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The Prosthetics and Orthotics Podcast
The Prosthetics and Orthotics Podcast is a deep dive into what 3D printing and Additive Manufacturing mean for prosthetics and orthotics. We’re Brent and Joris both passionate about 3D printing and Additive Manufacturing. We’re on a journey together to explore the digitization of prostheses and orthoses together. Join us! Have a question, suggestion or guest for us? Reach out. Or have a listen to the podcast here. The Prosthetic and Orthotic field is experiencing a revolution where manufacturing is being digitized. 3D scanning, CAD software, machine learning, automation software, apps, the internet, new materials and Additive Manufacturing are all impactful in and of themselves. These developments are now, in concert, collectively reshaping orthotics and prosthetics right now. We want to be on the cutting edge of these developments and understand them as they happen. We’ve decided to do a podcast to learn, understand and explore the revolution in prosthetics and orthotics.
The Prosthetics and Orthotics Podcast
Engineering Hope: Lasting Global Solutions with Bill Wright
Bill Wright shares his global healthcare and engineering journey spanning 36 countries over 50 years. His uniques experiences reveal how important it is to create lasting impact through sustainable solutions with good engineering.
•On one of his jourey's Bill was introduced to prosthetics in Bangladesh where he encountered the Jaipur foot made from sandals and rubber tire parts
• The design uniquely suited patients who walked barefoot and needed to squat for daily activities
• Working across 36 countries required addressing universal needs: water, wastewater management, electricity, and material supply chains
• Haiti stands among the most challenging locations due to extreme poverty and lack of infrastructure
• Solar power has revolutionized healthcare delivery, from small charging panels to systems powering entire hospitals
• 3D printing offers potential for on-site manufacturing but requires finding and retaining technically skilled personnel
• Success can be measured in individual lives changed – like Jose Manuel who now drives and studies law despite missing all four limbs
• Sustainable development requires training locals rather than relying on expatriate presence
• The most effective organizations focus on teaching
Special thanks to Advanced 3D for making this episode possible.
Welcome to Season 11 of the Prosthetics and Orthotics Podcast. This is where we chat with experts in the field, patients who use these devices, physical therapists and the vendors who make it all happen. Our goal is to share stories, tips and insights that ultimately help our patients get the best possible outcomes. Tune in and join the conversation. We are thrilled you're here and hope it is the highlight of your day.
Speaker 2:Hello everyone, my name is Joris Peebles and this is another episode of the Prosthetics and Orthotics Podcast with Brent Wright. How are you doing, brent?
Speaker 1:Hey, Joris, I'm doing well. Obviously, you're not at ABUG and I'm not at ABUG.
Speaker 2:I know I feel bad. I feel really bad. I have colleagues there, so that's good but I feel really bad.
Speaker 1:I have colleagues there, so that's good, but I feel really bad missing it. Yeah Now, when was the last time you've?
Speaker 2:been. I don't remember, I don't know, maybe never.
Speaker 1:I don't know A long time ago, it's been a while. So Katie Richmond, my colleague from Advanced 3D, is there. She's actually presenting there with Chris Baschuk from Point Designs about some 3D printing stuff.
Speaker 2:So from point designs, about some 3d printing stuff, so that's awesome, it's, it's really neat. So who should go to amog? That's the question, right? I mean, I think if you're in new to printing, I don't think you should actually, because it'll be maybe not worthwhile and maybe a little bit you need to be into it. You know, I wouldn't do it if you're new, or I wouldn't do it if you're just getting into it.
Speaker 2:But if you're gonna like, for example, if you're buying industrial machine and you're buying more industrial machines, definitely go.
Speaker 2:You know, if you want to know which of the whatever DED machine or which LPBF machine is right for you, this is the place where you can find a guy or girl and talk about, like you know, the nitty gritty of why something works and why it doesn't, or something like that.
Speaker 2:If you're shopping for a post-processing unit, this is where I would go to kind of like, get into the technical stuff, and also I think you can learn a ton as well from these workshops and all the stuff they do is really really great. So not for newbies, I think, not for people who are, you know, more for the guy operating the machine than the business person or the marketeer or something like that. And yeah, events, some, some people, as different than all the 3d printing events like this is an event that's kind of an annual pilgrimage for people that have been doing this for 10 years or something and they would just keep going with the same crowd and they keep kind of interacting and it's it's a big part of their lives, so, or or quite a part of their lives, let's say so. So really exciting event for the right people, I think.
