*Chapter Spotlight Project*

Learn about the e-NABLE chapters around the world that are making things happen! This regular installment will cover 6 topics: Site & Community, Tech & Specs, Team & Specialities, Design & Process, Projects & Collaborations, and Research

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GRIT3D | Karachi, Pakistan | April 2021

Chapter Spotlight also available in Google Docs

Site & Community


  • Active e-NABLE members since 2016
  • Based in Karachi, Pakistan
  • Over 200 devices delivered to 190 recipient volunteers

GRIT3D's chapter leaders were first introduced to e-NABLE in January 2016 through a doctor working on the Syrian border. By the end of the year, GRIT3D became the first chapter in Pakistan. This Spring, they opened a new lab space with access to nearby carpentry and electronics workshops. They continue providing devices free of cost to recipient volunteers and also function as a rapid product development company (see Team & Specialities and Funding sections).

Agricultural accidents are common in Pakistan. Chaff cutter machines used to prepare feed for animals lack safety features and cause 90% of the amputations. Other accidents are caused by electrocution from unsafe working conditions, and using molding and hydraulic machines without safety training. The resulting amputations can be below and above the elbow, as well as at the wrist. Improper amputations can result in anomalies, which can make device fitting a challenge. Recipient volunteers often resist the idea of additional surgical procedures after their initial treatment experiences.

The majority of Pakistan’s recipient volunteers are adults whose limb differences result from an accident. They often arrive at the GRIT3D lab years after losing their limb, having adapted to their new circumstances as best as they can. This can make the process of learning to use a new device difficult.

Most of GRIT3D’s recipient volunteers struggle with poverty and live in rural regions of Pakistan. Visiting GRIT3D's office can be a challenge for them. There is no national system in place for prosthetics, so recipient volunteers find the chapter through a variety of sources such as NGO referrals, hospitals, and at times the web or Youtube.


Tech & Specs


The lab currently has seven 3D printers:

  • Creality Ender-3
  • Creality CR-10
  • Lulzbot
  • Formbot (2 machines)
  • Ultimaker 2
  • Ultimaker S3

The team uses multiple types of material including PLA, ABS, PET-G and sometimes fiber coated sockets. In their new lab, they have access to CNC and laser cutters, as well as lathe machines for teflon customization. Through their network of partners, they can now custom build parts as needed.


Team & Specialities


  • Asad Jabbar | Co-founder & CTO
  • Rabi Imran | Co-founder & CEO

The GRIT3D team includes 5 full-time staff, 2 on-call staff, and several volunteers. The team includes professional prosthetists, mechanical engineers, designers, and 3D printer technicians.

In addition to prosthetics, the team provides rapid product development for automotive, fast-moving consumer goods (FMCG), medical industries, and academic institutions. They also provide 3D models to surgeons for pre-surgical planning, support research and development projects, and promote the value of 3D printing technology.


Design & Process


The team has experience producing and testing the Raptor hand, Phoenix Hand, Flexy hand, and Gripper Thumb. They released the Gripper Palm Remixed V. G3D which substitutes torsion springs for the standard rubber bands (see Projects & Collaborations). 3D printed elbow actuators were also developed to support above-elbow (transhumeral) amputations.

Over time, GRIT3D found that people were not using their devices because they were not meeting the cosmetic and aesthetic needs of their recipient volunteers. Family and social activities are central to Pakistani culture. For traditional events like weddings, blending in is more important for guests than standing out (or looking like a superhero or a cyborg!). GRIT3D has found that cosmetic gloves with naturally colored organic-looking hands are preferred. These devices provide recipients with a sense of dignity within their communities and workplaces and minimize unwanted attention to their limb difference.

GRIT3D has researched devices that are cosmetically appropriate while still being functional, robust (even in hot climates), skin safe, easy to repair, and self-powered (non-electric mechanical devices). Custom molding is sometimes required to meet specific daily challenges like eating, and specific needs related to their livelihoods like the ability to drive a rickshaw or bike.

The team settled on an elbow-actuated metal mechanical device that their community accepts. These are covered by silicone cosmetic gloves that can be matched to skin tones. The metal device and glove are both easily purchased from Chinese regional shipments, and are affordable for community support (see Funding). The team provides 3D printing to support these devices with custom arm shell pieces, joints, and sockets.

GRIT3D takes initial data of recipients on paper forms along with photo ID. They use a management system to track progress and develop statistics of all recipients served. Because many recipient volunteers are embarrassed or uncomfortable allowing visitors to their homes, most outreach occurs via phone calls: a month after each delivery, a team member follows up to collect feedback and ask how much the device is being used.

After being fitted for a device, GRIT3D also offers rehabilitation counseling in their office for those who can make regular visits. They have a professional prosthetist on team who can cover assessments and evaluations, analyze the movement or challenges, and provide rehab. They typically schedule 4-5 sessions to build trust, to assess pain, and to address special needs.


Projects & Collaborations


GRIT3D's Gripper Palm Remixed V. G3D was made more robust by replacing rubber bands with torsion springs. The team developed a post-processing technique of grinding, sanding, and painting to achieve the smoothness and skintones requested by recipient volunteers. However, they ultimately found that achieving natural skin tones was difficult, that paint chipped from daily use, and that smooth hard materials like PLA diminished grip strength. These problems were not solved by PLA+ and laminated fiber. Eventually they began using a silicone glove instead of their own Gripper Remix.

GRIT3D has collaborated with NGO’s like Saylani Welfare. They receive referrals from the Indus Hospital Network and HASWA Foundation. Team members participate in corporate social responsibility (CSR) programs with national corporations to provide devices in large numbers and provide healthcare education programs about marginalized communities.


Research


GRIT3D conducts seminars at Schools, Universities and educational institutes. They share their research and development processes and lead workshops on how to use technologies like 3D scanning, 3D designing, and 3D printing. By working with prosthetics, GRIT3D has developed expertise in software-driven automation (Industry 4.0 skills) which applies to many other fields and industries.


Funding


In Pakistan today, there is no local manufacturing of 3D printing supplies. Bulk orders were the only way to minimize material costs, shipping, and import fees from Customs. For this reason, purchasing remains within the region (often from China). GRIT3D began reselling supplies like 3D printers and filaments to product developers and design firms.

GRIT3D acts both as a business and a non-profit by separating their charitable contributions from commercial work. While the business venture and projects do help cover operations costs, a clear separation in their finances allows them to develop non-profit partnerships. They rely on individual donors for each e-NABLE case to sponsor expenses, and often find recipient volunteers through NGOs or hospitals. Individual donors find GRIT3D through personal references, in the media, or online.


Public Presence


Website: www.grit3d.com

YouTube Channel: GRIT 3D

facebook.com/grit3d

instagram.com/grit3d


Featured in News, TV, and CSR Campaigns

Googly News TV | 2020 (Spoken in Urdu)

Samsung CSR 2017 (English)

Dawn News | 2016 (video with English Subtitles)