TAKING UP ARMS
By Shazia Hasan
2024-02-25
Rida was eight when she climbed atop a table at her house in Bajaur to use it as a vantage point while playing with other children. This was when she accidentally touched some uninsulated electric wires hanging from the wall. The burns from the electrocution were so bad that the child`s right arm had to be amputated from the elbow.
The accident was earth-shattering for her parents as well; they knew that the loss of a limb would greatly limit their child`s prospects in life. The girl had been maimed and was handicapped for life.
Rida`s father, Zair Ali Khan, knew of one other child in the village who was also missing an arm. One day, after offering Friday prayers at the local mosque, Zair Ali noticed the other kid running around, but ostensibly with both arms. There seemed to be nothing wrong with him anymore.
He looked around for the boy`s father and caught up with him to quiz him about his son`s newfound limb. This is when he learned about a Karachi-based company called Bioniks and their work with prosthetic arms. Zair was quick to get the contact details of these apparent miracle workers.
The next step for him was to call Bioniks to understand their work and also explain his daughter`s situation. Upon realising that they could help his little girl, he decided to make the roughly 1,600-km journey with his daughter in tow from his village in the country`s north to the southern city where the company is located.
It was here that Rida was fitted with a prosthetic arm, and without any surgery being involved. When she started moving her new arm, opening and closing her hand to grip little toys, plastic blocks and buckets with it, the father stood watching from behind, brimming with joy. Rida had found her lost arm again.
UNUSUAL BEGINNINGS Bioniks was founded in 2016 by two friends, Ovais Hussain Qureshi and Anas Niaz, who previously offered electromechanical product designing services. The decision to start the company was spurred by the case of a five-year-old child, Mir Baiyaan Baloch, from Turbat in Balochistan, who had been born without an arm.
Baiyaan`s father, who worked at the State Bank of Pakistan in Karachi and was familiar with Bioniks` products and designs, approached them with his son`s request for a bionic arm.
`That was the first time we entered this domain,` says Ovais, who is Bioniks` chief executive officer (CEO).
During the research and development phase, continues Ovais, they found out about the lack of sustainable solutions for artificial limbs. `There used to be prosthetics we have also seen them in stories and comics, where a pirate wore a hook, but there was no sustainable solution available.
Earlier, the sustainable solution was just a prosthetic you wore, maybe with a harness, according to the young CEO. `But there was no solution to the problem, because it was just cosmetic. There was no grip. You couldn`t even bring a glass of water to your lips with it,` Ovais points out.
Other than offering minimal movement and lacking a proper grip, these artificial limbs were often clunky and expensive.
`[The old type of prosthetic] was very heavy to wear seven days a week or even for 10 hours a day,` says Ovais, who claims his company offers a lighter, better solution.
`The prosthetics made by Bioniks are made of [lightweight] carbon fibre and aircraft aluminium. Using these, we have designed and developed many different prosthetics since 2016.
Currently, Bioniks offers a basic prosthetic arm, their flagship module called Zindagi 2.0. `Our prosthetic arm can move and the hand has a grip,` says a beaming Ovais, before adding that the company`s clients include people in Pakistan as well as in Afghanistan, Saudi Arabia and the United Arab Emirates.
SCIENCE, SENSORS AND SERVICE Bioniks` prosthetic limbs involve sensors, which pick up the electrical impulses from the body`s nerves, which are also known as the muscle nerve signals, and translate that into movement in the hands. This is why people who have had arms amputated find it relatively easier to adjust to the prosthetic limb. Children who are born without arms need some time to get used to the artificial limbs, as they have not developed certain motor skills and sensory perceptions associated with their use.
For problems of functionality, the Bioniks team have found an equally adept solution, with its Zindagi 2.0 prosthetic being backed by a mobile-based application for repair and maintenance. In case any prosthetic user outside Karachi has any problems with his arm, they don`t need to send it back. They only require connecting the prosthetic to the mobile application and it can be recalibrated remotely to resolve the issue, says Ovais.
He points out that they have two clients in Jeddah a 55-year-old man and a six year-old girl. If there is any issue with their prosthetic limbs, they don`t have to travel to Pakistan, says Ovais. `Instead, they can use the app and opt for online troubleshooting to resolve the problem.
A person with the app can help other users near him or her as well, he suggests. `This is also our way of cutting down on carbon emissions, as they don`t need to come back to us for repairs and maintenance.
For Ovais, the vision behind Bioniks is to make the technology available not only in Pakistan but for others outside the country. `So many people are impressed and inspired by things from the West, but we have this technology right here which also uses artificial intelligence [AI] to help people use their arms,` says Ovais.
He says his company has racked up multiple achievements in a short time, including serving one four-year-old who is the `youngest person in the world to be fitted with a bionic arm.
Others to benefit from their services include clients whose arms were amputated at the shoulder, with the prosthetic fitted, without surgery, in the shoulder socket.
`If they had opted for a surgery abroad, it would cost as much as 200,000 dollars for the targetted muscular surgery and the robotic arm,` adds Ovais. `With our intergenerational AI, we can provide the bionic arm for 58,000 dollars, and without any surgical procedure.