Speaker 1:Yeah, a hundred percent agree. And and you know what's funny is, I talked to the companies and all that stuff and this is not a show that you send your salespeople to.
Speaker 1:I totally agree, because the salespeople and all that stuff very quickly and if you can't answer the questions you actually may lose a sale. So that is very interesting. I guess you would say in that. So I had a company say yeah, this is when we say, bring out the nerds, we're sending the nerds. It's not the typical people that would go to say a rapid or something like that. So I think it's great and I noticed that when I looked at the program they had some programming actually for prosthetics. They had three or four things and, believe it or not, I think they also had the ability to get some continuing education credits for prosthetists that go there. Having that kind of go mainstream is kind of quote-unquote mainstream. Very, very neat. Chris Batchuk actually won the technical competition last year at AMUG, so he's speaking on the main stage about his project from last year, which is really cool.
Speaker 1:So, yeah, really really neat stuff.
Speaker 2:Yeah, so who is our guest today?
Speaker 1:So today we have a special guest, and you kind of already guessed a little bit. We have Bill Wright. Related to me, he is my dad, and what I wanted to have him on is just share, you know, not only a little bit of his journey and some of the why of what he does, but then also I just thought it would be interesting to hear a little bit more about some of his adventures along the way too, and so when we talk about a bunch of things, I'll probably even learn some new things today, so I'm really excited about that.
Speaker 2:Okay, that's super cool. So welcome Bill Wright to the podcast.
Speaker 3:Thank you very much.
Speaker 2:So, first off, how did you get involved with OMP yourself?
Speaker 3:It started in Bangladesh and I'm trying to remember the gentleman's name that was the prosthetist there, but he introduced me to the Jaipur foot.
Speaker 3:I was involved in installing medical equipment but I was fascinated by the Jaipur foot because it was locally produced. They took sandals and rubber tire parts formed into the mold of the Jaipur foot, stuck it in a steam sterilizer at 250 degrees for about 45 minutes to an hour and it melted the rubber and out came a foot. And he was able to adapt that because the patients that he was dealing with did not wear shoes, so this foot had to be adaptable to a very harsh environment of walking barefoot. And so I took pictures and I was just really fascinated because one of our missionary supporters friends of ours, tony Platner, was a prosthetist and I thought that he would be very interested and in fact Tony and his wife Barbara ended up going back with me to Bangladesh. They worked with this gentleman while I did other things. So that's how we got started and I think Brent took a particular interest in that. Is that right, brent?
Speaker 1:Yeah, that's right, and so, yeah, from there I would actually in high school I volunteered or no, he actually paid me. So that was cool, to do everything in that clinic. So I would not only mow the grass and pull weeds, but then I'd pour down, cast, do, sewing, leather metal and then I would just kind of progress every summer with them. So it was a.
Speaker 2:it was a great contact for sure I love the idea of this foot, by the way, of just it being present. It's, like you know, produced on locally, developed locally, but also just good for a very particular set of circumstances, like barefoot people. It's just the reality and that's the the preferred way of walking for certain people and that's all they have to. I love that. It was just like completely locally developed to suit the local conditions.
Speaker 3:Yeah, and I'm not real sure, the Jaipur foot. I believe he had to buy the molds. I think he had three or four different sizes, obviously depending on the patient, but I believe that they had to buy the molds from an organization in India. I believe Is that right, brent? That that was developed in India? I believe so, but he sort of perfected it and was able to figure out how the materials interacted with each other in order to make this foot. Now, one thing that Brent did mention, and he can comment on this, is that I'm not sure that I brought one home or you did some research on it and got a sample or whatever, but you mentioned, brent, that it did not bend and act like a foot. It wasn't anatomically whatever.
Speaker 1:Yeah, I mean. So one of the neat things about the Jaipur foot is that it is very low cost to make, and using locally available materials tires that sort of thing. One of the things that's different, though, is that a lot of the movement comes from the ankle rather than the actual foot itself, and that's because a lot of people in that region of the world like to actually relax in a full squatted position, and that's also how they go to the bathroom. You know, usually there's like a hole in the floor and that sort of thing. You know, usually there's like a hole in the floor and that sort of thing, and so traditionally, like Western feet wouldn't work, because you can't get into that sort of squatting position, and so I think that's where the Jaipur foot actually fits a very, very interesting need and I love the fact that it's made in a local factory. Do you remember how they actually made the prostheses From?
