While traveling overseas, Roger Gonzalez kept seeing people he couldn’t put out of his head: amputees with little hope, often begging on street corners.
Where the need for prosthetic limbs was the greatest, in the developing world, why was the supply the smallest, he wondered? And where the need was the smallest, in wealthy countries, why was the supply the greatest?
Even the most simple limb system can cost $10,000. Rehabilitation is tens of thousands of dollars more, and the limbs eventually wear out. That leaves prosthetic limbs out of the reach of many.
And in developing countries, where roads are often dirt and ramps and sidewalks nonexistent, two feet are sometimes the only means of transportation. Losing a limb can mean losing your job and family.
The World Health Organization estimates that more than 25 million amputees in the developing world don’t have access to even basic mobility devices.
Gonzalez, an El Paso-native who now chairs the engineering leadership program at the University of Texas at El Paso, made solving the problem a student project. The goal was to “design a low-cost, polycentric knee that would be cost effective for the poorest of the poor,” Gonzalez says.
“We tried to reverse engineer one type of knee, a classic engineering problem, to take out 90 percent of the cost but keep 80 or 90 percent of the functionality,” he says.
More than a decade later, that student project is now an El Paso-based non-profit, which helped more than 1,000 amputees last year.
LIMBS International partners with clinics around the world to help people walk again. It has distributed its durable, cheap prosthetic limb system in more than 40 countries, including Mexico, and in Juárez.
Before going into academia, Gonzalez worked for General Electric where he helped design engine components and, later, worked in research and development for the company’s appliance division. He can describe in detail how the engines in a stealth bomber work and the proper way to load a dishwasher.
Gonzalez grew up in El Paso and graduated from Austin High School. He spent many weekends working on his car to keep it running and found he enjoyed the work. He also knew he wasn’t interested in English or the arts, so he chose engineering as his major.
An expert in biomechanics, Gonzalez graduated from UTEP in 1986 with a bachelor’s degree in mechanical engineering. He earned a master’s degree and a doctorate from the University of Texas at Austin.
Now Gonzalez chairs the Department of Engineering Education and Leadership at UTEP, where he is a tenured professor. He was named a finalist for the Global Humanitarian Engineer of the Year award in 2013.
In January, LIMBS expanded its executive team and brought on Bill Mitchell as president to help grow the organization. Mitchell has worked as the CEO of several corporations and is now a business coach.
Gonzalez and Mitchell sat down with El Paso Inc. and talked about what the non-profit is doing to help, why it’s hard to fundraise for a global cause in El Paso and a man named Peter.
For more information, visit www.LimbsInternational.org.
Q: What does losing a limb mean for people in developing countries?
Gonzalez: When you lose a limb it obviously impacts your mobility, but the impact is much bigger than that. Many in the developing world have to walk; they don’t have a car and some don’t even have a bicycle. And if you can’t be mobile, you can’t work. And if you can’t work, you can’t provide for your family. When you live in a place that doesn’t have a societal safety net, you have a tremendous impact on your family.
There’s also a very strong psychological component. You lost a piece of yourself, and there’s an issue of, am I still worthwhile? Am I still pulling my weight? I’m being a burden to my family? Is it even worth me being here? So some of these individuals get to the point where they need to provide somehow and end up on a street corner begging.
On the flip side, I saw what was happening in the U.S., where we have some very sophisticated technologies and I wondered why there wasn’t a trickle down affect. Part of it is the components developed in the U.S. are very, very good but they are not made for rugged environments and are not made to be easily repairable in the field. At the end of the day, they aren’t cost effective.
We came up with a prototype and started implementing it in Kenya where we had a good contact and there was a good environment to test it at a clinic. And from there we were able to grow to more clinics around the world.
We’re not the only ones trying to meet the need, but we try to do it in a unique way.
Q: How so?
Gonzalez: This is a very complex problem and it is not just about technology.
That is only one piece of the puzzle. Part of it is: Are there clinics to fit these people? Part of it is: Can they then sustain themselves?
When you get fitted, there are a series of follow-up steps and the challenges are different in each place.
I would love to tell you that it is as easy as handing out boxes with our limb all over the world. If we did that, we may feel really good that we are handing out boxes, but at the end of the day, we want to help amputees walk again.
Q: Is there a story that best illustrates the impact LIMBS has?
Gonzalez: We fitted Peter about 12 years ago. He is young and he is strong; he just had an accident. So giving him the ability to walk again really did change his life. I mean, when he became amputated, his girlfriend left him. How are you going to provide for the family?
But today he is married to another woman and has two young kids. Even to this day he’ll tell you being able to walk totally revolutionized what he is able to do. One of the jobs he has had is walking house to house as a census worker for the Kenyan government. He couldn’t even do that if he had a wheelchair, because he couldn’t go up and down the dirt streets.
