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Things that work

Victoria Hand Project harnesses technology and a network of technicians to help amputees around the world

Technicians fit a Haitian amputee with a customized, locally printed Victoria Hand.

Things That Work: The Globe and Mail looks at businesses, services and other projects in British Columbia that aren't often talked about because they actually work.

In a small, windowless lab in the University of Victoria's Faculty of Engineering complex, prosthetic hands dangle from a peg board. These prototypes – produced with a 3-D printer and a few nuts and bolts – have launched a program that provides patients with customized, working hands in the most impoverished communities around the globe.

"There is a great need," said Josh Coutts, lead designer of the Victoria Hand Project. He has travelled to Haiti, Guatemala, Nepal and Cambodia helping set up the systems that will allow medical technicians in remote communities to fit patients who would otherwise go without.

Members of ARCHUB PNH—the 3D design and print centre in Phnom Penh, Cambodia—assemble
the Victoria Hand for patients of the Battambang Regional Physical Rehab Center
in the city of Siem Reap.

Mr. Coutts went into engineering at UVic because he was good at math and physics, and he was drawn to the challenge of making new things.

With this non-profit venture, he has learned how creating new things can have life-changing benefits.

The patients typically have lost a limb because of accidents, violence or medical complications from poor diet. Often, their access to health care is limited, and even the cost of travelling to a medical clinic can be prohibitive. The project will also finance transportation to allow patients to reach the clinics.

The Victoria Hand being demonstrated to a group of Haitian technicians who were learning to 3D print and assemble 3D printed Prosthetics.

The design is based on a master's project in the late 1990s by Nikolai Dechev, director of biomedical engineering at UVic. He made a mechanical hand of aluminum and plastic that used a Kevlar cable to pull in the fingers for grasping. It was innovative and attracted a lot of peer review. But it cost $1,500 just to manufacture the parts. It had no practical application.

"Then along came 3-D printing," Mr. Coutts said. It is ideal technology for producing one-off items such as prosthetic limbs that must be tailored to each wearer.

A 3-D scanner is used to design a custom-fit device from the patient's limb, and a 3-D printer builds it using heated plastic filament that is extruded layer upon layer. There are 54 individuals who now have a Victoria Hand system, and by January, the number will grow to 80.

Isabel Mendez, a Guatemalan amputee who has been part of the 3 trials with Victoria Hand Project, demonstrates his hand in February.

The Victoria Hand Project works with hospitals and clinics, training local technicians to run the equipment. The kit that the lab assembles and ships is not large – a 3-D scanner and two Ultimaker printers, plus spools of plastic filament, silicone fingertips and trays of springs, nuts and bolts to complete each hand. The average cost is $300, and most of that pays for the labour – based in the communities where the hands are being fitted – to assemble and fit the hands.

The mechanics of the hands are activated with a simple shoulder harness system that can trigger the grip with a shrug. The stronger the movement, the tighter the grip. A reporter visiting the lab was instantly able to pick up her tape recorder – although working the controls required practice.

For Mr. Coutts, who now has his degree in engineering, this opportunity has shaped what he will do with it.

Technicians with Cambodia’s ARCHUB PNH demonstrate the Victoria Hand system they custom-printed on site.

"Technology is very empowering, but the one thing I have learned is that while the engineering is such a huge aspect, what is more important is who is actually getting these devices to people who need them." The Victoria Hand Project is building a delivery network so that when new and better devices are developed, it will be easy – and inexpensive – to transfer the technology to the people who can deliver it to those in need.

"The key is to work with trained professionals on the ground," he said, "to partner with them."

The prosthetic hands are constantly being refined, with the assistance of UVic engineering students. They volunteer their time to work on improving the functionality and the appearance. But the next big thing is to expand who they can help. Right now, the devices work only for those who have had amputations between the elbow and wrist, and Mr. Coutts and his team would like to develop options to accommodate more people.

Joshua Coutts, Victoria Hand Project, shows a Haitian amputee the different functions of the prosthetic he received.

The Victoria hand system currently is a hybrid between a cosmetic hand, often fashioned from wood, and a functional split hook that can be manipulated. The wearer can hold a cellphone or carry a bag, but it does not provide the dexterity or strength of a fully functioning hand.

Dr. Dechev recalls fitting out a boy in Egypt for a hand. "He is growing quickly. He had a wooden hand that didn't move at all then he outgrew it and then he had nothing. When we fitted him, he was blown away. He showed all his friends."

Moments like that drive the project. Dr. Dechev, who has been in academia since 1992, says this project would not have happened without the opportunities for research and development in the university system. "But this is not so much an academic project so much as it is about making a difference in the world."