Summary
The Restoring Hope initiative in Gaza demonstrates the power of co-creation in addressing the unique challenges faced by amputees in resource-constrained environments. By involving engineers, medical professionals, and users in the prosthetic design process, the initiative is bridging the gap between innovation and application, transforming amputee support in Gaza.
Gaza faces an unprecedented amputee crisis due to ongoing conflict, with medical teams operating under severe conditions. Restoring Hope is addressing this by using direct communication channels, such as weekly video calls, between Jordanian medics and prosthetic designers to create a continuous feedback loop. This collaboration is driving ground-breaking developments that are ensuring the delivery of prosthetic care meeting the specific requirements of amputees in Gaza. This includes the development of Koalaa’s world-first fast-fitting above-elbow prosthetic and Amparo’s innovative paediatric leg sockets, both tailored to Gaza's needs.
This model redefines traditional roles in medical innovation by positioning frontline medics as equal partners, ensuring solutions directly meet the needs of the amputees in Gaza. The emotional and motivational aspects of co-creation also play a pivotal role, with the frontline medics and prosthetic designers uniting around a shared sense of purpose.
This model is providing a blueprint for revolutionising healthcare innovation worldwide, showing that the best outcomes emerge from genuine co-creation. By centring designer and practitioner voices, it not only restores hope in Gaza but sets a new standard for transformative healthcare solutions.
Introduction
Medical innovation is often a top-down process, led by engineers and designers far removed from the environments and realities of those who will use their products. The Restoring Hope initiative in Gaza challenges this notion by putting co-creation – a collaborative process involving engineers, medical professionals, and users – at the forefront of prosthetic development. This model bridges the gap between design and application, offering a template for addressing critical healthcare challenges, and in particular amputee support in resource-constrained settings. The model builds on the established co-creation thinking that has evolved within the technology industry and is known in that context as agile development. Such “agile development” reflects the real-life consideration that the best outcome is not known at the start of the innovation work and it needs to emerge by learning from the front-line practitioners.
Through a partnership between the Royal Jordanian Medical Services in Gaza, prosthetics companies, digital health technology companies and Life Sciences Network (LSN), Restoring Hope is revolutionizing prosthetic care. By using input from frontline practitioners and patients, new prosthetic designs are being developed in direct response to the lived experiences of frontline medics.
The need for innovation
The ongoing conflict in Gaza has created a humanitarian crisis that is unprecedented in terms of amputees. According to the World Health Organization, approximately 10 children a day became amputees in Gaza in the first three months of the crisis, with no prosthetics readily available to meet their needs. Medical teams in Gaza operate under extreme conditions, grappling with high patient volumes, damaged medical facilities, unreliable transportation and communication infrastructure, and the frequent displacement of patients. These conditions are demanding innovative, adaptable solutions in amputee support: to develop prosthetics that not only address the immediate resource scarcity issues but also meet the specific needs of the population in Gaza they serve.
Direct communication is a catalyst for progress
Video conferencing and direct communication channels have been a transformative tool in the Restoring Hope initiative, building the relationship between the Jordanian frontline medical teams and the prosthetics design and development teams. Weekly direct conversations between the teams are enabling a continuous feedback loop of co-creation, driving the rapid refinement of prosthetic designs.
For example, Abood, one of the Jordanian frontline medics in Gaza, is providing the engineers of the upper-limb prosthetic with detailed observations on usability and patient needs. Abood has provided feedback on the importance of an upper-limb prosthetic with a tool for cycling and for carrying: activities crucial for daily life in Gaza. And he has also provided detailed feedback on the type of prosthetic fixtures that best suit Gaza's challenging environmental conditions, including the heat and sand. These insights are resulting in innovations in designs that are tailored to the patients' needs and the realities of Gaza’s medical landscape.
The feedback from a successful prosthetic fitting is immediate, and can be emotional at times. Engineers, designers and the prosthetist provide more than just a device, but rather it represents opportunity, and a return to normalcy for someone who had a life-altering event happen to them.
- Alex Dahinten, Clinical Specialist
This model extends beyond technical feedback. Regular video calls and consultations between the medical practitioners and designers is creating a shared understanding of the challenges faced by patients. By grounding innovation in lived experiences, Restoring Hope is hugely accelerating the development of prosthetics.