Speaker 3:the foot to the socket. I believe it was actually wood. I don't think that he had components such as pylons and so forth. Don't think that he had components such as pylons and so forth. The same thing happened, brent, at Kajabi Hospital in Kenya. They used the Jaipur foot and the connection was by carved wood. So that's how they got from the foot to the socket was a piece of wood.
Speaker 2:Okay, that's good. And do you think, like, given your experience now, do you think we should get more things to be designed in the countries where they're supposed to be used? Do you think that that because now it's kind of more like we'll make something here, because we're more technologically advanced or something, but maybe not the right solution for them and maybe they can come up with a better solution locally?
Speaker 3:I'm not sure on that one. Most of the mission hospitals are fairly advanced now but the world of prosthetics in the developing world I don't think is all that developed and you know, locally available materials aren't as, probably as strong and require more maintenance. But if they have a local person maybe they can make that work. I'm not sure on that one. I think that they need to develop also for ease of assembly and ease of maintenance of the devices.
Speaker 1:Yeah, I was just going to say so.
Speaker 1:I think doing stuff locally is kind of the way of the future.
Speaker 1:You know, we have all this stuff, especially like just in the environment around the world, where the more stuff that you can do locally, the better off you're going to be. And I really think that's where 3D printing is going to be able to be harnessed and some of these outlier mission hospitals and other out there hospitals is that with clean energy and a relatively basic 3D printer, you are going to be able to make a lot of your stuff in-house. And I think that's the exciting time that we live in, where the materials are pretty much there for these devices to last a very long time, and so I'm excited that there may be an option where you have you're injecting, molding this rubber recycled foot and then you're also using a 3d printed socket that attaches to the foot, and so it's. It's a mishmash of stuff, but it's also all locally sourced, where you know you don't have to deal with customs and hand carrying stuff in and and that sort of thing. It really creates access at a grassroots level.
Speaker 3:I think one of the things that would be necessary to make that happen is someone who is a prosthetist but very creative, creative in the use of local materials, creative in the way of adapting to that and being able to work around what's available. And that takes a special person. That is, that's not your run of the mill person that walks over and, you know, picks out a nut and a bolt and a screw out of a basket and they pick out this from you know the shelf and go with it. It takes a very special person to be able to see and do that sort of thing.
Speaker 2:Yeah, I totally agree and also to work with, like whatever's not available or intermittent power or all sorts of problems that might occur. And you've worked in these mission hospitals and like lots of different types of countries and different countries, right, so each of these countries is, of course, also vastly different.
Speaker 3:That is true. That is true. I've worked in actually 36 different countries and each of the places are unique in a sense, but the basics are all there you have to have water, you have to have wastewater, you have to have a source of electricity and also you need a source for materials and parts, and how that's done in each country can be quite unique, but those are the basics that you need to run a hospital.
Speaker 2:And then was there one place that was like the worst, or significantly worse. Was there a place where you're like, oh, I really should not be here right now?
Speaker 3:There's been a number of places like that. Some of it was political and of et cetera, and other is just poverty and the lack of resources, and I think Haiti and I haven't been back in probably 15 years I think Haiti and I haven't been back in probably 15 years was one of the most dire places on earth, that I visited four different hospitals there over a period of time and it was probably one of the most dire places on earth to work. It is just very, very bad.
Speaker 2:Yeah, I've heard of people there, people there too, because also like there's like water, infrastructure, government safety, I think I think it was.
Speaker 3:Everything was at a a very, very basic level there, right yeah, that is correct and, um, you know I'm not going to get into the political climate that exists today, but as the united states and Europe and Canada pull back from aid overseas from Australia, from United States and they bought and built hydroelectric power plants and power plants and transmission lines and the whole continent just rose. It really did. It rose to the occasion to have this new electrical source and then, around 2008 to 2010, you know, united States went through some pretty tough times financially, some of the aid dropped off. Europe went through the same issue and that's about the time where these systems needed maintenance and fixing, which didn't happen.
