With words of happiness, Mohamed Suleiman Abu Madi, a resident of Khan Yunis in the southern Gaza Strip, spoke about his experience in using a smart electronic prosthesis that brought him back to normal life, gave him hope and helped him grip objects, even the smallest ones, and integrate with people without shame, after he had been covering his amputated arm for years.

HH Sheikh Hamad Bin Khalifa Al-Thani Rehabilitation and Prosthetics Hospital in the Gaza Strip, funded by the Qatar Fund for Development, has raised hope among the people of the Gaza Strip whose limbs were amputated during the Israeli wars and aggressions, after the Prosthetics Department manufactured smart electronic limbs and supplied them within the framework of the first phase of 21 amputees in the Gaza Strip, while during the second phase, expected next September, 40 other smart prostheses will be installed for urgent cases and productive groups within the Palestinian society.

Since its operation in April 2019, the hospital has provided its services to more than 14,000 patients and people with disabilities through its three main departments: Prosthetics Department, Hearing and Balance Department and Medical Rehabilitation Department, while the Prosthetics Department at the hospital installed 263 lower limbs, 65 upper limbs, 428 limbs devices and 162 chiropractic devices until last May.
The Medical Rehabilitation Department received more than 8,000 beneficiaries in the in-patients departments, day-care and outpatient treatment and provided its services through various and comprehensive rehabilitation units for rehabilitation medicine, physical and occupational therapy, speech and swallowing, while the Hearing and Balance department provided its comprehensive services to more than 6 thousand beneficiaries.

The idea of a smart limb is based on the use of electronic electrodes placed directly on the amputated part and taking the command through the brain and sensory nerves, and then turning this command through the electronic hand and microprocesses technology into a movement such as opening and closing the hand, which helps the patient to control the grip of objects naturally.
Speaking to the Qatar News Agency (QNA), Abu Madi says that he was finally able to use his right hand after many years of suffering from a motor disability due to the amputation of his hand.
Abu Madi, who lost his hand at the age of five, adds that the loss of his hand negatively affected his psyche and made him feel that something was missing, especially when he was a child, as he used to cover his hand with a sock so as not to reveal the amputated part in front of people around him.
"But today, after I installed a smart prosthesis, I feel happy, my life has returned to normal, and here I am drinking with my hand, going to the market and carrying shopping items with my hand, even a small rose I can hold in my hand," he said.
Abu Madi and 20 other Palestinian amputees were able to install an electronic prosthetic hand that they can use and move through the brain control that sends motor signals to each of the muscles and nerves connected to that prosthesis, and what distinguishes smart limbs is being functional and cosmetic at the same time, according to Dr Ahmed al-Absi, head of the Prosthetics Department.
Dr al-Absi told QNA that the prostheses rely on the sensitive electrodes inside the electronic hand, where it takes the signal from the brain and converts it into movement, so the patient can open and close his hand, in addition to handling all the tools he wants.
Al-Absi pointed out that the Prosthetics Department is working to provide an integrated treatment circle for people who need prostheses, which is divided into three stages, including psychological and physical rehabilitation, and then producing and installing the limb, and then training the patient to use it, confirming that all these teams dealt with the cases for which an electronic limb was installed and worked to help all patients in order to accept the idea of an electronic prosthesis.
"At the beginning, there was a difficulty in accepting the smart prosthesis and fears of how to deal with it, but today we can say that we have 21 success stories," he said.
For his part, Director General of Sheikh Hamad Hospital Dr Nooreddin Salah said that the Prosthetics Department is equipped with the latest technologies and devices and has obtained the best limbs from the largest international companies, the German company Otto Bock, pointing out that the German company provides them with the best prosthetic materials, while the limb is manufactured entirely by skilled local hands in a workshop affiliated to hospital.
He added that the installation of prostheses needs multiple stages, especially for children who are going through different phases."In the previous stages, we used to install cosmetic prostheses, as well as prostheses for athletes with a movable joint.
However, the important precedent and the first event at the level of the Middle East region was the installation of smart electronic upper prostheses for Palestinian youth and boys, which sets a precedent because the upper limbs have much higher functional tasks than the lower limbs, such as drinking water, holding pens and papers, and for the doctor, holding surgical instruments,"he said.
Dr Salah explained that smart limbs are being installed to restore the functions of upper limbs because the installation of the limb means restoring the patient to his usual lifestyle and integrating him into routine life as he was in the previous state before he was subjected to amputation.
He reiterated that the first phase included the installation of 21 smart upper limbs for both young and children.
About 40 other prostheses will be presented in the second phase, expected in September.
As for the mechanism of limb manufacturing, Dr Salah pointed out that both types of prostheses, whether cosmetic or smart electronic, are manufactured in a workshop affiliated to Hamad Hospital by skilled local hands trained from international experiences in previous stages.
He affirmed that the priority in the installation of prostheses is usually for productive groups within the Palestinian society, such as teachers, doctors, boys and girls, because these categories constitute productive and sensitive segments within the Palestinian society."We are interested in restoring these important parts of society to their normal lifestyles and integrating them into the Palestinian society," he said.
Dr Salah thanked the Qatar Fund for Development, the main financier of the hospital, confirming at the same time that the high financial costs of the upper and lower limbs pose a dilemma and a great challenge, and said that the cost of a conventional cosmetic prosthesis may reach seven thousand dollars, while the cost of a smart electronic prosthesis reaches more than $16,000.
He explained that some cases have complex disabilities and need more than one prosthesis, the latest of which is the case of 11-year-old girl Rahaf Salman, who lost her legs and hand during the recent Israeli war on the Gaza Strip, she needs several prostheses, and a quick intervention to psychologically rehabilitate the girl and help her accept prostheses and how to deal with them, because those who lose part of their body are exposed to trauma and urgently need the intervention of a psychologist.
Omar Shawa, prosthetics and devices specialist at the hospital, spoke about the stages of preparing the prosthesis, and said that the patient is first shown to an orthopedist for examination and obtaining preliminary approval to start preparing and installing the limb.
Shawa added: "For the installation of the prosthesis, we take the measurements by gypsum to make the appropriate mold for the patient, and then adjustments are made and the experimental mold is prepared and the patient is trained to wear and handle it," explaining that the patient deals with the experimental mold for a specified period before the final limb is prepared for him.
In the case of smart limbs, Shawa says that they study the patient's condition first to determine the best place and the right muscle to place the sensitive electrodes, and the electronic limb is installed and tested in a final session, and then the patient is trained to deal with it.
According to the data of the Ministry of Health in Gaza, 122 Palestinians have had their lower limbs amputated because they were targeted by the Israeli occupation army during the Return Marches that have been going on along the borders of the Gaza Strip since March 2018, in addition to 14 others who lost their upper limbs.
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