk for having a baby with limb reduction defects, although more research is needed.

Certain sets of limb reduction defects might be associated with other birth defects, such as heart defects, omphalocele, and gastroschisis.

Can limb reduction defects be prevented?

There is no known way to prevent this type of defect, but some of the problems experienced later in life by a person born with a limb reduction defect can be prevented if the defect is treated early.

Even so, mothers can take steps before and during pregnancy to have a healthy pregnancy. Steps include taking a daily multivitamin with folic acid (400 micrograms), not smoking, and not drinking alcohol during pregnancy.

References

1. Mai CT, Isenburg JL, Canfield MA, Meyer RE, Correa A, Alverson CJ, Lupo PJ, Riehle‐Colarusso T, Cho SJ, Aggarwal D, Kirby RS. National population‐based estimates for major birth defects, 2010-2014. Birth Defects Research. 2019; 111(18): 1420-1435.

2. Yang QH, Khoury MJ, Olney RS, & Mulinare J. Does periconceptional multivitamin use reduce the risk for limb deficiency in offspring? Epidemiology. 1997;8: 157-61.

3. Rosano A, Botto LD, Olney RS, Khoury MJ, Ritvanen A, Goujard J, et al. Limb defects associated with major congenital anomalies: clinical and epidemiological study from the International Clearinghouse for birth defects monitoring systems. Am J Med Genet. 2000;93: 110-16.

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national center on birth defects and developmental disabilities

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Facts about Upper and Lower Limb Reduction Defects | CDC

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Upper and lower limb reduction defects occur when a part of or the entire arm (upper limb) or leg (lower limb) of a fetus fails to form completely during pregnancy. The defect is referred to as a "limb reduction" because a limb is reduced from its normal size or is missing.

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The global powers that met two times in Vienna for landmark discussions on ending the war in Syria may meet again in New York this month while several hurdles remain. In a March 2015 op-ed for the National Interest, I proposed a six step plan with 10 principles to resolve the Syrian conflict. During the past two years, I have sought to promote this proposal in numerous international seminars and conferences.

In late October, the International Syria Support Group agreed in Vienna on principles virtually identical to my six step proposal. In a joint communique issued after the conclusion of the talks, the participants agreed on the following:

1. Syria's unity, independence, territorial integrity, and secular character are fundamental.

2. State institutions will remain intact.

3. The rights of all Syrians, regardless of ethnicity or religious denomination, must be protected.

4. It is imperative to accelerate all diplomatic efforts to end the war.

5. Humanitarian access will be ensured throughout the territory of Syria, and the participants will increase support for internally displaced persons, refugees, and their host countries.

6. Da'esh (Islamic State), and other terrorist groups, as designated by the U.N. Security Council, and further, as agreed by the participants, must be defeated.

7. Pursuant to the 2012 Geneva Communique and U.N. Security Council Resolution 2118, the participants invited the U.N. to convene representatives of the Government of Syria and the Syrian opposition for a political process leading to credible, inclusive, non-sectarian governance, followed by a new constitution and elections. These elections must be administered under U.N. supervision to the satisfaction of the governance and to the highest international standards of transparency and accountability, free and fair, with all Syrians, including the diaspora, eligible to participate.

8. This political process will be Syrian led and Syrian owned, and the Syrian people will decide the future of Syria.

9. The participants together with the United Nations will explore modalities for, and implementation of, a nationwide ceasefire to be initiated on a date certain and in parallel with this renewed political process.

During their subsequent meeting in November, the ISSG elaborated on the specific phases of a conflict resolution plan that echoed those I laid out in my March op-ed. The differing side agreed on a Jan. 1 deadline to form a broad-based forum comprised of President Bashar al-Assad's government and opposition groups. The forum agreed to establish within six months, a "credible, inclusive and non-sectarian" transitional government that would determine the schedule for drafting a new constitution. Within 18 months, a free and fair U.N.-supervised election will also be held.

Moreover, the ISSG agreed that the violence in Syria should come to an end through a cease-fire in "parallel" to the process of political transition.

These are all remarkable achievements and represent a major step towards the resolution of the tragic war ravaging Syria today. However, there are still three major obstacles in the path of a diplomatic solution, but they should not prove to be insurmountable.
Obstacle 1: What to do with Assad President Putin shakes hand with President Assad in Moscow. Alexei Druzhinin, RIA-Novosti, Kremlin Pool Photo via AP.
The first expectedly has to do with President Bashar al-Assad. The United States, Russia, Iran, Turkey and Saudi Arabia, the five major international and regional powers with influence in Syria, sharply diverge on the issue of Assad's future in Syria. The Saudi-U.S.-Turkey coalition's priority is the removal of Assad, whereas Iran and Russia's is to first eradicate from Syria the terrorist organizations that have occupied some 50 percent of the country and then to hold free elections monitored by the United Nations to decide the country's president and constitution. For its part, Iran has maintained for years that it is the Syrian people who should decide on who their president should be, not other countries.

After the ISSG Vienna meeting, President Barack Obama declared: "Russia and Iran must decide whether they want to prop up Syrian President Bashar Assad or save the Syrian state." However, the experience of Libya these past few years shows that Obama is wrong. NATO and its Arab allies attacked Libya, overthrew Qaddafi, and have since then sat totally helpless as the country has descended into chaos and come to the verge of being a failed state.