Speaker 3:So now, in the mid-2015, the structures were starting to deteriorate for lack of parts and things were going downhill. And now it's, and things were going downhill. And now it's particularly difficult because I just read an article that it appears now that the health care in many of these countries that was on the backs of aid from United States, canada, europe, etc. Is evaporating, and so it's going to be tough. It's going to be really tough on that continent. I think it does.
Speaker 1:I think that is an interesting point, though, and I mean I know you've been to a lot of places where you've seen things done well as well. Can you share some of that?
Speaker 3:Well, yeah, and Kujip Hospital in Papua New Guinea is a good example. The AusAid people gave a lot of money to build the facility and it was done correctly. It was done by Aussies and it was also done by people from Europe and some from the United States. We installed a hydroelectric power plant there. They built new operating rooms, we installed very nice surgical suites and the doctors there trained the nationals to do these procedures and it was done very well. But Papua New Guinea again is very dependent upon Australia for aid and times are difficult there.
Speaker 2:And is there any way to like everybody's always talking about, like give a man to you know fish, or teach a man to fish, you know? Are there good examples of that as well? Because that's always the idea. It's like no, but if we could just get it self-sustaining, is that? Is that something you've really seen happening, or is that kind of still a myth, kind of that that we that it's really easy to implement, or that it's even possible to implement stuff like that, where you can get them to level up independently of our financial troubles or our willingness to help out or not?
Speaker 3:In some locations. Yes, what I'm finding is that, depending on the non-governmental organization, is their philosophy of expats at the location. Some of the hospitals are pretty much run and doctored and cared for and nursed with expat staff. I'm working with a new small hospital in Togo, west Africa, and their philosophy is yours. Just as you said, it's going to be run by nationals, it's going to be maintained by nationals, by nationals, and so that if the expats can't be there, it will continue on in the work. And they're doing it. It's a very slow process. It's not like you could come in, build a hospital, hang the lights, put the shingle out in front and start seeing patients. If you do it this way, it takes years to train personnel in finance, administration, doctoring procedures. But they're doing it. They're doing this and I'm very pleased to help them out.
Speaker 2:That sounds like a really great project. And also, I've always wondered about this. I mean, if you're looking at because you mentioned Papua New Guinea, that's a very, very difficult place to operate as well, especially inland and stuff like this. That was actually a friend of mine's vote for one of the most difficult places he's ever been. It's nice to see that in your context. That's like no, that's a great success story. So it all depends, but it would be easier to do the same thing in Botswana, for example. Right, botswana has trained nurses, probably maybe even some doctors. Your aid would even go further, maybe, but the other place is much more deprived. Or, if you talk about a place like Congo, much more difficult to operate, but it's much more deprived. So what's your criteria? Should you just help wherever we can, or should we help where the dollar stretches the most or the live stretches the most? What are the criteria for really helping out or the lives stretched the most? What?
Speaker 3:are the criteria for really helping out. Right now, the statistics are that health care on the continent of Africa and of course this could apply to Haiti and some of the others 80% of health care is handled by nongovernmental organizations, and it's not just faith-based groups, it's Doctors Without Borders and others. It depends on where you can get a visa. It depends on where you can get permission to operate. I do know that this little small hospital in Togo went through two years of getting registered in country to actually practice and then they went from a dispensary to a clinic to now a hospital, and this has taken almost five years of paperwork to get to that point. So it depends.
Speaker 3:It's very unique per country. Where it's most needed is all over. The need is infinite. It's just very yeah, it's just infinite. So to try to say where you can best use it is where you can get access. For a while we couldn't get into Angola. A visa would take six months and travel within Angola was very difficult. But now the visa is available online and they're sort of welcoming Western input there, and so times are changing a little bit there. So those are some of the things you get to look at. Uh is governmental permission, logistics of getting there, logistics of importing and Brent knows all about importing things into Guatemala Uh, sometimes it's not terribly straightforward.
Speaker 2:And what if I want to get involved, like as a volunteer, maybe for, uh, you know, for a couple months or a season or something I can imagine? There's a lot of organizations out there. Some of them are more effective than others. How do I know what a good organization is, or how do I judge that they're being effective, that I should really help them, because that's always been my problem.
