Our guest is Francisco Díaz, from Autofabricantes, a research project that brings together different actors (engineers, architects, therapists, families) around a common mission: to design and manufacture prostheses that provide more inclusion, autonomy, and life quality for children.
We talk about the project, how it came about, how children are involved in the design and manufacturing process, what transformations occur in their lives as a result of their use, and much more.
If we are talking nationally in Spain, prosthetics are luckily covered by the National Health System. If someone is born without part of their arm or hand or lose it in an accident, the state provides one for them. So, the rest of society takes on the cost, which depends on the needs of the child or adult. Prosthetics that are merely aesthetic, usually myoelectric.
Although prostheses are covered by social security, basic prostheses cost between 2,000 and 20,000 euros. Moreover, the official catalog has not been renewed for 20 years.
Here comes part of the problem, we have really outdated technology. On the other hand, the state tells you what prosthetics to use and what the protocol is for using it. In children, it’s a functional thing. In general, they seldom use them because they are very cumbersome and slow. Children need agility, something that works right away, if not, they quit using them. So, the user learning curve is really slow and that causes rejection of the therapy process to be long-winded. On the other side of the coin, the acceptance or rejection, in the same way, is also pretty long because the user isn’t a part of the design or the decision process. In other words, it’s something completely alien. That also depends a little on the social rank each child falls into. If we move on to other countries, access to prosthetics is much more expensive or inaccessible, but at the end of the day this stems from the same root of the problem, it’s just that the user isn’t participating.
At Autofabricantes, we don’t even call it a “prosthesis” anymore, but a “support product that helps you in your daily life”.
Something that understands that the body isn’t to be repaired, but to help in very specific cases. We usually do collective workshops where we have therapists, designers, all sorts of engineers, people who know how to 3D print, and between them all they create a trustworthy workforce to give the child hope that there’s a possibility of building the thing they have in their head. We go into the workshop, a workshop where there is not just one child and one group of adults, there are 5 or 6 parallel groups solving specific problems.
This is particularly important because the child does not see him/herself in a medicalized space, nor an individualized space, but sees that there are other people just like him/her.
We start with a dynamic where everyone gets to know each other, where everyone knows what’s going to happen on that day and the days following on.
They also learn how the technology (the 3D printer) works, and we start working with them in group dynamics to get to know each other.
From there, discuss the challenge we want. With a pencil, paper, card, and a little plasticine, we create what we want to make. The rest of the team, once the workshop is over, they get to work.
Always guided by the therapists, who are the ones that evaluate firstly the child and then the limits they can reach. There are motor function pre-evaluations. How their arms move, how they socialize. There’s a series of parameters regulated by the World Health Organization (WHO). Some revision standards. This is later on throughout the design process. Not at all, because at the end of the day there are clearly defined roles. As well as that it’s a space of learning. We all learn from the child’s experience; they are nothing more than experts in experiences as we call them. There’s an understanding of a common objective from all sides. It started in MediaLab Prado, in Madrid on the 5th of October 2015.
It started two years earlier in Seville, when a family we didn’t know, who was going to have a baby girl they knew was going to be born without a hand, asked us how technology could help them to make the child more autonomous.
There was a call for project development and in the first call, first meeting, the first call, 29 people showed up, among them, five families who didn’t know us at all and with 5 or 6-year-old children who had the same concern.
The most important thing is that they make their prosthesis. Then at the end, it is their prosthesis in the color they have chosen with some detail of the Hulk or their favorite team.
This way the prosthetics are theirs from the start. Parents tell us in their emails or videos they send us about the change in their child, they tell us that it’s a positive reinforcement in school, having that hand, their hand, it’s new, it’s colourful and even does things better than their classmates’ hands. So, there is a very important positive change there.
Afterwards, in the workshops, where they see there’s a group of people who listen to them and make what they have in their head possible, and they see that there are other children with the same problems they have.
What usually happens is that he is a child who has never seen anyone like him. Adult amputees participate in the workshops in the group phase that we do. So, they also see a reflection, that they are not exceptional.
Since we have been working in Madrid, they have participated in the artisan workshops that last 3 months. There’s a workshop every month and we have done around 30, we have worked with some 35 families,
All the designs we make are online, you can download any of them as long as there is a forecast, a revision from the therapist. We know that more than 1000 families all over the world have downloaded them.
