Training in Prosthetics & Orthotics Training in Prosthetics & Orthotics Engineering inEngineering in ININDDIA IA

Pritpal Singh SidhuPritpal Singh Sidhu

Sr .Clinical OrthotistSr .Clinical Orthotist

Central Orthotist Ltd. Central Orthotist Ltd.

Palmerston NorthPalmerston North

Personal ProfilePersonal Profile

B.Sc Non Medical 1988 (India)B.Sc Non Medical 1988 (India)Diploma in Prosthetics & Orthotics Engineering 1991 Diploma in Prosthetics & Orthotics Engineering 1991 (India)(India)PG Diploma in Lower Limbs Prosthetics Bio-Mechanics PG Diploma in Lower Limbs Prosthetics Bio-Mechanics (1998)(1998)M. Sc Rehabilitation Science (Adv. Prosthetics ) 2004M. Sc Rehabilitation Science (Adv. Prosthetics ) 2004

Work experience Work experience Prosthetist/Orthotist & Office In charge in District Prosthetist/Orthotist & Office In charge in District Disability Rehabilitation Centre Patiala (India) Feb1992-Disability Rehabilitation Centre Patiala (India) Feb1992-July2007July2007

Clinical Orthotist Orthotics Centre Wellington & Auckland Clinical Orthotist Orthotics Centre Wellington & Auckland July2007-Jan 2009July2007-Jan 2009

Professional ProfileProfessional ProfileThe 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.

National Institutes National Institutes New DelhiNew Delhi

– Department of Rehabilitation, Safdarjung Department of Rehabilitation, Safdarjung HospitalHospital

– Indian Spinal Injuries CentreIndian Spinal Injuries Centre

– Pandit Deendayal Upadhayaya Institute Pandit Deendayal Upadhayaya Institute for the Physically Handicapped for the Physically Handicapped

MaharashtraMaharashtra– All India Institute of Physical Medicine & All India Institute of Physical Medicine &

Rehabilitation,Rehabilitation,

GujaratGujarat– Government Prosthetic & Orthotic College Government Prosthetic & Orthotic College

& Dept. Paraplegia Hosp. & Physiotherapy & Dept. Paraplegia Hosp. & Physiotherapy CollageCollage

West BengalWest Bengal– National Institute for the Orthopaedically National Institute for the Orthopaedically

Handicapped,Handicapped,

OrissaOrissa– Swami Vivekanand National Institute of Swami Vivekanand National Institute of

Rehabilitation Training and Research, Rehabilitation Training and Research,   

Other Institutes & OrganizationsOther Institutes & Organizations

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

The ALMICO is running a one year technician courseThe ALMICO is running a one year technician course

Taj Mahal (Agra)Taj Mahal (Agra)

Courses for Engineers / Technicians Courses for Engineers / Technicians

Master of Science in Prosthetics & OrthoticsMaster of Science in Prosthetics & Orthotics

Bachelor in Prosthetics & Orthotics Prosthetics & Orthotics

Diploma in Prosthetics & OrthoticsDiploma in Prosthetics & Orthotics

Certificate Course in Prosthetics & Orthotics

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.

Bachelor in Prosthetics & OrthoticsBachelor 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.

Diploma in Prosthetics & OrthoticsDiploma 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.

Certificate Course for TechniciansCertificate Course for Technicians

Entry Requirement Certificate 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. Purpose To 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

Char Minar HydrabadChar Minar Hydrabad

Recognition of P&O course in IndiaRecognition of P&O course in India

UN (UN (Holte Report ) 1968 ) 1968

WHO 1990WHO 1990

REHABILITATION COUNCIL OF INDIA 1992REHABILITATION COUNCIL OF INDIA 1992

ISPO ????ISPO ????

Rehabilitation Council of IndiaRehabilitation Council of Indiawww.rehabcouncil.nic.inwww.rehabcouncil.nic.in

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

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

CRITERIA FOR CRITERIA FOR STANDARDIZATIONSTANDARDIZATION

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

Privilege of Persons Registered with RCIPrivilege 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.

Golden Temple (Amritsar)Golden Temple (Amritsar)

CONTINUING REHABILITATION CONTINUING REHABILITATION EDUCATION PROGRAMMESEDUCATION PROGRAMMES

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

Objectives of CREObjectives of CRE

The Council supports relevant CRE The Council supports relevant CRE programmes with the following objectives :programmes with the following objectives :– To upgrade the knowledge & skills of in To upgrade the knowledge & skills of in

service & practising Rehabilitation service & practising Rehabilitation Professionals & Personnel already registered Professionals & Personnel already registered with the RCI u/s 19 of the RCI Act of 1992. with the RCI u/s 19 of the RCI Act of 1992.

