The Legacy of War: Improving Lower-Limb Prosthetic Design in Northern Sri Lanka

The JJCDR provides prosthetics based on ICRC designs, adapted using local materials for better durability in Sri Lanka’s climate. However, since the original designs weren’t tailored to Sri Lankan users, two collaborative studies were conducted to understand how amputees in the north use their prosthetics. The goal is to co-design improved prosthetics that meet local biological and cultural needs through a multidisciplinary approach called anthroengineering, which combines engineering and anthropology.
The database was first queried for demographic information relevant to prosthetic design. There were 3,665 unique patients who registered with the JJCDR from 1986 – 2018, the majority of which were males.
Of the 555 patients with occupation data, many were housewives (124) or unemployed (85), suggesting a greater need for prosthetics suited for basic mobility rather than heavy labor. The majority of patients lived in the Jaffna peninsula (82.5%) and most amputations occurred in the Northern province (94.3%), primarily due to war. Most amputations were lower-limb, likely caused by landmines and blasts, and were treated at teaching hospitals (65.6%). As JJCDR offers limited upper-limb prosthetics, the actual number of upper-limb amputees may be underrepresented.
Contrary to expectations based on ISO 10328 standards for lower-limb prosthetics, there was little evidence of prosthetic foot fractures. However, it remained unclear whether delamination between the keel and the rubber occurred.