It is has already been agreed in Vienna that "Syria's unity, independence, territorial integrity, and secular character are fundamental" and that its "state institutions will remain intact." It is difficult to imagine how the collapse of Assad would not portend the total collapse of the security-military establishment of Syria. And without the current Syrian military and security forces -- which are the most consequential force on the ground fighting terrorist groups like the self-proclaimed Islamic State, Al Qaeda and Jabhat al-Nusra -- it would be impossible to preserve the territorial integrity of Syria. Indeed, in the fight against terrorism in Syria, the insurgents supported by the West and its Arab allies like the Free Syrian Army have been almost completely ineffective.

Therefore, the critical priority should be to clear Syria of terrorist groups, reestablish the country's territorial integrity, create the conditions for the return of displaced persons and refugees, and then leave it to Syrian people to choose their leadership through transparent, free and fair elections within the framework of a new constitution that enshrines protections for all minorities.
Obstacle 2: How to effectively fight terror groups in Syria The Paris massacre and threat of further ISIS attacks abroad underscore the importance of this cooperation. AP Photo/Militant Website, File.
The second key obstacle to a sustainable peace in Syria has to do with how to effectively fight and destroy terrorist groups in the country like ISIS. The fact is that airstrikes are only effective when conducted in support of a well-organized military partner on the ground. In Syria, the largest and most effective ground force fighting ISIS and other terrorist groups is the Syrian military, which is supported by Russia and Iran. Regional U.S. allies, on the other hand, have been supporting many of the terrorist groups fighting the Syrian army.

The United States and its allies need to understand that it is impossible to fight ISIS and the Assad government simultaneously. To form the necessary coalition of air and ground forces to destroy ISIS, cooperation between NATO, the Syrian army, Russia and Iran is vital. The Paris massacre and threat of further ISIS terrorist attacks abroad makes such cooperation even more necessary and politically viable.
Obstacle 3: Extremist movements' ties to West's allies Extremist Sunni movements draw their ideology and the vast majority of their weaponry and financial support from the closest allies of the West in the region. AP Photo/Hasan Jamali.
The third dilemma is the reality that extremist Sunni movements such as Al Qaeda, ISIS and the like draw their ideology as well as the vast majority of their weaponry and financial support from the closest allies of the West in the region. It is time to realize that because ISIS is first and foremost an ideology and culture, not merely a militia, the world will never be able to defeat it as long as Western allies are actively promoting its ideology.

As former U.S. Ambassador Curtin Winsor, who was special emissary to the Middle East at the beginning of the Reagan administration, wrote in 2007:

The Saudis have spent at least $87 billion propagating Wahhabism abroad during the past two decades ... The bulk of this funding goes to the construction and operating expenses of mosques, madrassas, and other religious institutions that preach Wahhabism. It also supports the training of imams; domination of mass media and publishing outlets; distribution of Wahhabi textbooks and other literature; and endowments to universities. By comparison, the Communist Party of the USSR and its Comintern spent just over $7 billion propagating its ideology worldwide between 1921 and 1991.

The first day that Russia launched military strikes against terrorist groups in Syria, a prominent citizen of a U.S. ally in the region told me at a conference in Berlin, "we will make Russia bleed." The blowing up of a Russian passenger plane claimed by ISIS and a Russian military jet by Turkey are steps in that direction.

What the major Western powers need to keep in mind is that their efforts in the past few decades to transform certain countries through military and political intervention have failed. In Syria, this approach has led to a "secular" political order coming to the edge of being overthrown in favor of a Salafi-Wahhabi Islamic state taking control of the country. Until this approach is abandoned in favor of pragmatism, the war on terror will not end and terrorist attacks in the West and elsewhere will continue.
Ambassador Seyed Hossein Mousavian is a research scholar at Princeton University and former deputy of Iran's national security foreign policy. His latest book, "Iran and the United States: An Insider's View on the Failed Past and the Road to Peace" was released in May 2014.

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To Solve the Syria Crisis, We Need to Overcome These Three Obstacles

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The global powers that met two times in Vienna for landmark discussions on ending the war in Syria may meet again in New York this month while several hurdles remain. In a March 2015 op-ed for the National Interest, I proposed a six step plan with 10 principles to resolve the Syrian conflict.

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There are 11 million of them, the best estimates say, laboring in American fields, atop half-built towers and in restaurant kitchens, and swelling American classrooms, detention centers and immigration courts.

In the public's mind, the undocumented - the people living here without permission from the American government - are Hispanic, mostly Mexican and crossed the southwestern border in secret.

In the eyes of their advocates, they are families and workers, taking the jobs nobody else wants, staying out of trouble, here only to earn their way to better, safer lives for themselves and their children.

At the White House, they are pariahs, criminals who menace American neighborhoods, take American jobs, sap American resources and exploit American generosity: They are people who should be, and will be, expelled.

Illegal immigrants can be many of these things, and more. Eleven million allows for considerable range, crosshatched with contradictions.

