Training in Prosthetics & Orthotics Engineering in IN D IA

1. Training in Prosthetics & Orthotics Engineering inINDIA Pritpal Singh Sidhu Sr .Clinical Orthotist Central Orthotist Ltd. Palmerston North

2. Personal Profile • B.Sc Non Medical 1988 (India) • Diploma in Prosthetics & Orthotics Engineering 1991 (India) • PG Diploma in Lower Limbs Prosthetics Bio-Mechanics (1998) • M. Sc Rehabilitation Science (Adv. Prosthetics ) 2004 Work experience Prosthetist/Orthotist & Office In charge in District Disability Rehabilitation Centre Patiala (India) Feb1992-July2007 Clinical Orthotist Orthotics Centre Wellington & Auckland July2007-Jan 2009

3. Professional Profile • The following professional profile has its basis in the Report of the United Nations Inter-Regional Seminar on Standards for the Training of Prosthetist (UN, 1968) – the so called Holte Report. It has moreover been modified to comply with Guidelines for Training of Personnel in Developing Countries for Prosthetics & Orthotics Services (WHO, 1990). • Participates as full member of the clinic team; take part in the designing of the prosthetics/orthotics device, including the socket or body/device interface, suspension and selection of proper components. • Records and reports any pertinent information regarding patient and patient’s families, including a determination of expectations and needs regarding prosthetic and orthotic aids and communicates appropriate information to the patients and their families about these.

4. National Institutes • New Delhi • Department of Rehabilitation, Safdarjung Hospital • Indian Spinal Injuries Centre • Pandit Deendayal Upadhayaya Institute for the Physically Handicapped • Maharashtra • All India Institute of Physical Medicine & Rehabilitation, • Gujarat • Government Prosthetic & Orthotic College & Dept. Paraplegia Hosp. & Physiotherapy Collage • West Bengal • National Institute for the Orthopaedically Handicapped, • Orissa • Swami Vivekanand National Institute of Rehabilitation Training and Research,

5. Other Institutes & Organizations • ALMICO {Artificial Limbs Manufacturing Corporation of India} is a non-profit making organization, working under the aegis of Govt of India, Ministry of Social Justice & Empowerment. It was incorporated in 1972 to take up manufacture and supply of artificial limb components and rehabilitation aids for the benefit of the physically handicapped and started production in 1976. • The ALMICO is running a one year technician course

6. Taj Mahal (Agra)

7. Courses for Engineers / Technicians • Master of Science in Prosthetics & Orthotics • Bachelor in Prosthetics & Orthotics • Diploma in Prosthetics & Orthotics • Certificate Course in Prosthetics & Orthotics

8. M.Sc. in Prosthetics & Orthotics • Entry Requirement: Bachelors degree in Prosthetics & Orthotics from recognized University & RCI. • Teacher student ratio: Two nos. per teacher • The two year full time applied science curriculum combines clinically oriented course work in Rehabilitation Medicine.

9. Bachelor in Prosthetics & Orthotics • Entry requirements A candidate who has passed 10+2 in science or equivalent with physics, chemistry and mathematics/biology (with aggregate of 50% marks) will be eligible for admission to this course (equivalent to NCEA Level 3 in NZ with science subjects). • DURATION OF COURSE The total duration of course is of 4 years with 6 months internship. • Teaching Hours Total teaching hours in a year would be approximately on the basis of 6 hours per day 204X6 =1224 hours in a year.

10. Diploma in Prosthetics & Orthotics • Entry requirements • A pass in the Higher Secondary Examination (10+2) in science subject, viz Physics, Chemistry, Biology and/or Mathematics. ( equivalent to NCEA Level 3 in NZ) OR • A pass in the 10+2 in the vocational stream in the trade of machinist or 10+2 and I.T.I. Certificate in the trade of Fitter / Turner / Machinist / Tool or Die Maker. • A pass in the final diploma examinations conducted by the Board of Technical Education of the State Govt. in Mechanical, Electrical/ or Electronics Engineering are also eligible. • Duration of the course • The course duration is Two Years followed by Internship of Six Months in any recognized Rehabilitation / Limb Fitting Centres.

11. Certificate Course for Technicians • Entry RequirementCertificate from I.T.I. in any of the trades of fitter/carpenter/leather. Or 10th class pass and two years of practical experience in a recognised P&O Centre under a P&O Professional. • PurposeTo train category III personnel (bench workers) for assembly and fitting of Orthopaedic appliances, artificial limbs and other rehabilitation aids under supervision of Prosthetist & Orthotist (Category I professional). • Duration One year

12. Char Minar Hydrabad

13. Recognition of P&O course in India • UN (Holte Report ) 1968 • WHO 1990 • REHABILITATION COUNCIL OF INDIA 1992 • ISPO ????

