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Enabling the Future

Due to a birth defect, 8-year-old Aidan was born without fingers on his left hand. Growing up, he couldn’t grip things unless he used his “nubby” hand to hold them against his body. At home, Aidan’s lack of fingers didn’t bother him. But in public, he rolled down his sleeve to hide his arm or pretended he didn’t have an arm at all.

Aidan’s parents understood he was self-conscious but there didn’t seem to be any viable alternatives to assist their son.

A prosthetic hand would cost thousands of dollars. A surgical procedure could add a finger but one of Aidan’s toes would need to be removed to do so.

“Neither was something we were interested in,” said Aidan’s father, Andrew Delisle.

Then in February 2017, Delisle read about a prosthetic hand made on a 3-D printer. Through an online community called e-NABLE, he found someone near their home in Rockford, MI, who not only owned a 3-D printer but wanted to print, fit, and assemble a hand for Aidan — for free.

Delisle shared measurements of Aidan’s wrist and hand. Aidan shared his request that his new hand be in Jango Fett (the “Star Wars” bounty hunter) colors: royal and ocean blue. Three days later, it was time for the fitting.

“It was a magical moment,” said Delisle. (Right down to the surprise detail of a Jango Fett helmet on the prosthetic palm.)

This new hand, said Delisle, “allowed Aidan to talk to other children about his limb difference. It was an easy way to get kids interested without any negativity. Instead of, ‘Ew what’s wrong with your hand?’... it’s more like... ‘Wow! Is that a robot hand?!’”

Giving a “helping hand”

3-D printing is used to make everything from dishwasher parts to trendy clothing. It’s also proven to be a game-changer for another, less obvious demographic than “makers” and manufacturers: people missing their hands.

On the forefront of this trend is e-NABLE, a global network of as many as 30,000 volunteers who make 3-D printed hands and below-elbow devices for those who need them. That number of volunteers includes schools, libraries, companies, and robotic teams as well as individual members of e-NABLE’s active Google+ group.

To date, over 5,000 devices have been built in over 100 countries.

e-NABLE’s founder, Jon Schull, a research scientist and entrepreneur in Rochester, NY, prefers not to call it an organization, but a movement instead.

“We are pioneering a new phenomenon [called] “connected humanitarianism” that can address problems that remain unsolved by traditional organizations like businesses and governments,” said Schull.

e-NABLE helps connect volunteers willing to make 3-D printed hands and lower arms for adults and children who need them.

Want to build your own? e-NABLE’s extensive resources and community volunteers can help with that too. They can suggest the type of device, guide you through the process, and even help you gain access to a 3-D printer in your area.

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So how does a printer make an actual hand?

It doesn’t come out fully formed. (Not yet, at least.) First, a 3-D file is needed. People can design one in a special computer program or use a file someone else has already generously created and uploaded to the internet for others to share.

Using the coordinates supplied in that file, a 3-D printer then melts and extrudes hot plastic to build the desired parts, layer by layer. The finished pieces can be assembled into a limb, sometimes using basic nuts and bolts from the hardware store.

On average, e-NABLE hands and devices cost around $15 in plastic and about $50 in materials. In some other countries, where needed materials are harder to source, the price can rise as much as $300.

That’s still far less than a traditional prosthetic. The cost of a single traditional artificial hand can run as high as $20,000.

Most insurance companies cap the annual limit they’ll pay for these devices, leaving many people scrambling to cover the cost. It can add up quickly for children. Because they’re still growing, they’ll likely need a new prosthetic every 2 years until they turn 18.

“There’s been an increase in the number of children born with congenital upper-limb deficiencies or acquired traumatic amputations during the past two decades,” said Jorge M. Zuniga, PhD, a professor of biomechanics who studies 3D printed prosthetics, orthotic, and assistive devices at the University of Nebraska at Omaha.

In the United States alone, more than 32,500 children go through a major pediatric amputation and about 1,500 children are born with upper-limb reductions each year. Because of that, “there’s a critical need for practical, easy-to-replace, customized, aesthetically appealing, low-cost prosthetic devices for children,” Zuniga said.

