Autofabricantes, empowering children with disabilities through accessible solutions

Autofabricantes is a collaborative research project that aims to generate alternative solutions available in open source to empower children with malformation. The organisation strives for a world where inclusion comes true.

In recent years, more and more innovative therapeutic approaches have focused on the patients’ ability to progress, not for returning to normal, but rather for reintegrating them in their project life. Adaptation and self-reliance are thus the keys of successful therapy. Yet so many areas within healthcare are still unidirectional and outdated such as the orthopedic industry.

Very little investment in research and development has been devoted to developing less intrusive and more useful forms of prosthetics for people with malformation. The very specific user needs are not taken into consideration. This problem gives way to a very standardised offer: the catalogue of orthopedic prosthesis of the Spanish public health system has not been updated since 2000. It is estimated that over 50% of traditional prostheses are left unused due to the difficulties experienced, not to mention the inadequacy of the system to respond to families’ needs. 

Protheses are also very expensive. In Spain, costs range from 2,000€ to 20,000€, while the public health system has limited resources to cover the demand of the 88,000 people that need prostheses.

The problems are particularly relevant to children who report feeling that they are merely beneficiaries of a medical solution, reinforcing the idea that they are different from others. Social exclusion and low self-esteem are thus exacerbated rather than resolved. 

These are all the reasons why Ashoka Fellow Fran Díaz created Autofabricantes. With his initiative, he reverses these problems by putting the patient at the centre of the creative process. 

Fran relies on a community of expert volunteers who work together to co-create accessible orthopedic solutions. He brings together volunteers who are engineers, designers, therapists, and physiotherapists. He also develops relationships with NGOs focused on functional diversity in children to determine projects and make calls to interested patients. 

The process then begins with a workshop. The co-creation team meets with families and children to understand their needs. Patients are thus at the heart of the conversation, which leads to practical, personalised, and scalable solutions. For many children, this is the first time they have considered their difference through the lens of autonomy, empowerment, and control of their own needs.

These workshops occur every 3 to 4 months and each one develops solutions to be presented to the families and to be tested on the children. There is regular follow-up with the children and their families to establish whether the solutions are still effective and whether the impact on the child’s emotional and physical wellbeing is positive.

Autofabricantes has already created more than 20 tested and approved prosthetics. Through 3D printing, the designs are inexpensive and, most importantly, accessible. They have all been posted online and downloaded more than 2,000 times worldwide. 

The project results demonstrate that children need less than a week to master their new prosthesis. Six months later, 100% of them continue to use it and 95% say they have higher self-esteem and feel more included.

Having measured the impact of his work, Fran is now working to obtain medical validation to register his products in the catalogue of orthopedic prosthesis. Therefore, he has launched a PhD programme that should prove the health and wellbeing benefits of his model. He has also developed a pilot project in collaboration with the Hospital of La Coruña. At the same time, Fran has convinced universities to get involved in the project by introducing their design students to his community. The Autofabricantes methodology is now being integrated into a design degree at the public University of Barcelona, with the aim of including patient-centred design as a module in all Product Design degrees. This should lead to a mindset change in the medium term. 

 Thanks to all these efforts, the main orthopedic companies are starting to reconsider their approach to design and update their process. Finally, the approach of Autofabricantes is to offer its methodology to specialised organisations already in the field so that they can take it up, implement it, and thus multiply the number of beneficiaries. Thus, Fran follows a clear research process in open source. It has resulted in a scale-up package that allows the project to be replicated with minimal instruction covering the following three key areas: the network of necessary partners and volunteers, the development of the listening process to understand patients’ underlying needs, and the design characteristics and used materials. Therefore, his methodology has already been replicated in three different regions of Spain and has been exported to Colombia, Italy, Brazil, Morocco, and Uruguay.