Speaker 3:I think that you have to decide what you're going there for. Are you going there as a prosthetist? Are you going there as simply a helper, teacher? And I can say this for my daughter and son-in-law who are now in El Salvador. He went to El Salvador. He's Salvadorian, but he kind of has found a niche in teaching. So he did not go there to practice actually administering anesthesia, but to teaching others. So I think you have to pick what you want to do, whether it's a hands-on, is it teaching? Is it going there as a helper for somebody else? As a helper for somebody else, finding the organization, you have to find one that has that ability. If you went to Kajabi in Kenya I'm not sure that they have prosthetics as an emphasis and you would be frustrated there, whereas if you went to the hospital in Bangladesh there, whereas if you went to the hospital in Bangladesh, which is part of what they do, it makes it a little bit easier because that's their emphasis and so forth.
Speaker 1:So you have to do your research and I would also say and you alluded to this a little bit is, with the advent of the internet, there's a lot that you can do for some of these organizations from your house. You don't have to go on site. I mean, some people need help with social media website design. Maybe they need some sort of consulting or help with writing a grant or just some organizational type of stuff that you can literally do working into your current life and people would be thrilled to have you help with some of those things. And I think that's the other part that I'm super excited about this aspect of prosthetics in the developing world. Prosthetics in the developing world, you have the opportunity also to, as a prosthetist, say, let's say, in the US or in Europe and you're a digital prosthetist, you can actually modify these sockets from the comfort of your own home or your office and email them back to somebody to 3D print on site. So I think that's one thing that's neat.
Speaker 1:I think the other thing that's changing and that I really love that's changing about some of these organizations is you know, there used to be this like a team that would go do construction or hey, we're going to go paint a building or whatever, and I think some of that is kind of going to the wayside, because the reality is that you can find local labor to build.
Speaker 1:You can find local labor and they'll probably even paint better than the team that would come down. And now there's always specialized things like, say, some sort of roofing structure or even some of the commercial side of things that is important. But I think those days of the feel-good or the humanitarian tourism, I think those days are kind of gone and now you can actually specialize in what you're good at doing, whether it's from home or you do something on site. So I would agree on finding somebody that is well-known in their community, that is focused on allowing local people in leadership and locals. Because what happened during COVID was amazing. I mean, it literally shut down travel for everybody, and the hospitals that succeeded through that time were hospitals that had taken the time to actually have the local people in country trained to treat their own people, and I thought that was really an amazing thing, even though it was a terrible time, but it really exposed what we needed to do as far as helping in the care of others, and how can we scale without being there?
Speaker 3:I do know that the teaching aspect is pretty much kind of a hands-on. I do know there's a group called ECHO down in Arizona that does video state video platform for doctors and so forth in the medical field to learn new techniques and so forth. But I do know that there's another group, the Pan-African Christian Surgeons Organization, that actually go to the hospital and teach procedures and it's a long process for these nationals to learn these procedures but sometimes hands-on is the only way you could do it.
Speaker 2:Yeah, totally, and it seems also like 36 countries across a number of decades. It seems like maybe a couple of times it was very, very dangerous for you as well.
Speaker 3:Yeah, that's kind of an understatement. I have been scared a few times, that's for sure, and only the Lord and God intervened. Specifically, I was visiting a small hospital in the the eastern end of Afghanistan called Tank T-A-N-K Tank, but we called it Tank and we had to travel out of Peshawar, pakistan, across this wasteland in Afghanistan and we came to a bridge. I hope this isn't wrong to say that. We came to a bridge and I looked over and there was this big factory sitting right off of the interstate which there was nobody around, I mean, all it was. It looked like moon rock. So I asked our driver, I said what's the factory? And he looked at me and kind of hesitated. He said, well, that's where they make AK-47s. And I said can we get a factory tour? And he did not respond to that comment. Yeah, that was a time that the hospital was actually between two groups that were throwing explosive devices at each other over the compound. And yeah, it was. That was a very difficult location.
Speaker 2:Wow, and has it been another time as well? Because, like also maybe I think you know you hear a lot of times, when it gets really dicey, things like ferries. Ferries are bad, crossing rivers, stuff like that is also like without armed groups, that kind of stuff is also kind of of like very dangerous as well.