How e-NABLE became a reality

Collaboration is the reason for e-NABLE’s success, and it’s been a part of the organization’s foundation from the beginning.

Jen Owen is the founder of Enablingthefuture.org, an informational hub that shares information developed by the global e-NABLE community. But back in 2012, Jen (who’s also an artist) said she and her husband at the time, Ivan Owen (a puppet and prop maker), were “two nerds who spent our days letting our imaginations take us to find new adventures.”

They dressed up in cosplay costumes, ran around in superhero outfits, and made “weird” inventions with their kids. On an outing to a steampunk convention, Ivan created a giant metal puppet hand as part of his costume. It garnered rave reviews at the event, so once the couple returned to their home near Seattle, Ivan posted a short video on YouTube.

A carpenter in South Africa who’d lost the fingers on his dominant hand in a woodworking accident saw the video and contacted Ivan.

“Richard was unable to find any replacement prosthetic fingers for himself that didn't cost at least $10,000,” Jen recalled.

He asked Ivan to collaborate on a design for one finger.

The two spent almost a year working via Skype and email to come up with various prototypes. Jen started blogging about their collaboration, which led to a request from a mother in South Africa: Could they also build a hand for her 5-year-old son, Liam, who was born without fingers?

Ivan took the design for his steampunk hand and made four tiny metal fingers. Then, he flew to South Africa so he and Richard could make the little boy a hand. When it took them all day to assemble — and after they realized Liam would quickly outgrow it — Ivan began researching 3-D printing.

That way, a design could be scaled up as Liam grew, not to mention printed out in a matter of hours.

Instead of patenting that design, Ivan put it into the public domain so others could use it and build on the design.

When a video of Liam and Richard’s “Robohand” hit the Internet, “the response was quite positive,” Ivan said. “Many people responded by asking how they could get involved and assist.”

Schull knew. After watching the video and reading the comments, he left his own comment. In it, he invited others who owned 3-D printers or who needed prosthetics to put pins in a map so they could find one another and suggested forming a Google + community.

Within the year, e-NABLE had 3,000 members.

“I watched this grow from a silly art project created in my garage to a global movement of makers who are making a difference in the lives of thousands of people all over the world,” said Jen.

What a 3-D printed limb can and can’t do (yet)

A hand or lower arm fresh off a 3-D printer can be a good option for people who don’t have access to medical care. e-NABLE’s designs can also give medical professionals a jumping-off point if they need to customize a special prosthetic for patients who may not have other options.

But “with the present state of the technology, the functions of these hands are still limited and they don’t match the strength and durability of injection molded parts,” said Ivan. “These are not life-changing devices. They’re tools which have been made available for people to try out and see if they’re a good fit for use in their lives.”

Zuniga, who was a founding member of e-NABLE, agrees that “transitional” prosthetics play an important role.

“If a child isn’t using prosthetics and doesn’t want one, that’s fine,” says Zuniga. “But if they have interest and do want one, e-NABLE will fill that gap.”

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What the future holds

e-NABLE has begun to not only offer free solutions for partial hand amputations, but also for transradial and upper arms. Work is under way on lower-limb devices and Schull hopes to expand the group’s scope to other volunteer-makeable 3D printed assistive technologies, like tactile graphics for people with visual differences.

Schull also recently established Enable Limited, a nonprofit that creates infrastructure for the global e-NABLE community and supports a local program in Rochester that provides training in 3-D printing and prosthetic-making to inner-city high school students.

In the meantime, e-NABLE continues to excel at building not just hands but long-lasting connections. Nearly six years later, Ivan continues to make hands for Liam as the South African boy needs them.

Aidan’s father now owns his own 3-D printer and has created dozens of hands and arms for others. A field service technician for IBM, Delisle envisions a new career for himself in 3-D printing.

Aidan, who will turn 9 this summer, doesn’t wear his Jango Fett hand so much anymore, but Delisle still sees that as a positive.

“I think it’s because he’s finally comfortable with who he is,” Delisle says. “It also helps to see all the pictures of the recipients that we help out. Aidan just knows now that he isn’t alone.”