14. Rehabilitation Council of Indiawww.rehabcouncil.nic.in • The Rehabilitation Council of India (RCI) was set up as a registered society in 1986. On September, 1992 the RCI Act was enacted by Parliament and it became a Statutory on 22 June 1993. The Act was amended by Parliament in 2000 to make it more broad based. • The mandate given to RCI is to regulate and monitor services given to persons with disability, to standardize syllabi and to maintain a Central Rehabilitation Register of all qualified professionals and personnel working in the field of Rehabilitation and Special Education. The Act also prescribes punitive action against unqualified persons delivering services to persons with disability.

15. Objective of RCI • The Council ensures that its recognized training institutions situated across the country adhere to the established norms and for this purpose the Council continuously monitors the quality of the training programme by adopting following policies:- • Inspection of the Institution • Surprise Inspection & Mid -Term Report

16. CRITERIA FOR STANDARDIZATION • One of the main functions of the Council is to standardize the training courses for various categories of Professionals/Personnel for ensuring quality services to the people with disabilities. The Council keeps on modifying/revising the existing syllabus and adopt new training programmes incorporating new developments. • The Council has so for standardized 80 Long Term/ Short Term Training Courses, which include 11 Courses developed during the current year, with the help of respective Expert Committees constituted by the Council.

17. Privilege of Persons Registered with RCI • No person, other than the rehabilitation professionals/ personnel who possess a recognized rehabilitation qualification and is enrolled on the Central Rehabilitation Register: • shall hold office as rehabilitation professional or any such office (by whatever designation called) in Government or in any institution maintained by a local or other authority; • shall practice as rehabilitation professional anywhere in India; • shall be entitled to sign or authenticate any certificate required by any law to be signed or authenticated by a rehabilitation professional; • shall be entitled to give any evidence in any court as an expert under Section 45 of the Indian Evidence Act, 1872 on any matter relating to the handicapped: • Any person who acts in contravention of any provision of above shall be punished with imprisonment for a term which may extend to one year or with fine which may extend to one thousand rupees, or with both.

18. Golden Temple (Amritsar)

19. CONTINUING REHABILITATION EDUCATION PROGRAMMES • RCI is also responsible for development and standardisation of training courses in the field of Special Education & Rehabilitation and also to update the knowledge & skills of professionals working in different areas of disability. • The Council has taken a decision that attending two CRE's 5 days duration each is a pre-condition for revalidation of registration for the professional/personnel. The information regarding Continuing Rehabilitation Education (CRE) Topics and Programme being conducted at selected RCI approved Training Institutions Nationwide is given underneath for the Rehabilitation Professionals & Personnel working in disability areas, so that they can join the nearby centre to upgrade their professionals skills.

20. Objectives of CRE • The Council supports relevant CRE programmes with the following objectives : • To upgrade the knowledge & skills of in service & practising Rehabilitation Professionals & Personnel already registered with the RCI u/s 19 of the RCI Act of 1992. • To update Professional knowledge of Masters Trainers working in the field of Rehabilitation & Special Education.

21. Categories registered under RCI • 1.Audiologist and Speech Therapists • 2.Clinical Psychologists • 3.Hearing Aid and Ear Mould Technicians • 4.Rehabilitation Engineers and Technicians • 5.Special Teachers for Education and Training the handicapped • 6.Vocational Counsellors, Employment Officers and Placement Officers dealing with handicapped • 7.Multipurpose Rehabilitation Therapists, Technicians • 8.Speech Pathologists • 9.Rehabilitation Psychologists • 10.Rehabilitation Social Workers • 11.Rehabilitation Practitioners in Mental Retardation • 12.Orientation and Mobility Specialists • 13.Community Based Rehabilitation Professionals • 14.Rehabilitation Counsellors/Administrators • 15.Prosthetists and Orthotists • 16.Rehabilitation Workshop Managers

22. Metro Rail service (DELHI)

23. INDIA GATE (DELHI)

24. Other institutes in India • About 1000 NGO’s & other private institution are working in the filed of prosthetics & Orthotics. Some of them are also conducting various short courses & training programmes.

25. Otto Bock India • Otto Bock India established as 100% owned subsidiary company in Mumbai, India in 1998 with the objective of making the highest quality of international mobility solutions available to India's estimated 9.0 million disabled people.

26. ENDOLITE India Ltd. • Endolite India Ltd., an ISO 9001:2000 Company was established on 07 Dec 95. It is a Rehabilitation Services Company focussed on Prosthetic & Orthotic services through its Company run clinics and dealers. It is managed by a Board of Directors & has its registered office a A-4, Naraina Industrial Area Phase-I, New Delhi

27. Bharat Vikas Parishad • Bharat Vikas Parishad is the only non-governmental organisation beginning with the establishment of its first Viklang Centre in Delhi in 1990 that renders service to the largest number of handicapped persons in the country year after year. The Parishad has so far   provided artificial limbs, calipers, tricycles, wheel chairs and hearing aids to about 2.65 lakhs handicapped persons costing over Rs. 32 crores free of cost (110000 NZ$ approx).