Speaker 3:Right, yeah, it is Well. One thing I have found out and I've heard this from other NGO groups is always go with nationals who know where to go and what to do. Where to go and what to do. I traveled to Kenya for years, actually, starting in 1986, traveled there quite a number of times. Brent spent some time there too, and as I used to drive into Nairobi and I would have a briefcase full of shillings, which was the national currency, and I would walk all over in the morning and buy things in the industrial park, going right in front of the prison and everything else, I would walk all over the place and nobody paid any attention to me. One of the last times I was there, the gentleman that picked me up at the airport it's late when you get there. It's like 10 o'clock at night and by the time you get through customs and all that sort of stuff, he said get in the back seat, put your head down and don't look up until we're at the guest house and I thought oh, dear, times have changed.
Speaker 1:Well, I think one of the other great things, though, is with technology. Now, I mean, it's good and bad, but you know, there were times, and and yours you might get a kick out of this Like when we lived in Ecuador, our only contact was through my dad's ham radio, so like there was no phoning the grandparents, there was no internet. In fact, my grand I think it was my grandfather, dad, you might have to correct my grandfather passed away, and we didn't find out for like eight weeks, and so my dad missed that funeral.
Speaker 1:Just because there was no way to find out like you can't just call yeah and so now with things with email and, you know, text and facetime and all this stuff, the world has definitely become flatter as far as being able to um, get around, like even in guatemala, I mean ways, has the jungle roads on it as well, so you can, you know it'd be really hard to get lost.
Speaker 1:So I think that's an interesting thing. But in the same way, like in Guatemala, in the city, when we are there and this was, I think it's a little better now, but there were they only allow one person to drive a motorcycle. You're not allowed to have a passenger, because what was happening is that the passengers a lot of times were some sort of nefarious people and they would use these things they call Bluetooth sniffers. So if you had the Bluetooth on, they could actually come straight to your car and say give me your phone and you would hand your phone over and then they'd throw it over and call your contacts and try to get like ransom money, essentially like faking stuff. So in that sense, the technology is, is, is is not a good thing, but um, it's. It's pretty great to be able to keep up with dad as he's away and you know, and sharing the pictures and and wins along the way as well.
Speaker 3:I can remember one time, brent, if I could throw this in, we were. We came into Kabul, afghanistan, right after Karzai took over, as a group of engineers to look at, you know what could possibly be rebuilt or not? And I had a Tharia phone, which was a satellite phone, and I had rigged up an extension cord for the antenna and I had an antenna that had a magnetic base. So I would go out in the evening and take this magnetic thing, put it on top of the swing set of the guest house and that's how I communicated uh back to usa and uh, that was probably. Uh, that was a little dicey, to say the least.
Speaker 2:I think it's interesting all these places. I think one other thing is because I was in Kenya as well when you were there first as well, but I was a little kid there. My parents lived there and I went with them and my sister as well, and so I was in the same period. I was like eight years old and running around there and I was allowed to bike to a friend's house and stuff like this, like in Kenya, and we lived in Nairobi and I was just biking to a friend's house and going places, stuff like that, and I couldn't even like. I talked to Kenyans years later and they were just like full of disbelief that I was just this little kid biking for one time like 10, 15 minutes to another person's house, and they tried uh like they kind of can scarcely believe it.
Speaker 2:But one thing that I remember from back then is I went to Kibera and other places like it, which kind of uh, uh I think we can call it differently, but I think we should call it a slum because it's. It's not fun to live there, um, and there's no infrastructure, essentially, but just the amount of activity that was going on there and the amount of entrepreneurship and the amount of people just doing all sorts of stuff to make a living and make their own kind of world, you know, from power to you know little restaurants and little shoe shops and bike shops, all sorts of stuff. That amount of just that gumption, if you will, and that inventiveness and that energy. I still remember that, even though I was really, really tiny I was only eight years old at the time and so I still remember that. That just really fills me with hope, that idea of these guys just making do and being super creative and inventive with the circumstances.
Speaker 3:Well, this is where solar power has really taken over all the way from just like a single small panel charging a little battery to much larger systems for an entire hospital. Solar has definitely taken over and given the hospital the possibility of some clean power away from the utility source. Even in that very place that you talked about, you see these little solar panels all over the place where you can charge your phone and possibly run a sewing machine, you know, et cetera. And again, it's the creativity based on need.
