Moving Parts

Episode #629: “They don’t sleep with their leg on.” Jason Bender, a certified prosthetist who lived and worked in Myanmar from 2014 to 2021 before supporting cross-border work from Thailand, uses that basic reality to explain why providing a prosthetic limb cannot be reduced to handing someone a device. A leg may restore mobility after a landmine injury, but the socket changes as the body changes, feet wear out, sores develop, and users must learn to walk again across environments that were difficult to navigate even before amputation.

In Myanmar, that process can require months of healing followed by a journey to one of relatively few clinics, where a patient may remain for days or weeks while a socket is made and walking begins. Rural hills, dirt paths, stilt houses, and inaccessible urban sidewalks often make wheelchairs impractical, while years on crutches can damage the shoulders and leave both hands occupied. Near conflict-affected border regions, Bender recalls landmines and other war injuries accounting for most of the amputations he encountered.

The work demanded adaptation. Forestry workers asked Bender’s team to remove the toes from prosthetic feet because the shortened shape made steep mountain climbing easier. When imported aluminum pylons became unavailable at one remote clinic, local practitioners found a strong, lightweight tree and carved wooden replacements. New technologies may offer further options: digitally scanned and 3D-printed sockets could allow more stages of care to happen closer to patients.

The 2021 coup intensified the contradiction. War-related trauma increased while clinics moved, supply routes deteriorated, and patients with conspicuous injuries risked questioning at military checkpoints. Bender sees local training, digital tools, and improvisation as ways to preserve access, but none eliminates the need for continuing care. A prosthesis may restore a person’s ability to move through the world; keeping that possibility alive depends on people and services remaining close enough to repair it when the body, the device, or the country changes.