28. Bhagwan Mahaveer Viklang Sahayata Samiti & Jaipur Foot • Technology Jaipurfoot HistoryVisitors Views  The idea of making Jaipur foot was first conceived by Mr. Ram Chander Sharma (Masterjee) who designed and developed the foot and the limb.The Jaipur Foot was developed in 1968. • The BMVSS is working under the leadership & guidance of Mr. D. R. Mehta and because of his Managerial background this research work could be organized. Indian Space Research Organization (ISRO) (Indian equivalent of the NASA of USA), the most prominent Scientific Institution of India, dealing with space research and products has signed an agreement with BMVSS for the development of polyurethane foot (instead of vulcanized rubber).  

29. Handicap International (INDIA) HI activities are carried out by or in partnership with local organizations. Handicap International provides capacity building support (technical, financial and organizational) to enable the partners to sustain their mission and carry out the activities mentioned below. • 1. Specialised services as a condition for full participation: orthopaedics and rehabilitation • 2. Equal opportunities: Inclusion, visibility and rights of disabled people • 3. Public health and disability prevention • 4. New project areas • Livelihoods for  persons • Livelihoods for  persons with disabilities in India • HIV/AIDS • Exploratory mission to disaster prone states such as Orissa

30. Indian Red Cross Society • Indian Red Cross Society (IRCS) was established in 1920 under the Indian Red Cross Society Act and incorporated under Parliament Act XV of 1920. The act was last amended in 1992 and of rules were formed in 1994. • The Indian Red Cross is a voluntary humanitarian organization having a network of over 700 branches throughout the country, providing relief in times of disasters/emergencies and promotes health & care of the vulnerable people and communities.

31. LOTUS Temple (DELHI)

32. Qutab Minar (DELHI)

33. Professional Bodies • Orthotics & Prosthetics Society of India • Indian Association of Prosthetist & Orthotist • Indian Association of Rehabilitation professional • ISPO (INDIA)

34. Provision of Aids & Appliances • Aids/appliances are supplied to persons with disabilities under ADIP scheme of Ministry of Social Justice & Empowerment, Govt. of India

35. Referral System • PMR Specialist • Orthopedic Specialist • Prosthetist/Orthotist registered under RCI • Other Specialist ( ENT, Eye, & Skin Specialist)

36. Jaisal Mer (RAJASTHAN)

37. Persons with disability Act 1995 • While India's economy growth rate has risen, 35% of the population still lives below the poverty line and 39% of adults are illiterate. The number of disabled people would be around 55 million. Despite the introduction of legislation like the Persons with Disabilities Act, disabled people disabilities are amongst the most disempowered groups in India. They are constantly faced with discrimination and are subjected to neglect, prejudice, revulsion, rejection and pity.

38. Criteria for ADIP assistance • Disability certificate ( only 40% permanent disabled can get benefits under ADIP • Monthly income Less than 6500 rupee = 100% subsidy Between6500-10000 = 50% subsidy Over 10000 = NIL

39. Benchmark statement for prosthetics and orthotics • Subject benchmark statements provide a means of describing the nature and characteristics of programmes of study and training in health care. They also represent general expectations about standards for the award of qualifications at a given level and articulate the attributes and capabilities that those possessing such qualifications should be able to demonstrate. ( The Quality Assurance Agency for Higher Education 2001. Australia)

40. Why Benchmark? • Benchmark statements are used for a variety of purposes. Primarily, they are an important external source of reference when new programmes are being designed and developed. (The Quality Assurance Agency for Higher Education 2001. Australia)

41. Legal Importance of bench marking • Expectations of the Prosthetist & Orthotist in providing patient/client services; • The application of practice in securing, maintaining or improving health and well-being; • The knowledge, understanding and skills that underpin the education and training of P&O professionals.

42. Planning for P&O Training in NZ • Awareness • Willingness • Communication • Generation of resources • Documentation • Implementation

43. Awareness • To carry on the rehabilitation work in NZ the P&O professionals has to under stand that there if the situation (NO TRAINING) remain same then after 7-10 year there wouldn’t be any body to render services. • More over on 100% depaendence on international work force is not a good idea.

44. Resources we need • Master trainers • Volunteer for infrastructure suppliers • Own funds ( Annual Subscription & donation) • Request for funds from Govt. • Sponsorship from local suppliers • Interested learners

45. Implementation of International curriculum in P&O in NZ • Phase one (Manpower Development): • Training/work shop for local professionals by local master trainers for 3-4 times a year at least for two years. {2009-2011} (TELE-CONFRENCING) • Phase Two ( Trainers Development) • Advance Training of all professional by international master trainers,1-2 times a year. {2011-2012} • Phase Three (Start of Diploma course & Certificate course in P&O). {2012-2015} • Phase Four ( Start of Degree Course & then Master Degree) {2015-----}

46. Phase Two ( Trainers Development) • Advance Training of all professional by international master trainers,1-2 times a year. {2011-2012}