Speaker 2:Yeah, totally, totally. You know, because one thing I've always thought about is like building on a solar panel thing. Is this idea of like a containerized kind of solution where you get all the power and some of the water needs just in a container you bring it there. That's kind of like the core of your hospital. You know it has like the storage in it, the solar panel. Do you believe in approaches like that where you can really literally have a container that you know in most cases will be like the kind of the technical core of your hospital or the kind of for water and power at the same?
Speaker 3:There are groups that do that. They actually build operating rooms in a container and drop them in, but, yes, for energy supply that is possible. What has happened, though, is interesting, is some of the manufacturers of the inverters because it's all 50 hertz in Africa and some of these other spots. You can't even buy the equipment in the container in US and ship it somewhere, because some of the materials or some of the inverters and devices are not available in the United States. There's no market for a 50 hertz solar inverter in the United States, and so that's the way I used to do. It actually is. I used to buy everything through SMA America, and the equipment would come from Germany. We'd put it in a container and ship it over, et cetera, but that was all shut down because I was not a very big customer, let's put it that way. But yes, that is an approach. One thing about solar energy you need a lot of space, so you can't have enough solar panels on a single container to make it worthwhile.
Speaker 2:you, you pretty much have to build a field, uh, of solar panels in order to make it worthwhile yeah, and then how do you believe about like this kind of like, because we've always talked about this for 3d printers and stuff, because there's people that you don't want to make kind of ruggedized, special 3d printers oh, we need to adapt it.
Speaker 2:And there's other people just like, well, you know the commoditized printers, we just use the bamboo or the creality and make do in that environment. How do you, you know, when introducing technology like that, I mean, typically, if you make like this rugged stuff, it might last longer but it'll probably be a lot more expensive. But if we look at the, you know, mobile phones, nobody made mobile phones for africa until africans started getting some you know, millions of them started uh, uh, becoming subscribers and becoming uh, pay-as-you-go customers and then all of a sudden it was a market and that technology you know, no, that wasn't charity, that was like a business, people trying to make money off it. Now I think mobile phone penetration across the continent's like 50 or something like that, um, and it's one of the you know, the only ones with growth. So there's a lot of interest there by companies. You know, what is your belief about technology? Should we make like specific stuff? Should we piggyback? Does it matter?
Speaker 3:on the case, Wow, that's an interesting one. None of these devices are actually made. They're all imported, obviously, and you have to have support for them. So there's a certain level of education. You have to have support for them. So there's a certain level of education. There's a certain level of the technology of the software and everything else. So 3D printing is not for the faint of heart. Brent sort of got me started and I've made a few things and tried to learn AutoCAD, fusion and so forth, and it takes a very, very bright national to be able to do that. And they do exist, but you have to find that person that has that capacity.
Speaker 1:And I would also argue, though you find somebody that has that capacity and they may help you for a little bit, but a lot of times, especially in some of the places where we're at in Guatemala, where you go, and some of the other places the jobs are not going to be great out there now have a massive asset that can be leveraged to go to the capital or to another country. Or maybe you're so good at one specific thing that you get some sort of visa where you go to Canada or the US or somewhere in Europe where they're going to use your talents that way Europe where they're going to use your talents that way.
Speaker 2:So, trying to keep that skilled labor in country is also a very difficult thing to do. And if you, I think, and then so you've been all over the world, there is this country, but you've also, like, we've returned to Guatemala, like a lot, right, you've been there, you've lived there a long time, is that an advantage as well, because you know you have seen that place fundamentally changed very, very much over the decades, right?
Speaker 3:Yeah, I think I'm going to refer that to Brent, because I haven't been back to Guatemala as much as he has been, you know, twice a year since then. But yes, fundamentally the country is quite different.
Speaker 1:Yeah, I mean. And the infrastructure. There's a lot of money pouring in from other countries too, and so the infrastructure is greater in not only Guatemala but other countries, because other countries Japan's actually very good at it Even some of the European countries sometimes Israel is involved as well where they'll come in and they'll build roads and connect two areas. So, for instance, there's a road that runs from Guatemala City to the northern part of Guatemala. It's a very nice paved road now that wasn't available before, and so you have this ability to be mobile more around the country, and that can be good and bad. It makes healthcare more accessible.