A HAPPY COHORT Recently, Bioniks welcomed 18 children from different cities across Pakistan to be fitted with prosthetic arms. Rida was one of them. Alongside her was Waqas, another kid from a village also in Bajaur, who lost his arm to a landmine blast. He had picked up what he thought was a toy, only for it to explode in his tiny hands. Next to them was another girl from the same district, with an eerily similar story.As Waqas went through the fitting and tried his new prosthetic arm, his face reflected equal parts excitement and resolve. He was determined to learn the mechanics of his new limb while trying to make it work according to his needs. As he practised with his new arm, the arm also was learning to accept its new host, thanks to the AI component involved.
Anas Niaz, who is the organisation`s cofounder and holds the designation of chief `visionary` officer, calls word-of-mouth marketing their greatest source of clients.`It is just like Rida`s father finding us after hearing about us, and then sharing that information with others in the area, or even bringing them along,` says Anas.
A little girl from Karachi, around four, was among those trying her new prosthetic arm, but she was taking some time getting used to it. Every now and then, she would resort to using her good arm instead of the prosthetic one and needed to be reminded to use it.
`It is because she was born without one arm. She has never used her motor skills for that arm,` says Anas. `It can be frustrating for the child, as it takes longer than an amputee to learn how to use the arm through muscle and nerve coordination by those who have never experienced the sensation. They have to go through the learning curve, but they are children and eventually adapt to it,` he adds.
Ovais says that they once got a kid who was born without both arms. `We had him fitted with two new arms and then he returned one day with one of them broken.
He said that he was showing off before his mother, demonstrating to her how he can climb a tree. But then he fell and broke one arm,` he continues.
`He came back apologising, crying that he will never dare to do such a thing again.
But we told him to carry on, as we would try to strengthen his new arm further.EVOLVING NEEDS When asked if the artificial limbs provided to children would need changing as the child grows, the Bioniks team said they didn`t need to change the size of the artificial limb, only the area that connects to the arm is broadened for an easier fit.
`Still, the global standard for one prosthetic limb is three to five years,` Anas adds.
He also says that children need a durable and lightweight product or they would get irritated. `A child`s prosthetic arm weighs around 300 grammes and an adult around700 grammes. Your own human arm weighs around 1.4 kilogrammes,` he says.
Dr Ayesha Zulfiqar, who is Bioniks` chief medical officer, collects the medical histories of those fitted with prosthetic arms. She also counsels the recipients as `there are many cases where an amputee`s world changes after an accident.
One such kid is 16-year-old Jafar Ali from Sadiqabad, who lost his left arm.
Jafar was cutting grass for his family`s animals in a chafing machine, when the blade also severed his arm by mistake.
That was some four years ago. It turned his world turned upside down. He stopped going to school, too.
He recently found out about Bioniks from social media and he was soon asking them if they could also help him. `I want to pick up from where I left off at the time of my accident. I want to resume my education, says Jafar.
Dr Ayesha says this challenge was faced by amputees across the age spectrum.
`Happily married women who may lose a limb in an accident can get divorced.
On the other hand, someone`s marriage prospects may also improve after putting on a prosthetic limb,` she says.
`Sadly, we have also seen cases where the parents of young amputees have left their children at orphanages,` she adds.
Sometimes, says Dr Ayesha, amputeescan be seen as a burden by families that have limited financial resources. `With a prosthetic limb, they can get jobs.
With artificial limbs, tragic outcomes can be avoided. She cited the case of a young client who rides daily on his bicycle to a tyre repair shop where he works. `We also have one client who is now a rider for an online food delivery service. He is no longer a burden on his family after getting his prosthetic arm,` Dr Ayesha points out.
However, Bioniks serves only a sliver of the population that needs artificial limbs.
`We have so many congenital deformities in Pakistan,` says Anas. `According to an Aga Khan University Hospital report, some 10 or 11 children are born each day without limbs.
So far, says Anas, Bioniks has provided 650 people, including 53 victims of conflict, with prosthetic limbs.
The situation is equally bleak globally, with one World Health Organisation report from 2017 estimating there were `between 35-40 million people in need of prosthetics with only 5-15 percent having access` to them. The situation is skewed further in developing countries, where the majority of those in need of artificial limbs tend to be from low-income groups.
This is also the experience at Bioniks, where a large number of its clients are from small towns and villages, often barely able to afford the travel to Karachi.
It helps that Bioniks is a social enterprise. The founders say they provide the prosthetic arm free-of-charge if the client cannot afford it. But this limits their ability to serve a larger number of clients, with around 5,000 said to be on the waiting list.
`This is why we are looking for donors and sponsors. We are planning a campaign for Ramazan, with the aim to provide 500 bionic arms free of cost to deserving people in Pakistan,` says Anas.
Their long-term goal is to sell their offerings at competitive prices globally, and to use the proceeds to sustain and enhance their social impact in Pakistan.
`That said, there are such countries like Pakistan where we will give our limbs at subsidised rates or even free of cost, continues Anas. `Basically, those who cannot afford it, they can get it free of cost, and those who can afford, can purchase from us,` he concludes.
The writer is a member of staff X: @HasanShazia