There may be no more powerful symbol of how fixedly Americans associate illegal immigration with Mexico than the wall President Trump has proposed building along the southern border. But many of the unauthorized are not Mexican; almost a quarter are not even Hispanic.

Countries of origin for unauthorized immigrants in the U.S.

After Mexico, Guatemala, El Salvador and Honduras, the largest number of unauthorized immigrants comes from China (an estimated 268,000), where deportations run aground on a less literal wall: China is one of 23 countries that do not cooperate with deportations. (The Trump administration has pledged to pressure all 23 into doing so.)

They tend to be younger - the Pew Research Center has found that adult unauthorized immigrants were, at the median, about a decade younger than American-born adults - and skew slightly more male than the rest of the country.

Geography and demography are only two ways to anatomize these 11 million. Circumstance offers another: As he seeks to tighten law enforcement's grip on unauthorized immigrants, Mr. Trump will grapple with a population of people who arrived in several ways and for myriad reasons, each slice presenting its own challenges.

To hear many liberals and immigrant advocates tell it, most undocumented immigrants are productive, law-abiding members of society, deeply rooted in communities all over the country, working hard, living quietly, paying taxes and raising families.

Statistics show that many of the undocumented fit this profile. About 60 percent of the unauthorized population has been here for at least a decade, according to the nonpartisan Migration Policy Institute.

A third of undocumented immigrants 15 and older lives with at least one child who is a United States citizen by birth. Slightly more than 30 percent own homes. Only a tiny fraction has been convicted of felonies or serious misdemeanors.

Of course, as the Trump administration has emphasized, merely being here without authorization is a violation of the law.

Even the wording of the issue is revealing: conservatives favor the term "illegal immigrants," which hardliners often truncate to "illegals"; immigrant advocates prefer "undocumented immigrants," a phrasing that they say prods the conversation back toward the humans in question, but that also has a whiff of euphemism. "Unauthorized" often shows up as a neutral alternative.

No matter the label placed on them, people like Lydia, 47, who runs a small jewelry store in Los Angeles, do not think of themselves as lawbreakers.

Lydia, who like several undocumented immigrants did not want her last name published for fear of being deported, crossed the border through Tijuana in 1988. She looked for legal help from a notary, mistakenly thinking that a "notario" indicates a legal expert, as it does in many Latin American countries.

She was eventually ordered out of the country. But the Obama administration deprioritized deportations of people who had committed no major crimes, and it allowed her to live and work in the United States as long as she checked in with an immigration agent each year.

Lydia raised four children, all citizens, and sent them to public schools in Sun Valley, a suburb north of Los Angeles. She and her husband bought a home there, paid off their mortgage and bought a second home nearby.

Now she is a candidate for deportation once again, and is anxious each time she steps out of her home.

"I am in limbo," she said. "I am afraid I will go out and never come back."

Criminal Records

Few nemeses loomed larger in the narrative of Mr. Trump's presidential campaign than the figure of the illegal immigrant who threatened Americans - one of the "rapists" and "killers" from Mexico, as Mr. Trump has put it.

Such people do exist. The Migration Policy Institute has estimated that 820,000 of the 11 million unauthorized have been convicted of a crime. About 300,000, or less than 3 percent of the 11 million undocumented, have committed felonies. (The proportion of felons in the overall population was an estimated 6 percent in 2010, according to a paper presented to the Population Association of America.)

Immigration agents regularly arrest what the government calls "criminal aliens."

At the end of January, agents arrested a 50-year-old Mexican man near Milwaukee who had felony convictions for assault with a deadly weapon, battery against a police officer, car theft and intentionally harming a child, and who had been deported twice before. Last week, they caught an undocumented Honduran man in North Carolina, Francisco Escobar-Orellana, who is wanted in Honduras for allegedly hacking two men to death with a machete in 1993.

The Trump administration has said it will continue to prioritize deporting those with serious criminal records, but, in a break from the Obama administration, the new policies also take aim at immigrants whose offenses are limited to living here without permission or minor crimes that enable immigrants to work here, like driving without a license or using a fake Social Security number.

The Social Security Administration estimated that in 2010, 1.8 million undocumented immigrants worked under a number that did not match their name.

Surrounded by the sugar cane fields of Clewiston, Fla., working backbreaking jobs, Maria and Benjamin took pains to follow the rules, pay taxes and stay out of the way. But now they fear the one rule Benjamin had to break to survive - he used a fraudulent Social Security number to secure a job - may prove their undoing.

Benjamin, 42, fixes the hydraulic trucks used for the area's cane-cutting operation, which means he works 17 hours a day, often at night.

"This worries us, but we don't have an option," said Maria, 38, who arrived from Mexico when she was 19. "He has always worked and has always had a fake Social Security card. That is the way you get a job."

Overstayed Their Visas

Some people endure long journeys by foot, train, boat and smugglers to make it across the border. But for an increasing number of immigrants, illegal status arrives overnight, without a single step.

In each year from 2007 to 2014, more people joined the ranks of the illegal by remaining in the United States after their temporary visitor permits expired than by creeping across the Mexican border, according to a report by researchers at the Center for Migration Studies.

A partial government estimate released last year said that 416,500 people whose business or tourist visas had expired in 2015 were still in the country in 2016. That does not count people who came here on student visas or temporary worker permits.