Q: It’s not like here, where many places are wheelchair accessible.
Gonzalez: Right. Peter is not a casual walker. He is so intense that if we need to test a knee, we give it to him to find out how it performs.
A more recent story is a pastor we met across the border in Juárez who had lost his leg due to diabetes. His church and community put a leg together where the socket was made out of cardboard and the knee was made from a nail pushed between two pieces of wood. It was what they could cobble together, because they wanted to help him.
He was able to be fitted with one of our prostheses, and he has been able to go back to what he used to do – walking the community. It’s neat that we can impact somebody right across the border and halfway around the world.
Q: How much do prostheses cost usually?
Gonzalez: It varies a lot. In the U.S., a very uncomplicated system would be $5,000 to $10,000. It can be as high as $200,000 or more for a very sophisticated system and if you need a high level of rehabilitation.
Q: How much does the LIMBS system cost?
Gonzalez: We make it available to non-profit organizations and give them a cost break on it. We can put those things together for $300 to $500. We are actually in the process of redesigning our knee, and we are going to add a little bit of sophistication so it is going to impact our price point. But we are in the low hundreds of dollars.
We have a donor program, and we give systems away based on how much we can raise in that program.
Q: Where are the knees manufactured?
Gonzalez: Right now, they are manufactured in Bangladesh.
Q: Does LIMBS work in this region?
Gonzalez: We’ve done some work in Juárez and throughout Latin America. We’ve been trying to work in Juárez, but one of the challenges we face everywhere we work in the world is having the right community partner to support patients through rehabilitation.
Q: Is it difficult to fundraise for a global cause in this region?
Mitchell: Yes, it is. There are a lot of needs here in the region and there are many charitable organizations that work here and right across the border. So it can be hard for people to see the opportunity that we provide not just in Juárez, but also around the world.
Q: Why has LIMBS stayed in El Paso?
Gonzalez: ( Laughs) I get asked that question.
Mitchell: A key component of what we do is research, and UTEP has done a lot to work with us. We are also a border community, and there is a great opportunity for us. I’m a native El Pasoan. Roger (Gonzalez) is a native El Pasoan, and this is our home.
Q: How does LIMBS work with UTEP students?
Gonzalez: LIMBS has an agreement with UTEP to involve students in the development of our products. We have students doing stuff like looking at how to repair a particular knee joint or coming up with new technologies.
It is a win-win for LIMBS and the students because they have a chance to do something that is real. We have a student from El Paso High, we have undergraduate students, we have master’s students and we have a doctoral student.
Q: What is your strategy for growing the non-profit?
Mitchell: Raising awareness is key and making people aware of the unique way we meet a need. One of the things about LIMBS, when you give people the gift of mobility, it’s not something that is only going to help them short term.
This has long-term effects that can last a lifetime; it can impact generations. When people see the scope of what their gift does, I believe we will see more people involved in giving.
We’d like to establish a foundation where people could make sizeable donations. In addition to that, we want to continue to write grants and possibly expand our Learning for LIMBS to be a national program.
In addition, we have what’s called community-based rehab, and that is going to be our big focus. It’s not just enough to give somebody the leg, they’ve got to learn how to walk on it. So we’re working to identify areas of the world where we can partner with clinics or establish our own community-based rehab.
Q: How is LIMBS funded?
Mitchell: Through donations and some grants. But it’s primarily funded through individual donations. We have a program called Learning for LIMBS, which partners with schools where the students get real-life global experience.
The students do some fundraising and get a picture of the person who the limb goes to. The program includes a STEM curriculum for K-8 grade, which is built around understanding different cultures and the ramifications of becoming an amputee. It’s real life, so they see how the math and science are applied and are encouraged to be creative and come up with ideas to help.
Q: Is growing the non-profit part why you brought on a president?
Gonzalez: Part of it is my responsibilities at UTEP continue to grow. But a lot of it is Bill (Mitchell) brings a set of skills that I am not well versed in. He has been a CEO and led organizations.
One of the things that is really necessary for us to accomplish our mission is to bring in someone with a plan to help us grow. We’re doing a lot of good, but the potential we have is tremendous.
Q: What’s next for LIMBS?
Gonzalez: The electronic knee design we are working on is something that is two to three years out. It’s something that is really going to reach a new segment. It’s able to adapt to how a person walks and help the person from falling.
Typically these kinds of legs are in the thousands of dollars, and we are trying to do it for hundreds. The target market is those who are poor but may work in offices and have a bit more income.
Q: What you could call the emerging middle class?
Gonzalez: Yes. It is a growing segment of the market, especially throughout Southeast Asia.
One of the things we are probably going to get much more active in is doing customer needs assessments for what is happening in the developing world.
Rather than us coming to you with a technology that could help you, we want to better understand the things you most have issues with. We want that to be driving our technology rather than the other way around.