– To update Professional knowledge of Masters To update Professional knowledge of Masters Trainers working in the field of Rehabilitation Trainers working in the field of Rehabilitation & Special Education.& Special Education.

Categories registered under RCICategories registered under RCI

– 1.Audiologist and Speech Therapists1.Audiologist and Speech Therapists– 2.Clinical Psychologists2.Clinical Psychologists– 3.Hearing Aid and Ear Mould Technicians3.Hearing Aid and Ear Mould Technicians– 4.Rehabilitation Engineers and Technicians4.Rehabilitation Engineers and Technicians– 5.Special Teachers for Education and Training the handicapped5.Special Teachers for Education and Training the handicapped– 6.Vocational Counsellors, Employment Officers and Placement 6.Vocational Counsellors, Employment Officers and Placement

Officers dealing with handicappedOfficers dealing with handicapped– 7.Multipurpose Rehabilitation Therapists, Technicians7.Multipurpose Rehabilitation Therapists, Technicians– 8.Speech Pathologists8.Speech Pathologists– 9.Rehabilitation Psychologists9.Rehabilitation Psychologists– 10.Rehabilitation Social Workers10.Rehabilitation Social Workers– 11.Rehabilitation Practitioners in Mental Retardation11.Rehabilitation Practitioners in Mental Retardation– 12.Orientation and Mobility Specialists12.Orientation and Mobility Specialists– 13.Community Based Rehabilitation Professionals13.Community Based Rehabilitation Professionals– 14.Rehabilitation Counsellors/Administrators14.Rehabilitation Counsellors/Administrators– 15.Prosthetists and Orthotists15.Prosthetists and Orthotists– 16.Rehabilitation Workshop Managers16.Rehabilitation Workshop Managers

Metro Rail service (DELHI)Metro Rail service (DELHI)

INDIA GATE (DELHI)INDIA GATE (DELHI)

Other institutes in India

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

Otto Bock IndiaOtto Bock India

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

ENDOLITE India Ltd.ENDOLITE India Ltd.

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

Bharat Vikas ParishadBharat Vikas Parishad

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

Bhagwan Mahaveer Viklang Bhagwan Mahaveer Viklang Sahayata Samiti & Jaipur Foot Sahayata Samiti & Jaipur Foot

Technology Jaipurfoot HistoryTechnology Jaipurfoot History  Visitors ViewsVisitors Views  The   The idea of making Jaipur foot was first conceived by Mr. idea of making Jaipur foot was first conceived by Mr. Ram Chander Sharma (Masterjee) who designed and Ram Chander Sharma (Masterjee) who designed and developed the foot and the limb.The Jaipur Foot was developed the foot and the limb.The Jaipur Foot was developed in 1968.developed in 1968.

The BMVSS is working under the leadership & guidance The BMVSS is working under the leadership & guidance of Mr. D. R. Mehta and because of his Managerial of Mr. D. R. Mehta and because of his Managerial background this research work could be organized. background this research work could be organized. Indian Space Research Organization (ISRO) (Indian Indian Space Research Organization (ISRO) (Indian equivalent of the NASA of USA), the most prominent equivalent of the NASA of USA), the most prominent Scientific Institution of India, dealing with space research Scientific Institution of India, dealing with space research and products has signed an agreement with BMVSS for and products has signed an agreement with BMVSS for the development of polyurethane foot (instead of the development of polyurethane foot (instead of vulcanized rubber).  vulcanized rubber).  