Watch here: www.youtube.com/shorts/KhImOFFRiCs
Co-creation in action
Restoring Hope builds on the success of past initiatives, such as the Masanga Mentor Ebola Initiative (MMEI), led by LSN during the Ebola crisis. This project brought together frontline health workers, technologists, and educators to create a training system tailored to resource-constrained environments. By incorporating local languages, cultural contexts, and real-time feedback, MMEI demonstrated how co-creation can drive impactful solutions.
Applying similar principles, Restoring Hope is bringing together frontline medics, prosthetic design specialists from companies Koalaa Soft Prosthetics and Amparo, and digital health specialists in Jordan to drive innovation. The development of Koalaa’s above-elbow prosthetic exemplifies this approach.
World-first above-elbow prosthetics
Abood and his team have identified an urgent need for above-elbow prosthetics. This demand arises from the frequent use of tourniquets during emergency surgical interventions, which are necessary to save lives. However, this life-saving measure often results in the loss of the entire arm, even when the initial injury is limited to the lower arm. This has created an urgent need for above-elbow prosthetics in the region, where the proportion of above-elbow amputees far exceeds global averages.
As a direct response, Koalaa is set to launch the world's first fast-fitting above-elbow prosthetic in January, providing an innovative solution tailored to the unique challenges faced by amputees in Gaza.
World-first paediatric fast-fitting leg socket
Amparo’s work on paediatric sockets further demonstrates the power of co-creation. By collaborating with Abood and his team, the company is developing the world’s first fast-fitting lower-limb paediatric prosthetic, set to be delivered to Gaza in January. The daily experience of Abood with patients has informed the design requirements: lighter, smaller, modular prosthetics that accommodate growth and can be adapted to the changing needs of young patients. The development of this adaptability prosthetic is vital in Gaza, where the demand for child prosthetics is unprecedented and follow-up care sporadic given the ongoing conflict.
Both of these ground-breaking developments highlight how collaboration can catalyse innovation, transforming limitations into opportunities for progress.
Redefining roles in medical innovation
Restoring Hope challenges traditional hierarchies in medical device development by positioning frontline practitioners as equal partners in the innovation process. Traditionally seen as implementers, the medics on the ground are now playing a central role in co-creating solutions. Their practical experience is as valuable as technical expertise in the development process. This paradigm shift is not only accelerating the development cycle but is also ensuring that the products are directly meeting the end-user needs.
The broader impact of co-creation
Beyond its technical achievements, Restoring Hope also underscores the emotional and motivational aspects of co-creation. When the medical design teams witness the direct impact of their work through video consultations and testimonials, it creates a shared sense of purpose that drives innovation. Seeing a child walk confidently with a new prosthetic or hearing Abood’s first-hand accounts of patients’ improved lives is reinforcing the shared commitment of all involved.
Ultimately the significant need for a child-sized prosthetic leg solution in Gaza has led to Amparo to adapt the same type of material that can be moulded (and re-moulded) directly onto a patient, into a solution that can serve paediatric patients.
- Alex Dahinten, Clinical Specialist
Importantly, this is not just a smaller size, but rather an innovative approach to allow a socket to “grow” and lengthen, as the child grows.
This emotional investment is fostering a deeper commitment to overcoming challenges and finding solutions. It is transforming a professional collaboration into a personal mission, accelerating progress and pushing the boundaries of what is possible.
Looking ahead
The Restoring Hope initiative offers a blueprint for the future of medical innovation. By valuing the expertise of those on the frontlines and fostering genuine collaboration, it is demonstrating that the best solutions emerge when all stakeholders are involved. This co-creation model has the potential to revolutionize other areas of healthcare, ensuring that the voices of patients and practitioners are at the heart of the innovation process.
In Gaza, where resilience and resourcefulness are daily necessities, Restoring Hope stands as a testament to what can be achieved when we work together. As Abood and his team continue to collaborate with medical design teams, they are not just restoring hope for their patients – they are building a brighter future for amputee care worldwide.
Special thanks to the Douglas Bader Foundation who have supported this briefing.
A first for Jordan and focusing on solutions for children. Keep it up