Numbers like these have convinced some conservatives that the federal government needs to worry more about people who abuse their temporary legal status than about border security.

In 2005, tourist visas brought Wei Lee and his parents to San Francisco from Brazil, where Mr. Lee's parents, who had emigrated from China, ran a restaurant outside São Paulo. They remained in the United States after the visas expired.

After being mugged and beaten in 2013, Mr. Lee recently received a U visa, which is reserved for victims of crime. His parents, however, are still undocumented.

"Some people misunderstand, they think people come here and overstay their visas intentionally, but there are all these push and pull factors," said Mr. Lee, 28, a college graduate who now works with Asian undocumented youth. "My parents had to make a decision for their lives."

After the expiration of the tourist visa that Rebeca, a former television reporter from Venezuela, used to enter the United States, she found work as a nanny, then got a job as a designer at a clothing business in Southern California. Rebeca, now 30, said she had left Venezuela after being attacked and receiving death threats for protesting against the government after the death of Hugo Chávez.

She has applied for asylum, but it will be years before her case is even considered: In Los Angeles, immigration officials are currently scheduling hearings for people who first applied in 2011.

Repeat Crossers

One reason Mr. Trump and many proponents of curbing immigration see the Mexican border as alarmingly porous is that thousands of people each year are convicted of illegally re-entering the country after being previously deported. In the 2015 fiscal year alone, 15,715 were convicted, according to the United States Sentencing Commission. About a quarter of people caught crossing the southwest border that year had done it at least once before, according to a Government Accountability Office report.

That said, the number of people convicted of illegal re-entry has declined by more than a quarter over the last five years.

In December 2013, border security agents caught Clemente Armenta-Velasquez trying to return to the United States near Nogales, Ariz. After arriving in the United States in 2000, he had lived and worked in Arizona, where, records show, he was prosecuted on drug charges in 2002. He also served time in prison after being convicted of possession with intent to distribute marijuana, a felony, in 2010. He was deported the following year.

Mr. Armenta-Velasquez's lawyer told a federal judge that his client, who had left school after fifth grade, had tried to come back to support his wife and three children in Mexico. "He couldn't find a job in Mexico that would give a decent life for his family," said the lawyer, Ricardo Bours, according to court papers.

Before sentencing Mr. Armenta-Velasquez to 57 months in prison, after which he will almost certainly be sent back to Mexico again, the judge suggested that Mr. Armenta-Velasquez might have been ordered deported as many as six times in the past.

"I knew I wasn't supposed to" return, Mr. Armenta-Velasquez said in court. "I did it out of great need, but I apologize for that."

Asylum Seekers

On Valentine's Day, Rogelio Ortiz stopped by the local immigration office in Charlotte, N.C., to update his family's address. He was seeking asylum in the United States after arriving from Honduras last February, fleeing arms traffickers who threatened him after he asked them to stop storing weapons in his brother's house.

Fifteen minutes later, an officer came out to tell Mr. Ortiz's wife, Teresa, and daughter, Abigail, that he had been detained. Without realizing it, Mr. Ortiz, 49, had already lost his asylum case: He had been deported 14 years ago after a previous stint working in the United States, and was ineligible.

Since 2009, migrants seeking asylum from Mexico and Central America's Northern Triangle region - Honduras, El Salvador and Guatemala - have surged across the border at a relentless pace, fleeing gang violence and poverty. Many of them are children traveling alone or women with children.

Nearly 409,000 migrants were caught trying to cross the United States' southwestern border illegally in the 2016 fiscal year, an increase of 23 percent over the previous year, according to government statistics.

Many ask for asylum, but in most cases, the requests are denied. While they wait, a process that can take years to conclude, they are often released to move freely into the country.

That can mean disappearing beyond the reach of immigration officials. The system has infuriated those who advocate tougher enforcement, prompting the Trump administration to propose detaining asylum seekers at the border or forcing them to wait it out in Mexico.

"I know coming into the country illegally is a crime, but millions of people have done it, and now we come here asking for help," Teresa said.

Now she seeks work to pay for a plane ticket. Teresa plans to renounce her own asylum claims to reunite, once again, with her husband - this time, back in Honduras.

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Here's the Reality About Illegal Immigrants in the United States (Published 2017)

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There are 11 million of them, the best estimates say, laboring in American fields, atop half-built towers and in restaurant kitchens, and swelling American classrooms, detention centers and immigration courts. In the public's mind, the undocumented - the people living here without permission from the American government - are Hispanic, mostly Mexican and crossed the southwestern border in secret.

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In this educational animated movie about Social Studies learn about immigrants, citizens, aliens, customs, naturalization, and visa.

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Get access to files anywhere through secure cloud storage and file backup for your photos, videos, files and more with Google Drive.

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Get access to files anywhere through secure cloud storage and file backup for your photos, videos, files and more with Google Drive.

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Computer Lab Video Guide Lesson on Syria

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About The Green Hand Mission S tatement I Am Syria Message Media Contact

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Mike Kacer practices unlacing his worn-out combat boots.

He doesn't use his fingers. He left those in Afghanistan, along with much of his left arm.

