Save the Children is proud to partner with Imperial College London and a host of medical and operational experts, to support children who’ve been injured in conflict.
In March, this partnership launched the Centre for Paediatric Blast Injury Studies at Imperial’s White City campus.
The Centre brings together medics, engineers, pain specialists, operational humanitarians and prosthetics and rehabilitation experts who are already driving new research and innovations to meet the clinical needs of children with blast injuries.
Understanding the needs of children
Some of the initial work is addressing the lack of prosthetics for musculoskeletal and extremity injuries in children led by Imperial College researchers Caitlin Edgar and Claudia Ghidini, who is the first PhD student funded by Save the Children.
As part of her research, Caitlin went to Cambodia earlier this year to meet child amputees, clinicians and prosthetists.
“We were working in collaboration with Exceed Cambodia and the Department of Prosthetics and Orthotics in Cambodia who interviewed 13 children who need prosthetics as well as speaking to their families and the clinical teams involved in the actual provision itself,” Caitlin explains.
“We’d worked with colleagues with engineering and child mental health backgrounds to make sure we were asking the right questions and were able to learn a huge amount how children view and understand their prosthetics.”
Cambodia is one of the world's most heavily mined countries resulting from the conflict in the 1960s to the 1990s. Many children treated in the clinics Caitlin visited were also survivors of road traffic collisions, resulting in limb loss.
The first phase of Caitlin’s project focuses on understanding the needs of children with lower limb loss in Cambodia and learning what the specific design requirements are for prosthetic legs in low- and middle-income countries.
Caitlin says it’s a challenge for children to understand that a prosthetic is “their” leg but also that it must be taken away and replaced as they grow.
“Interestingly, we found that younger children were more focused on prosthetics that looked more like intact legs whereas older, adolescent children were happy to sacrifice appearance for improved functionality,” Caitlin says.
She is working to develop a polycentric knee joint which will have the ability to grow with the child, which has never been done before.
The importance of specialist help
There are many challenges for children adjusting to having prosthetic limbs fitted.
Claudia explains: “The process of fitting prosthetic limbs takes much longer for children, especially young children between three and five years old. We’re learning that they essentially have to learn to walk again which of course is a hugely difficult process.”
She worries what the future will be like for children in countries such as Cambodia if specialist help is not available.
“In contexts like Cambodia, as the situation transitions from being a humanitarian response to a development one, that many NGOs are leaving – many of which have programmes and expertise in mine awareness and providing children with prosthetics if they are injured, Claudia says. “This could have huge implications for children being able to access prosthetics. Our interview analysis, for example, told of a 17-year-old boy who was on crutches for years before he was able to get a prosthetic”.
Research from Cambodia will be crucial in not only helping children with limb loss there, but in other active and former conflict zones around the world.
Caitlin adds: “We know that blast injury is a legacy. It's a timeline. We have instant catastrophic harm now in Ukraine and we know that people there are going to be suffering the consequences of this conflict for decades to come. It’s not going away, but we can start to do something about it now.”
Learn more about the paediatric blast injury partnership here.