Handicap International (INDIA)Handicap International (INDIA)

HI activities are carried out by or in partnership with local organizations. Handicap HI activities are carried out by or in partnership with local organizations. Handicap International provides capacity building support (technical, financial and International provides capacity building support (technical, financial and organizational) to enable the partners to sustain their mission and carry out the organizational) to enable the partners to sustain their mission and carry out the activities mentioned below. activities mentioned below. 1. Specialised services as a condition for full participation: orthopaedics 1. Specialised services as a condition for full participation: orthopaedics and rehabilitationand rehabilitation

2. Equal opportunities: Inclusion, visibility and rights of disabled people2. Equal opportunities: Inclusion, visibility and rights of disabled people

3. Public health and disability prevention3. Public health and disability prevention

4. New project areas4. New project areas – Livelihoods for  persons Livelihoods for  persons – Livelihoods for  persons with disabilities in India Livelihoods for  persons with disabilities in India – HIV/AIDS HIV/AIDS – Exploratory mission to disaster prone states such as OrissaExploratory mission to disaster prone states such as Orissa

Indian Indian RedRed Cross Society Cross Society

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

LOTUS Temple (DELHI)LOTUS Temple (DELHI)

Qutab Minar (DELHI)Qutab Minar (DELHI)

Professional BodiesProfessional Bodies

Orthotics & Prosthetics Society of IndiaOrthotics & Prosthetics Society of India

Indian Association of Prosthetist & Indian Association of Prosthetist & OrthotistOrthotist

Indian Association of Rehabilitation Indian Association of Rehabilitation professionalprofessional

ISPO (INDIA) ISPO (INDIA)

Provision of Aids & AppliancesProvision of Aids & Appliances

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

Referral SystemReferral System

PMR Specialist PMR Specialist

Orthopedic SpecialistOrthopedic Specialist

Prosthetist/Orthotist registered under RCIProsthetist/Orthotist registered under RCI

Other Specialist ( ENT, Eye, & Skin Other Specialist ( ENT, Eye, & Skin Specialist)Specialist)

Jaisal Mer (RAJASTHAN)Jaisal Mer (RAJASTHAN)

Persons with disability Act 1995Persons with disability Act 1995

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

Criteria for ADIP assistanceCriteria for ADIP assistance

Disability certificate ( only 40% permanent Disability certificate ( only 40% permanent disabled can get benefits under ADIPdisabled can get benefits under ADIP

Monthly incomeMonthly income

Less than 6500 rupee = 100% subsidyLess than 6500 rupee = 100% subsidy

Between6500-10000 = 50% subsidyBetween6500-10000 = 50% subsidy

Over 10000 = NILOver 10000 = NIL

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)

Why Benchmark?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)

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.

Planning for P&O Training in NZPlanning for P&O Training in NZ

AwarenessAwarenessWillingnessWillingnessCommunication Communication Generation of resourcesGeneration of resourcesDocumentationDocumentationImplementationImplementation

AwarenessAwareness

To carry on the rehabilitation work in NZ To carry on the rehabilitation work in NZ the P&O professionals has to under stand the P&O professionals has to under stand that there if the situation (NO TRAINING) that there if the situation (NO TRAINING) remain same then after 7-10 year there remain same then after 7-10 year there wouldn’t be any body to render services.wouldn’t be any body to render services.

More over on 100% depaendence on More over on 100% depaendence on international work force is not a good idea.international work force is not a good idea.

Resources we needResources we need

Master trainersMaster trainers

Volunteer for infrastructure suppliersVolunteer for infrastructure suppliers

Own funds Own funds ( Annual Subscription & donation)( Annual Subscription & donation)

Request for funds from Govt.Request for funds from Govt.

Sponsorship from local suppliers Sponsorship from local suppliers

Interested learnersInterested learners

Implementation of International Implementation of International curriculum in P&O in NZcurriculum in P&O in NZ

Phase one (Manpower Development):Phase one (Manpower Development):– Training/work shop for local professionals by local master Training/work shop for local professionals by local master

trainers for 3-4 times a year at least for two years. trainers for 3-4 times a year at least for two years. {2009-2011}{2009-2011} (TELE-CONFRENCING)(TELE-CONFRENCING)

Phase Two ( Trainers Development)Phase Two ( Trainers Development)– Advance Training of all professional by international master Advance Training of all professional by international master

trainers,1-2 times a year. trainers,1-2 times a year. {2011-2012}{2011-2012}

Phase Three (Start of Diploma course & Certificate Phase Three (Start of Diploma course & Certificate course in P&O). course in P&O). {2012-2015}{2012-2015}

Phase Four ( Start of Degree Course & then Master Phase Four ( Start of Degree Course & then Master Degree) Degree) {2015-----}{2015-----}

Phase Two ( Trainers Development)Phase Two ( Trainers Development)

– Advance Training of all professional by Advance Training of all professional by international master trainers,1-2 times a year. international master trainers,1-2 times a year. {2011-2012}{2011-2012}