He maneuvers two silver pincers, oversized tweezers that tug his laces loose. It does not go well.

"I could actually tie the shoe faster without the prosthesis," Kacer says.

Despite practicing with this artificial arm -- and with more than a dozen other Army-issued prosthetic limbs at his disposal -- Kacer said that most of the time he doesn't wear the devices. Even though the government has probably spent more than $117,000 to provide him with artificial arms over the past five years. Just one of the more sophisticated devices he owns cost more than $100,000, and it's a device he doesn't often use.

"If I had to put a timeframe on it," he says, "[in] a 13-hour day I probably wear a prosthetic four to five hours out of it."

Mike Kacer with his girlfriend Jessica Schulman at their home in Yonkers, N.Y. Heather Martino / NBC News

Kacer is far from alone. Of the roughly 1,600 veterans who have suffered major limb losses from the wars in Iraq and Afghanistan, about 319 have faced amputations of some part of their arms. And although they have little trouble getting artificial arms, many abandon them. Former soldiers criticize the devices as uncomfortable, unreliable and painful to wear regularly, according to a 2012 study by the inspector general's office at the Department of Veterans Affairs. "Consistently, veterans with upper limb amputations only reported lower psychosocial adjustment, physical abilities, and prosthetic satisfaction than those with lower limb amputations," the inspector general's investigators wrote.

In other words, soldiers who lost legs adjusted better than those who lost arms. Scientists have greatly improved prosthetic legs during the past decade with better technology, materials like carbon fiber and urethane, and rehabilitation. Improvements to artificial arms have not kept pace, according to many specialists. "The state of the art of upper limb technology is not as good as lower limb technology," said Dr. Linda Resnik, a Brown University scientist who works at the VA Medical Center in Providence, Rhode Island.
Read the Full Version of This Story in CUNY's 219 Magazine
A key reason is that artificial arms have not gotten the same priority, according to experts and the VA inspector general. The inspector general reported that veterans found VA staff were unfamiliar with arm prosthetics, lacked expertise and had not kept up with the latest technologies. Repairs took longer for artificial arms than for legs, and arm amputees sensed that the VA did not really listen to their needs.

Since 2007, the VA has had detailed guidelines for working with soldiers getting prosthetic legs. Similar guidelines for those who lost arms were issued -- at the inspector general's urging -- only this year.

Mike Kacer, top right, with fellow soldiers in Afghanistan shortly before his 2008 injury. Courtesy of Mike Kacer

Arm amputees now account for 22 percent of all new amputees according to Resnik.

But in the last fiscal year, the VA's Prosthetic and Sensory Aids Service spent $70.2 million went for artificial legs, while just $5.9 million was allocated for prosthetic arms.

In addition, artificial arms are proving more complex than legs. Since the 1950s, researchers have vastly improved the materials in prosthetics, but gains have been slower on mechanics, according to research by Gary Berke, a Stanford University instructor who operates a private clinic providing prosthetics. This has especially benefitted those who use artificial legs. Materials like polyurethane have helped decrease the mechanical forces applied to the remaining stump. Additionally, carbon fiber and other lighter, durable materials have allowed leg amputees to exert less energy when walking, making the task easier than before.

"Walking is relatively straightforward," Berke said. Artificial legs essentially can do everything that real ones do. Artificial arms, however, are not nearly as adept as the real ones. "We're behind the eight ball in terms of [artificial arms'] functional ability," said Berke.
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Confounding slow progress is rising expectations. In the Vietnam era, soldiers died on the battlefield from injuries that are treatable today. Survivors who made it home were not given many choices for prosthetics, said Lynne McFarland, an epidemiologist with the VA in Washington state. "When they were injured ￼there wasn't a lot of research on upper limb prosthetics," she said. "It was basically the kind of hook and grasper thing that was available ￼to them."

Rather than old-fashioned, pirate-style hooks, today's amputees get the choice of robot-like arms. These new devices may look like the real thing - but they still can't act like real arms. Many veterans are not impressed. "Even with all the high tech stuff, even then they kind of went, 'You know, it's not worth the bother,' " said McFarland, referring to reality that many veterans abandon their arm prosthetics

Another part of the difficulty is replicating sensations. Robotic motors can grasp everyday objects. But they are unable to feel what they are doing. Scientists call this a feedback loop: Those who have their natural arms use their muscles and nerves to work together. In artificial arms, that's missing. Berke said, "There's no feedback from the hand to the limb, so people can't say, 'Yes I have a grip on my cup of coffee and I'm not going to smash it.' "

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War Vets Cast Aside Costly Prosthetic Arms, Citing Usability

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Mike Kacer practices unlacing his worn-out combat boots. He doesn't use his fingers. He left those in Afghanistan, along with much of his left arm. He maneuvers two silver pincers, oversized tweezers that tug his laces loose. It does not go well. "I could actually tie the shoe faster without the prosthesis," Kacer says.

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At first glance, the shed, in a back garden in Swansea, doesn't look remarkable.

Step closer and you'll hear the whirring of a hard-working machine.

Open the door and, while I'd like to tell you it is Tardis-like inside, it isn't.

Every inch of space is rammed with equipment, and silver insulation lines the walls.