Speaker 1:So if there's something that's in the jungle of, something happens in the jungle of Guatemala, you can pretty reasonably get down to Guatemala City, where they have very good care. So I think that's some really interesting thing. But in the same things, like it's a little bit sad for me to see, is you also see some of the culture of countries, the things that make them special and them very unique, disappear and adopting more of a Western you know, mcdonald's, burger King and that sort of thing, which to me is sad and causes its own health issues as well, especially when we're talking about, you know Western food.
Speaker 2:I would say and the other thing is like, I think maybe even a question for the both of you. I think you know, if you look at the place like that I mean Guatemala you chose, I think, a lucky place. It has been quite stable for the past decades. You know you would have had a rougher ride in neighboring El Salvador, where your family is also at, like two of the countries I lived in when I was a kid. One is Argentina, which has gone terribly downhill and gotten a lot worse, and the other one, kenya, which also got a lot worse.
Speaker 2:I mean, in those kinds of circumstances like, how do you define success? Is it just about you, you know, setting out to do something and completing it, or doing the best you can? Or you know how do you do that? Because there are so many things that are outside your control, so many things that are just up to happenstance or a bad rainy season, or you know some political changes. How do you define success? I mean it's because you could devote a lifetime to this and you know, objectively, find it very difficult to deal with the consequences because they're totally out of your control. So how would you guys define success?
Speaker 3:Well, I'll give you an example. In Zambia I worked with a group called the International Vision Volunteers and they have a clinic there that does cataracts and all sort of eye surgeries for the indigenous population. And I was with a group and we put in a large solar system so that the hospital could run independent of the utility which was always dropping off and coming on and dropping off. How I envisioned success was this lady finished her eye surgery and she could see again. It made it all worth it. Just that one thing was a success.
Speaker 1:That she did the surgery. They did the surgery, it was successful, the equipment worked and she could see again. I would say that too is that success is. You know, you want to have an impact that lasts forever, but in the same sense, having an impact on one person is a success as well. So, when I look back at, one of the things that is so special to me is dad was on the first clinic when we went to Guatemala together and we saw a little kiddo named Jose Manuel, who was three years old, and that was in 2006.
Speaker 1:And now he's almost 23 years old and he is driving a car. He's missing both arms and both legs. He's driving a car, driving a motorcycle, he's going to school to be a lawyer. He'll be a lawyer for probably his little community and he'll be able to provide for his family.
Speaker 1:And that is, if we only went for that one thing and even though we've touched more patients than that in the last 20 years, that would make it all worth it, because that one, you know, one life changed also has made a change not only for his family, but it will also make a change for his community. But in the same way, you know he's dad's been doing this a long, long time and I think it's important, like he's invested a lot of time into training some people to do medical gas, which is very difficult to get in a lot of different countries and so having unlimited medical gas at a hospital is very important. So, in the same way, dad's been giving and teaching for other people to get the same access. So it will be there in the future. So I definitely see the teaching aspect and leaving a legacy also very important.
Speaker 3:Yeah, for sure.
Speaker 2:And one of the things that we've been exploring a lot in additive or 3D printing is that you know, this idea of having, like this unlimited library of things, so not only process, the prosthetics, but also like clips, clips for solar panels, filtration holders, all this kind of stuff, and there's a library of things printed out and, and you know, if we would try to get that in a lot of countries like the places you've been talking about, like zambia, guatemala, these places that are vastly different to their access to technology and the amount of schooling people have, and stuff like this, how would you advise, how could someone do something like that to really make you know, let anyone have access to more technology than they have had so far?
Speaker 3:I think it has to be a personal touch, touch and I know Brent has a lot of desire to learn.
Speaker 1:And so I think he's fostering that relationship.
Speaker 3:That's exactly where that's going. He is going, it's going to take off for him, and so it's. It's the personal touch.
Speaker 2:Okay, totally. Thank you so much, bill, and thank you so much, brent for your time and thank you for all the wonderful things you both do. So thank you for being on the podcast today.
Speaker 1:Thank you, and this was fun. This was fun, for sure, hearing some of those stories Dad, I don't know that I've heard all of those, so that was interesting too.
Speaker 2:So thanks yours, and thank you for listening to another episode of the prosthetics and orthotics podcast. Have a great day, hang in there.
