What might a local manufacturing kit look like?

What might a local manufacturing kit look like? What's in the box?

This depends on what we are trying to make and where.  We've been thinking about how we select items and manufacturing techniques that we want to "package up" into kits so that others can make them.

Every item we make in the field we develop to a different stage. Sometimes we’ve made one of a thing, sometimes many. Sometimes it's bespoke, a custom item for a specific need; sometimes it's a reusable design and can be repeated many times.  Sometimes we've tried different designs and techniques to solve the same problem, and sometimes we've just made one quick prototype. Sometimes we've documented our design process and final results fully, and sometimes we haven't. In addition to this, in the kits program we are exploring new items and manufacturing techniques.

We also think about how familiar folks are with the items we can make - for instance, is it a replacement part for equipment they already have, or is it something in an aid agency catalog?  Sometimes we can make an exact replica of a familiar item, or something very similar. Other times, we're solving a familiar problem in a very different way, so the item may seem quite unfamiliar, which may be challenging for adoption and uptake. We also encounter interest in updating or improving items or solutions, perhaps through aid agency requests for procurement seeking new solutions. 

As well as selecting items to turn into kits, there's also a piece of work, different in each case, to make the designs ready for others to make. To make sure the design works, that all the documentation you might need (design files, templates, instructions) is available and is sufficient for someone who hasn't made the item before to make one. There may also be general instructions - such as how to use a 3D printer, as well as how to successfully make a specific item. 

The result is that we're thinking about a number of different "kits".  One is a 3D printer kit, to create a set of items for health posts or small clinics. This builds on existing work we've done testing designs in different locations.  Another is a WASH kit, and we're exploring ideas both around making pipe fittings on demand, and making latrine parts there.  Our airbag design may also be a useful kit - and potentially is closer to becoming 'repeatable' manufacturing in that the use of hand tools means we don't need to ensure reliable operation of more complex manufacturing machinery.  Finally we are looking into shelter winterisation options as this is a significant need in cold regions.

One of the factors here is the technology readiness of the manufacturing system. We've evaluated the systems we've used so far, and possible additions which are viable to test and develop to a suitable level during 2017-18.

Testing an injection molder in the lab

Viable manufacturing technologies 2017-18

• 3d printing
• Injection molding
• Cnc machining
• Vacuum forming
• Hand tools
• Possible: simple plastic recycling methods such as heat press

Note that whilst hand tools and formers might be sufficient for a kit, we don't think they really show the potential for local manufacturing in the way that more advanced machinery might, so in 2017-18 we want to have at least one kit with more advanced machinery such as 3D printing, even if we also have hand tool based kits.

What's in the box?

A kit contains some or all of:

• Machines(s) to make things
• Hand tools(s)
• Raw materials
• Documentation
• Digital designs (SD card? USB stick?)
• Tablet or other user interface
• Sample items
• UPS + (solar / wind)?
• Packaging
• Formal shipping documents
• Monitoring system?

It's also worth thinking about some of the other factors that we may need to think about, which are not physically in a box, such as:

• Distribution
• Certification
• Insurance
• Import & other taxes
• Service & support
• Monitoring
• Updates and maintenance

Why we're using Kits to scale up local manufacturing

We've been thinking about our theory of change with help from the Humanitarian Innovation Fund recently, and this has helped us clarify why the "kits" program matters.

Field Ready's goal is that:

“in every humanitarian response, everyone has access to the supplies they need, when and where they need them”

To make this a reality, we need to improve manufacturing capabilities for humanitarian response, and our focus is on local manufacturing.  For this to be viable at scale, aid agencies and governments need to understand the possibility of local manufacturing, and for any resistance to change to be overcome, by demonstrating that local production can provide appropriate supplies more quickly, and more cheaply, and often with other benefits such as livelihoods and sustainability. This requires local manufacturing capacity, including access to machines, materials and designs, people with relevant skills, and coordination to make local sourcing of humanitarian supplies possible.

In the "kits" program, we're creating a way to package up our local manufacturing systems so that they can be used more widely.


This is a key part of our strategy to scale up our impact, so more people can benefit from our work, so it can be scaled up more rapidly, increasing local manufacturing capabilities. This will support more local manufacture of humanitarian items in a way that leads to new sources of revenue for Field Ready (potentially including surplus-making activities) to support our efforts to grow.

So kits will help our impact grow more quickly, as they can enable more local manufacturing of useful items.  Alongside our ongoing R&D work, testing new manufacturing techniques and designs, and our country programs, kits themselves can grow more quickly - a bit like this sketch:

Exactly what a kit is will vary depending on what it will make and how it will be used. But in essence, it's everything someone needs to make an item or set of items. That's likely to be a combination of tools and materials, and some information (designs, instructions), and maybe some support services around this, such as training or call out technical support. 

However, we're clear that just training doesn't make up a kit and is out of scope for this program. Also, just information is generally not in scope - we want to provide tools and materials in almost all cases, although information only may be an appropriate solution for some items in some circumstances (such as besieged areas). 

Scaling up local production: introducing our new 'kits' program

In 2017-18 Field Ready is developing a way to package up our local production systems so that they can be used more widely.  

This is part of our strategy to scale up our impact, so more people can benefit from our work, so it can be scaled up more rapidly, increasing local production capabilities. This will support more local manufacturing of humanitarian items in a way that leads to surplus revenue for Field Ready (more money we can use to support our work) and increasingly bigger impact in the aid sector.