It's Mission HQ of an extraordinary duo who call themselves Team Unlimbited - and they are on a self-funded mission to provide free 3D prosthetic hands and arms for children who are born without.

The children get to design their own colours and patterns, and the team - Stephen Davies and Drew Murray - do the rest.

Demand is high, and the shed is full of photos of children from around the world wearing their distinctive design.

Thanks to a blueprint the pair have open-sourced - meaning that anyone with access to a 3D printer, some fishing line and a bit of Velcro, can make one.

Stephen Davies, the owner of the shed, is a CAD (computer-aided design) engineer and father of three. He was himself born without a hand.

It was his own search for a prosthetic that led him to Drew Murray, an IT consultant from Milton Keynes who is part of a volunteer network called e-Nable that makes free 3D prosthetics for children.

Mr Davies says the prosthetic he was offered by the NHS reduced him to tears - and if you look at the photo, you can see why.

In despair he went online, discovered e-Nable and asked Mr Murray, who was the only volunteer based in the UK, to make a hand for him.

It was the first adult hand he had ever created.

"I never thought I would have been able to afford something like that," Mr Davies said.

"I felt 10ft tall, walking down the road, wearing it. It gave me a huge boost in confidence.

"I was so blown away by that, I knew I had to get involved."

So the team paired up, and Mr Davies invested hundreds of pounds in two 3D printers and materials.

With the insight of his own experience, they soon created their own design, fixing a few flaws in the existing e-Nable model along the way.

Team Unlimbited was born.

"Everything we do is funded by myself and Stephen and generous donations," said Mr Murray.

"We are not a charity, we're just two men in a shed. It's rewarding to use our professional skills in a different way."

Stephen Davies' first recipient was Isabella, who is now nine.

Isabella is very capable with what she calls her own "little arm", but the prosthetic has made tasks such as learning to play the piano, walking the dog, playing ball with her brother William and turning pages in a book much easier.

Her father discovered Team Unlimbited on Facebook, and Isabella chose a pink and purple theme for her first arm.

"The confidence it gave her was amazing," said her mother, Sarah.

"It stopped her feeling self-conscious. Everyone is different in their own way, but for her this makes her difference a bit more special."

"It helps me a lot with things I can't normally do, and things I haven't tried yet," said Isabella.

A video of Isabella receiving her first hand has been viewed almost two million times on YouTube and was included by Google in an annual highlights video.

She also appeared in an advertising campaign for the 2016 Paralympics.

She has received three arms so far, and Stephen and Drew's current template is named after her.

Each hand costs about £30 in materials to make, and takes 12 hours - and the two admit they are swamped with requests.

"I work full time, I've got kids, I've got a 10-month-old baby; we spend all our evenings and weekends doing this," said Mr Davies.

"We do it all for free, we don't even charge postage."

The design has not been CE-marked, which means it cannot be sold.

Mr Murray says their focus has been on keeping the arm open-source and freely available.

While the device is not as robust as traditional prostheses, which can cost thousands of pounds, children grow quickly and regularly require new ones anyway so they do not necessarily need a long lifespan.

Glyn Heath, senior lecturer in prosthetics and orthotics at Salford University, said 3D printing would not work for all prosthetics, especially lower limbs.

"The materials you can use are limited and the properties of those materials are not necessarily appropriate for taking heavy weights," he told the BBC.

The cost of traditional prosthetics was high because of the long process of getting them to market, he added.

"It takes a long time to develop prosthetics - they have to be tested to specific medical standards," he said.

"Not a lot of people use upper limb prosthetics, so the costs of manufacturing are also high relative to the amount you are producing."

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At first glance, the shed, in a back garden in Swansea, doesn't look remarkable. Step closer and you'll hear the whirring of a hard-working machine. Open the door and, while I'd like to tell you it is Tardis-like inside, it isn't. Every inch of space is rammed with equipment, and silver insulation lines the walls.

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Newsela | Afghan boy gets new arm from U.S. group helping children touched by war

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CLOSE

College and high school students in Greater Cincinnati are using 3D printing to solve medical problems in the community.

A group of biomedical engineering students at the University of Cincinnati started a student organization in 2015 to build inexpensive prosthetic hands for local kids.

Inspired by the global organization e-Nable, Enable UC can build a custom, functional hand in its lab on campus for less than $20 - instead of thousands of dollars - and get it to the patient in about a week. Pediatric patients aren't charged a penny and are able to shake someone's hand, catch a football or ride a bike with two hands.

These devices aren't meant to replace prostheses developed in collaboration with a medical professional. They're designed to be affordable and accessible tools for kids. The artificial hands are made out of plastic and don't use electrical sensors or robotics. Making them this way reduces the cost of supplying multiple prostheses when kids grow out of them and can be easily replaced if they break.

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Tue., Feb. 14, 2017: Ishan Anand, a fourth-year biomedical engineering student at the University of Cincinnati, holds a 3D-printed prosthetic that Enable UC, a student organization, produced. Behind him, are other biomedical engineering students that are part of Enable UC. From left: Nick Bailey, Jacob Knorr, Derryn Scott, and Yosef Kirschner. (Photo: The Enquirer/Carrie Cochran)

So far, in the group's less than two years of existence, students have built 42 prosthetic hands and assistive devices. And they want to do more.

