Lahore – Not all disabled people are lucky enough to afford artificial limbs. Not only that the materials used in the manufacturing of artificial limbs are costly, taxes and duty over the import of these materials adds to the end price of these limbs.
Classified as space age materials owing to their toughness, reliability and lightweight, costly materials used in manufacturing artificial limbs include fibreglass, high grade alloy aluminium, titanium, stainless steel and carbon fibre.
ORTHOTICS > PROSTHETICS
Professionally, the artificial limbs are categorized into prosthetics; which are replacement of lost body part, and orthotics or braces; which are fitted over the body to support or assist the body in performing certain functions. People who suffer polio or other paralytic conditions need orthotics and braces, while people who lose their limbs require the prosthetics to be fitted which mimic the natural limbs in look and function. The ratio of orthotics to prosthetics requirement is 70 to 30 therefore more people need orthotics than prosthetics.
It is a fact that artificial limbs industry never developed in a country already lacking in manufacturing facilities. Most of the components of prosthetics like hip-knee-ankle joints, feet and hands are ‘finished goods’ usually imported from industrialized western countries, where China has succeeded in grabbing a big share of the business.
DISABLED PRODUCTION, IMPORT DEPENDABILITY:
These prosthetic components mentioned as ‘finished’ parts above are although exempt from the import duty but are still very expensive. The essential material required for custom fabrication of orthotics or prosthetics are thermoplastics (polypropylene), fibreglass, stainless steel and high grade aluminum alloy. Most of the organizations in Pakistan are only assembling the parts and deliver the finished artificial limbs to disable persons and earn profit like other trade items.
A huge amount of foreign exchange is spent on importing artificial limbs but SRO is not giving any relief nor does it encourage to set-up artificial limbs industry in Pakistan. Although these are ordinary industrial materials but in order to use these in prosthetics these are converted to a specific limb grade materials and are regarded as value added materials and are imported from the same countries. The problem is that there is no duty exemption on these materials and customs authorities put them in the ordinary industrial category and are levied high taxes.
DISABLING THE HANDICAPPED
According to Dr Khalid Niaz Niazi, a rehabilitation and prosthetic expert of Mayo Hospital and Hope Rehabilitation Society President, the break-up of duties and taxes charged on the import of artificial limbs materials are 20 percent custom duty, 17 percent General Sales Tax and 3.5 percent Income Tax. “All these taxes, duties and manufacturing cost are being paid by the disable persons indirectly who are already living below the poverty line in society,” Dr Niazi added.
Dr Niazi is of the view that a large part of the handicapped population is living without proper facilities and is isolated by the mainstream because they cannot pay high prices of artificial limbs, while only the rich can buy the modern artificial limbs. The government on the other hand also does not open the centres for proper training for manufacturing artificial limbs. Lack of training has given birth to a large numbers of quacks, which were running artificial limbs businesses, and are selling century old heavy weight and uncomfortable wooden limbs.
It is very clear now that although the government of Pakistan has exempted duties on prosthetic finished parts but it is not giving any relief on imported material used in manufacturing the artificial limbs. “If the government relieves duties and taxes and subsidises the artificial limbs industry, the situation can improve,” said Dr Niazi. He said high tech electronic leg is very popular in Europe and is available at Rs 10 million, Chinese electronic wheel chair is available Rs 250’000, and it could be manufactured in Pakistan at half the price. If we start this technology in country we can save a huge foreign exchange but also export it.
HOW MANY?
Dr Noman Shakeel, an orthopedic surgeon at Jinnah Hospital, said that due to road accidents, occupational incidents, trauma, diabetes, heart and cancer diseases the amputation cases are increasing every day and only at Jinnah Hospital the surgeons amputate one leg every week. Another alarming scenario is the large number of teenage girls being deprived of their hands in fodder cutter machines in rural areas. Shamshad Ahmed Qureshi, UNICEF former program officer said that recognized disability population is 2.5 percent in country, according to the last census, although WHO provides a rough estimate of 10 percent of the world population suffering from one or the other disability. The ratio of mental retardation is very high followed by the physical handicap. The other types are visually handicapped, hearing and speech disorder.
Out of 3.6 million disabled people some 2 millions could be physically handicapped and if the government provides artificial limbs to these people, they could form the artificial limbs industry themselves increasing its volume to Rs 60 billion, he said. “We can convert disables into useful citizens of the country by promoting the artificial limbs industry in Pakistan. In Germany 90 percent high tech limbs were invented and produced by disabled persons,” he said.
TRADING LIMBS (ARTIFICIAL)
