Issues Faced



ISSUES FACED: Current Prosthetic Charity State of Affairs

For millions of amputees living in poverty, the gift of mobility and promise of an independent life remains a distant dream. Although a number of charities offer prosthetic aid, their resources reach just a fraction of the amputees who need limbs. According to a recent Land Mine Monitor Report, only 37,000 prostheses are produced or distributed worldwide by ICRC prosthetic centers, NGOs and other agencies annually. We saw an opportunity to help.

Before deciding on the idea of a world limb bank in 1998, we began by asking what services we could provide when viewed both from world need and from benefits already delivered by existing charities. From that inquiry we discovered that prosthetic charity operations for developing nations mostly conform to two business models.

Distribute Used Prosthetic Components Model
There are numerous charities that collect and distribute donated prosthetic components. Yet people around the globe go without, lacking knowledge of these unused resources.

The problem has been widely illustrated in industry publications:

“When [we] went to Bosnia in 1996, we were saddened to see what had
become of donated used components from well-meaning people around the world.
They occupied a large shed behind the rehabilitation hospital.”

O&P Magazine, May 2001

This happens for two reasons:
1.) Donated prosthetic components are highly customized products, each having a unique but extensive set of patient-defined features.

2.) Charity operations are generally established to serve a small geographical spread of patients or victims of disasters. Their limited inventories and “one-off” approach to providing care reaches only a fraction of the amputees who need limbs.

The customized nature of donated prosthetic components coupled with limited inventories make it difficult for practitioners to match available components with patients.


When viewed from a global perspective however, developing-world prosthetists will be able to choose from the combined supply with far greater effect. The problem is not that appropriate components don't exist; they simply are not efficiently shared beyond charity network boundaries.

Local Materials Manufacturing Model
The historical UN model of manufacturing prosthetic components made from locally available materials reveals its limitations when viewed in the long term. Products produced in this manner tend to break down much more rapidly; they require adjusting and replacing more often. The more rapidly deteriorating prostheses not only impacts clients' quality of life, according to relief prosthetists, but also adds to the true cost of providing prosthetic care when viewed in the long term.

Together, these two business models have been chiefly responsible for providing prosthetic resources for millions of the world's destitute amputees over the past 30 years. Yet, total efforts from International agencies and private charities pale in comparison. Faced with these realities, and from our understanding of the issues that confront current charity operations, we began to see another way.

SOLUTION: Prosthetic Exchange Network (PXN)

With the scarce supply of prosthetic components being a leading issue collectively faced by prosthetic charities, and recognizing that most prosthetic related charities serve patients on a “one-off” basis, we chose an alternative approach.

Starting with the desire to support collaboration amongst charity organizations and apply modern business applications to our expression of philanthropy, the idea a world limb bank was born. Similar in concept to the Organ Procurement and Transplantation Network (OPTN) developed in the U.S. where hospitals partnered with one another to efficiently distribute donated organs—the World Limb Bank provides the global infrastructure for joining together charities, relief agencies, world clinics, manufacturers and healthcare professionals together to synergistically address the growing global need.

Known in the commercial sector as a “procurement platform" (think Exchange), the idea is simple: Share global prosthetic resource information among existing charity “Limb Banks”. As in business, enormous benefits are realized by linking suppliers and users on a unified platform.

Centralizing autonomous inventory information allows resources to be shared beyond charity network
boundaries, extends access and deploys unused prosthetics precisely where needed.

By networking charities and virtually combining their inventories, synergies are realized that not only help charities to efficiently deploy their idle inventories, but with global visibility of available inventory, their own practitioners will be able to select prosthetic components that more precisely meet the clinical needs of their patients.


Navigate to "Manifest" for more details about the PXN web-application.


The Prosthetic Exchange Network (PXN) joins together charities, manufactures and healthcare professionals on a unified system with synergistic effect. With universal access to the global inventory, practitioners can select and charities efficiently deploy, prosthetic components that more precisely meet the needs of their patients.


Aggregating supply of prosthetic resources is only part of the solution. Creating a self-service system that supports business operations as well as clinical standard practices rounds out the program. Based on ISPO / VIETCOT patient management guidelines and developed with emerging-nation prosthetists in mind, the PXN also provides the following program features:

Membership Application and Certification
One of the fundamental processes to be administered by the WLB is clinic membership and verification. The WLB works closely with international standards bodies (ISPO) and local educational institutions to verify that the candidate prosthetist has met minimum certification, experience and local government requirements.

Inventory Deployment
After a member clinic has been approved, it would be eligible to biannually order a predetermined measure of prosthetic components, supplies and materials.

International Shipping
Having negotiated national account status with Federal Express, the World Limb Bank receives a 54% discount on international overnight shipping rates. These costs have fallen greatly over the last decade making the program an economical option, even when compared to the cost of locally manufactured prostheses made from native materials.

Patient Registration—Piracy Control
As a means to thwart piracy and to guarantee usage of shipped components, member clinics are required to submit photographic proof and patient profiles (online) of fitted patients before being permitted to process a new order during their next order cycle.

Backend Integration
In addition, data can be shared between the WLB database and commonly used accounting programs such as QuickBooks and MYOB, for easy integration with sourcing members' back office adminis-

Seeded Inventory
Providing the infrastructure for collaboration is only half our story. Unlike most prosthetic aid charities that collect and distribute used prostheses, the World Limb Bank offers an unprecedented volume to the global supply. Having a platform that offers integrated patient registration and piracy controls, the World Limb Bank in collaboration with it benefit partners, adds to the global inventory its own stock of near new, state-of-the-art prosthetic components; offering a selection that is both broad and deep.