"This is empowering students to have a direct impact in the life of someone with a disability," said Jacob Knorr, a 22-year-old biomedical engineering student and president of Enable UC.

The first person to receive a hand from Enable UC was a 13-year-old boy named Brody who was born with a partial right hand. It was hard for Brody to steer a bike, throw a ball or hold a lacrosse because of his disability, according to the university. Enable UC made a hand that looked like a Star Wars Stormtrooper for Brody, a huge fan of the movie franchise, so he could play with other kids his age.

The group's most recent hand recipient was 15-year-old T.J. McGinnis, a varsity football player at Rock Hill High School in Ironton, Ohio. T.J. was born a partial right hand and had never experienced using two hands before meeting the Enable UC team.

UC students find a patient or a patient finds them, often through relationships with UC Health and Cincinnati Children's Hospital Medical Center.

To produce a prosthetic hand, students don't need to meet with a patient. All they need is a picture of the patient's arm that needs the prosthetic, Knorr said.

Then, the students go online and find a 3D design file of a hand or fingers from e-Nable - a global open source organization and volunteer network that provides free prosthetic hands to kids in need around the world. The organization allows anyone with access to a 3D printer to make a prosthetic hand using its design files, which inspired the creation of UC's student group. Students at Xavier University and Walnut Hills High School are also using the e-Nable program to build prosthetics with 3D printers.

The downloadable file is, in essence, instructions the 3D printer can read. The students can make adjustments and scale the file according to the patient's disability to make sure the hand will fit.

Next, the students order the plastic materials to make the prosthetic and then load them in the printer like ink. Digital instructions are then sent to the printer and within 12 to 24 hours all the parts, including pins and hinges, are made.

The print process is slow and isn't always perfect. Imagine printing off thousands of pages at your home computer and after eight hours of waiting, there's a paper jam - it is a machine after all. Then, you'd have to reload the printer and wait for another 12 to 24 hours.

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Tue., Feb. 14, 2017: The beginning stages of a prosthetic hand is 3D-printed by the Enable UC, a student organization at the university. (Photo: The Enquirer/Carrie Cochran)

Once the pieces are printed, the team fits them together to make the plastic hand functional, wearable and comfortable for the patient, which takes a few hours.

Elastic keeps the hand open and a tensioned twine is tied to all the fingers, which is anchored to the wrist. So, when patients flex their wrist, the strings are pulled and the hand closes.

It takes about a week from the time the team finds a patient to having a completed product that's ready to use. The prosthetic hand costs less than $20 to build and it's free for the patient, a cost that's completely subsidized by the university by funding costs for materials and printing. According to e-Nable, a professionally made, muscle-actuated hand can cost between $6,000 and $10,000.

The UC students are also using 3D printing to build other assistive devices for the occupational and physical therapy programs at Touro University in New York. They aren't prosthetic hands, but tools that patients use to carry out everyday tasks they normally couldn't.

They built a device for a patient who had suffered a traumatic brain injury so that he would be able to drink independently at the dinner table. Students have also created devices that help patients to open a bottle of nail polish and play the violin.

"We're trying to help people live their lives a bit easier," Knorr said.

Christine Geeding, the clinical director at the Corryville-based J.F. Rowley Prosthetic and Orthotics Lab, said the innovation of 3D printing could make prosthetics more accessible and affordable.

"3D printing is going to have a really good place in prosthetics, it's just not there yet," Geeding said. "Once they start perfecting it and making it strong, then it will trickle down to being more affordable to us."

Printers need to be able to use stronger material and print faster, she said. When that happens, it could bring down the whole price as manufacturers are able to make the parts people can use cheaper.

Geeding has been a prosthetist for more than 20 years. Her office specializes in pediatrics and she said they rarely see patients looking for prosthetic hands or fingers because the human body adapts and compensates for the loss. Often, the loss doesn't become a concern for a patient until adolescence when it becomes more of a cosmetic issue.

When a patient does come in, she works closely with parents to identify the child's needs and goals.

Geeding casts the limb that needs the prosthetic, creating a mold. She customizes the device to the exact size and shape of the patient to make sure it's comfortable. Geeding makes a prosthesis in her office in about two hours, and the prices vary, but the bill is usually covered by insurance.

She said making a hand for one patient would cost her about $1,000. That includes the crafting the device itself and the socket where it attaches to the body, plus office visits. One of her recent patients had a prosthetic from the shoulder down and the insurance company paid $3,800.

Geeding makes prosthetics made out of titanium, which is light, and reinforced with a combination of carbon, the synthetic fiber Kevlar and glass.

She said that material combination makes prosthetics durable enough for kids to play on the playground or a baseball field without worrying about it breaking.

Students at UC, beyond invested in helping others

Knorr has worked as a co-op student and undergraduate researcher at Cincinnati Children's in the plastic surgery division since 2014. His research is focused on craniofacial abnormalities in children. He uses 3D printing to create tissue-engineered "scaffolds" used to grow bones to repair cleft lip or palate bone defects.

