Considering the magnitude of the problem and the limited services available in the country, BRAC added a rehabilitation component to its health programme in 2000 and established BRAC Limb and Brace fitting Centre (BLBC) in the capital (situated by Mirpur Road opposite to the Shaymoli Shishu Mela).

To expand the BLBC services beyond Dhaka and to lessen the burden for disabled people living in other parts of the country, BRAC is running two satellite centres in Chittagong and Mymensing. Trained technicians are providing orthoses (brace) and minor repair at these centres. Complicated cases are identified at these satellite centres for referral to BLBC.

The background history of the centre is very interesting. In 1997, a doctor of BRAC had a motor cycle accident while going to his duty station. His legs had to be amputated following the incident. He got artificial leg from Jaipur, India later on by the help of founder of BRAC Mr Fazle Hasan Abed. The doctor started a new life. Being inspired from the incidence, BRAC established BRAC Limb and Brace fitting Centre (BLBC) in 2000.

BRAC Limb and Brace fitting Centre (BLBC) was begun in order to provide support to physically disabled persons, especially the poor and those and who could be rehabilitated using quality limbs and braces with appropriate technology.

The goals and objectives of BLBC are --

• To provide low-cost, appropriate appliances and training for the disabled with an emphasis on the poor.
• To provide quality limbs and braces that are user-friendly.
• To provide information, education, and counselling services to the disabled and their family.

The services at the centre include providing prosthetic devices (artificial limbs) and training for amputated limbs (above- and below-knee), as well as provide orthotic services like brace (any type of splint or appliance worn for support, such as a metal support used on children's legs to make the bones straight or on teeth which are forming badly) for patients with disabilities like cerebral palsy, post-polio complications, spondylitis, drop foot, and congenital limb deformity. Special physiotherapy services are also offered by the centre for patients suffering from cerebral palsy, congenital club foot, cerebro-vascular accidents (CVA), arthritis, frozen shoulder, Guilen-Barré syndrome, and other clients who need artificial limb and braces.

In order to develop and implementation of the project, the centre is working in collaboration with SDMH, an esteemed and specilised pro-poor health services institute in Jaipur, India. BLBC is financed by Jaipur Limb Campaign (JLC) London, UK. Besides, International Committee of the Red Cross (ICRC) provides modified arterial limb and braces, technical support, machinery, and materials of the prosthetic devices and braces it supplies.

There are two types of artificial limbs available in BLBC. The in-charge of the centre Dr Md Shahinul Hoque (Ripon) informs that an artificial leg (below knee) costs according to Indian formula Tk 3100 only and according to Switzerland formula Tk 6100 only. The patients have to pay Tk 100 only as service charge. BRAC provides up to 50 per cent subsidy to make an artificial limb and brace. They also provide financial support to the patients who cannot afford the facility by their own. The centre also provides lodging to the individuals from remote areas who have no place to stay in Dhaka. Moreover, the individuals receiving BLBC service need to get further services as the shape of the socket changes, the device may need repair and so on. BLBC provides the service almost free of cost for the next time.

Mr Babu* was suffering from post polio complication and could not walk as a normal individual. He got brace and physiotherapy training from the centre and now can walk like a normal individual. He told that many people do not know that these sort of services are available in the country at such low-cost. He expressed that the quality of the products are very standard and the staffs are very skillful as well.

Dr Ripon also informed that all the staffs of the center including doctor, technician, physiotherapist are well trained from abroad either from Jaipur, India or London, UK. Some other staffs are on long training course.

A total of 899 individuals received artificial limbs (above-and below-knee) from BLBC while 1940 individuals received brace during July 2000 to September 2005. During the same period 666 clients received physiotherapy services.

Most of the individuals become economically unproductive, even after getting an artificial limb. The issue of economic empowerment is also addressed by BRAC to the patients receiving BLBC services, so that they do not become the burden for the society.

The BLBC has achieved good results in introducing physical rehabilitation into communities and has filled a gap in an area that has not been adequately addressed by the government. Sector specialist of this particular health programme of BRAC Dr Mohammad Raisul Haque expressed that BLBC services are likely to expand its facilities gradually in the capital and throughout the country.

People should know the availability of the low-cost services in our country.

* Name changed to protect identity