We have called this program "kits." A Kit is a box of manufacturing equipment and instructions, which will enable someone (who may not be a manufacturing or design expert) to make a specific item or set of items. For instance, as a simple example, a kit might be a 3D printer, some digital designs preloaded onto it, essential hand tools like scrapers, and instructions as to how to successfully print those items. That set of items would be selected to be a useful and coherent suite of things, that there is a demand to make locally.  We've realized that the term "kit" may not be the right name for this program, as "kits" are an existing concept in humanitarian aid, and it doesn't mean quite what we mean here. So we might rename the program later!

There are a number of things for us to figure out.  What manufacturing techniques and machines might we use?  What items might the Kits enable someone to make? How would we get kits to people? This includes distribution, business, and revenue models to support local manufacturing, and so on. We need to understand the value local manufacturing can offer to people and organizations, so that we can make sure we create something useful and sustainable that can scale up, offering locally made humanitarian items to more people around the world.

As part of this work, we are making sure we're systematic about how we document the things we've designed and made, and that we understand how "Field Ready" different manufacturing methods and designs are. We'll be sharing more thoughts on manufacturing maturity, safety and replicability in the coming months here on our Technical Blog. 

Our starting point is to identify items and manufacturing techniques which can be reproduced by nonspecialists in the field, and to make the process of doing this robust and repeatable. 

 

Success by 2019

We've set out what we want to achieve by the end of the two years during which we have support from the Humanitarian Innovation Fund for our Journey to Scale:

* 15 of each kit in use in a range of sites (eg clinics/hospital/camp/village) over 3 countries

* 2 x 2-minute videos showing non-FR staff using each kit in country

* List of potential buyers

* Recording system to know number of items made (manual system ok if used)

* Cost is known for present kit including labor, and cost estimate for making larger numbers of kits

* 1-page flyer to set out the benefits persuasively to potential purchasers (value for them, in their terminology)

* Documents translated into at least one language other than English

* Estimate of worldwide market size

* Local regulations understood for safety, performance and finances (eg tax and tariffs)

* 1 kit sold for real money

* 10 solid reliable items being made

We've got an initial plan for the first phase of this work and will be blogging more often here in the coming weeks.

Field Ready and Prosthetics

The Need

One of Field Ready's best known approaches to enabling aid workers to get the supplies they need is through 3D printing supplies in the field. However, it is becoming increasingly difficult to discuss 'humanitarian 3D printing' without also having a discussion on 3D printable prosthetics. A key reason for this is the huge need for affordable prosthetics - in particular, Field Ready has had many requests from organizations working with the Syria crisis, where an estimated 30-80,000 people caught in the conflict are facing life without a limb.

As a manufacturing technique, 3D printing holds a lot of potential in the world of prosthetics. One off, personalized devices can be manufactured affordably to fit an individual patient's needs, and with the attention the sector is receiving the number of designs and organizations making them is only set to increase. However, receiving a prosthetic is not as simple as having one printed out and putting it on.

The Issues

1. Medical Care
From a medical perspective, the journey of an amputee is a long one. After amputation, it typically takes 2-6 months for the wound to have sufficiently healed to accept a prosthetic device, depending on the injury. At this point, a full assessment is required to ensure the patient is in a physical condition able to withstand the physical and mental challenges of adapting to a prosthetic, and that an appropriate type of device is selected to support the usual day to day activities of the patient. After a prosthetic device is fitted, the patient must undergo physiotherapy to desensitize the skin and strengthen the muscles the patient will need to comfortably operate the device.

2. Usability
The number of 3D printable designs are increasing, which is a very positive thing. One of the main challenges with prosthetics is to find a device or set of devices that enhance the amputee's life sufficiently to outweigh the time, pain and mental challenges associated with adapting to the prosthetic. It can be very different for different people - for some it may be concealing the amputations, for others it could be managing everyday tasks, or very specific tasks such a handling tools or riding a bicycle. One of the biggest successes for 3D printed prosthetics is with children, for whom it can make a huge difference to get something to be excited about, and gain something the other kids don't have, rather than feeling left out or at a disadvantage.

3. Cultural Fit
As much as designs need to fit individual needs, there also needs to be sensitivity to the wider culture. Field Ready founder Dara Dotz experienced different challenges whilst making E-nable 3D printed hands in Haiti compared to her other experiences in the US. Making colorful 3D printed hands in Haiti raised some interesting issues surrounding cultural attitudes to amputation, where patients found the 3D printed devices advertised their status as an amputee, which resulted in negative behavior towards them.

Summary - Field Ready and Prosthetics

Overall, the future for 3D prosthetics looks vibrant, with many different players working towards a wider range of devices becoming available to more people. It is however a complex journey, requiring deep contextual research into what types of devices are appropriate and desired, developing these designs, manufacturing them and engaging in a long journey with amputees to help them adapt and gain maximum benefit from the device.

Field Ready's mission is to make sure those affected by crises can access what they need, and as such we are keen to work on projects which involve manufacturing prosthetics locally. However, we are not the right team to be designing and testing new prosthetic products, or to engage in the medical activities in supporting an amputee - we would need to partner closely with organizations performing both of these functions. At present, we have not got an active partnership with such an organization, and so we do not manufacture prosthetics as part of our activities. However, we would be happy to do so in the future if the right partnership and opportunity arises.