With that experience, he saw the opportunities his university could provide for other students and patients through 3D printing.

Knorr saw a news story about a civil engineer who made an inexpensive prosthetic for a veteran who had lost his fingers. He thought "this would be a cool thing to bring to UC."

Knorr and some of his engineer friends formed Enable UC, which became a formal student organization in October 2015. The group was awarded grants from the College of Engineering and Applied Sciences Alumni Association to buy the 3D printer. The university provides the materials and lab space on the Victory Parkway campus in East Walnut Hills. The University Funding Board and UC's Student Activities and Leadership Development also help fund the organization.

Now, the organization has about 30 students as members, a 12-member executive board and a faculty adviser, James Lin from UC's biomedical engineering program.

"Here, we can actually do something that's similar to what a professional would do," Knorr said. "It's giving students very valuable skills that will help them do this type of work later in life."

Knorr said students in the organization also want to address new medical problems by collaborating with Cincinnati's medical community.

For example, Enable UC is working with a seven-year-old girl at Cincinnati Children's to develop a hand that will help her overcome a nerve injury in her arm. She isn't missing any part of her arm, but she can't close her fingers.

They're building her a brachial plexus arm, the first of its kind, that will incorporate a glove design to help her grasp things.

"Our idea is to develop it on the basis of this one patient and then make it available to the open-source community so that other institutions can use the device we've created to help people with similar medical conditions," Knorr said.

At Xavier, the university has a "human-centered making" major where students learn "design, product engineering and critical thinking skills with an emphasis on empathy." Those students used a 3D printer to build a myoelectric hand that offers more control and dexterity than the plastic prostheses. Those devices have electrical sensors in the socket that are connected to the patient's arm and sense when the muscle is flexing to open and close their hand.

Geeding, who is a professional consultant to the Xavier students, has referred some interested patients to Xavier's e-Nable program.

She said the e-Nable movement is raising awareness of "an issue that a lot of people don't pay much attention to" and patients are getting access to something they're going to use every day.

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UC students build 3D-printed prosthetic hands for kids

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CLOSE College and high school students in Greater Cincinnati are using 3D printing to solve medical problems in the community. A group of biomedical engineering students at the University of Cincinnati started a student organization in 2015 to build inexpensive prosthetic hands for local kids.

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Columbia - artificial Legs

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Give prosthetic legs for 100 Children in Colombia on GlobalGiving

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Mahavir Kmina will provide artificial limbs to 60 low income kids and young Colombian amputees, giving them the opportunity to walk again. Any donation will me match a 100% by one of our generous donors!

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A Global Network Of Passionate Volunteers Using 3D Printing To Give The World A “Helping Hand.”

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"Never underestimate that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has."

- Margaret Mead [American Cultural Anthropologist]

Yesterday marked an important milestone for the e-NABLE volunteer community, as the 1000th member joined the group! 1000 people from all over the globe, all making 3D printed prosthetic devices FOR FREE for anyone who needs them. How amazing is that?

e-NABLE's crowd-sourced, Internet-enabled global network of volunteer designers, technologists, and researchers designs and delivers 3D-printed assistive technology devices to underserved communities around the world. We have already advanced the state of the art in technology and in collaborative pro-social innovation. We believe we can globally scale and generalize our approach.

Upper limb differences accompany up to 1% of live births worldwide. Fingers, hands, and arms are also lost in accidents and armed conflicts.

Traditional prostheses cost tens of thousands of dollars, and insurance coverage in the developing world and for children who will outgrow them are rarely adequate. As a result, physiological, sociological, and psychological development can be impaired and human potential wasted. Our distributed manufacturing model provides local solutions that are inherently sustainable, replacing industrial manufacturing processes with in-place fabrication by end-users with locally-reproducible, recyclable materials.

In less than a year, e-NABLE has grown to over 1000 members, spread around the globe, focused on providing 3-D printed prosthetic hands free of charge to anyone who requests assistance. e-NABLE continues to grow rapidly, currently at a rate of about 20% monthly.

What originally started out as a couple of guys who created something to help one child in need...has grown into a worldwide movement of tinkerers, engineers, 3D print enthusiasts, occupational therapists, university professors, designers, parents, families, artists, students, teachers and people who just want to make a difference.

They are coming together to create, innovate, re-design and give a "Helping hand" to those that need it - whether it is helping to print parts for them, creating a completed device for them or simply helping to guide them as they build one themselves.

There are people around the globe - 3d printing fingers and hands for children they will never meet, classes of high school students who are making hands for children in their local communities, a group of people that are risking their lives to get these devices onto people in 3rd World countries and new stories every day of parents working with their children to make a hand together.

Come see what it's all about...
e-NABLE's web site
e-NABLE's Facebook page
Ready to volunteer? Just fill out this form to get started.

Looking to obtain a free prosthetic device? Fill out the same form, and someone from the e-NABLE Matching Team will help match you with an e-NABLE volunteer.

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1000 Volunteers, Making Free Prosthetic Limbs for Those Who Need Them

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"Never underestimate that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has." - Margaret Mead [American Cultural Anthropologist] Yesterday marked an important milestone for the e-NABLE volunteer community, as the 1000th member joined the group!

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Abusing Pets

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