On a Thursday morning, an 11-year-old girl in the Dominican Republic entered a medical clinic with the assistance of crutches, which had been a necessary part of her life as a foot amputee. On the following Friday afternoon she walked out of the clinic crutch-free, using a commercial-grade prosthetic foot from the United States brought to the clinic by doctors working for Physicians for Peace.

While this effort meets the immediate needs of a few patients, it is not a viable long-term solution to treat the hundreds of amputees in the country needing prosthetics, but a University of Arkansas biological engineering faculty member and his students hope to change that.

The two major causes of amputations in the Domini-can Republic are diabetes and vehicle accidents, and the country doesn't have an adequate emergency medical system to care for the victims of these circumstances.

Doctors usually opt to amputate a leg that has been badly damaged in an accident rather than try to save it, because if they tried to save it and the patient doesn't receive adequate follow-up care, infections and other complications might develop, putting the patient's life at risk.

"Physicians for Peace is meeting most of their needs, but it's not sustainable," explained Tom Costello, associate professor of biological and agricultural engineering, an academic department housed jointly in the College of Engineering and the Division of Agriculture. "They're dependent on the tie-in from the U.S., and Physicians for Peace would like to move on to another country or another clinic and leave this current clinic in some kind of a situation that they could handle on their own.

"So what we're trying to do is come up with prosthetic designs that are relatively simple and easy to manufacture that they could make cheaply in their own country and not have to rely on commercial parts from the U.S., which are very, very expensive. A foot would cost them more than a year's salary. They wouldn't do it. They'd be on crutches instead of walking around."

Costello said the idea to work with the clinic and Physicians for Peace came from his students. At the beginning of every fall semester, he challenges senior biological engineering majors in his senior design class to use their engineering knowledge to solve a problem.

"Some of the students were interested in prosthetics," he recalled. "So they started searching around and came across this idea of a need in developing countries and how it's probably more practical for us to design simple things for them than it would be for us to try to compete with prosthetic companies that spend millions of dollars on research and development. In the process of doing that, they ran across Physicians for Peace. They contacted them and discovered they were in the midst of working with a clinic in the Dominican Republic."

This marks the second year Costello has had students in his senior design class working to engineer and manufacture prosthetics. Last year his students designed an arm that earned them a national design award from the Rehabilitation Engineering and Assistive Technology Society of North America.

After traveling to the clinic in Santo Domingo, Asociación Dominicana de Rehabilitación, Costello learned that the Dominicans are in greater need of lower extremity prosthetics and assigned this year's students to design a knee, a foot and a machine to test them.

Julie Abbott, Audrey Bearden and Linda Tarantino worked together to design and manufacture a foot. Sarah Elder and Matt Walker were on the team responsible for the knee. And the third team, charged with making a testing machine, was Nathan Helms and Aaron Strobel.

This year's goal was to manufacture three knees and three feet to give to a prosthetist who is traveling to the Dominican Republic in August to try out the designs and gather feedback. Based on that feedback, the next class of seniors could improve this year's designs or discover a new need to address.

Tarantino's chief role was to design, manufacture and test a foot that could be made of inexpensive components and easily replicated in the Dominican Republic. The design she developed is a fiberglass laminate that is constructed by cutting out strips of fiberglass, soaking them in a bonding compound, laying them on top of each other in a wooden mold covered in duct tape and using a hydraulic press to exert enough force to bond the layers together.

Tarantino, who was raised in Venezuela and speaks Spanish, traveled to the Dominican Republic twice. As a junior, she accompanied the senior class before her to serve as a translator and discover how to best fulfill the amputees' needs. The second time, she went as a senior to gather technical information. She spoke with patients about issues with their current prosthetics and learned what materials and tools were available to the clinic that could be used to make prosthetics.

Both trips taught her lessons she wouldn't have learned otherwise.

"In my major, you have the engineering part, and you also have the close relationships with the clients," she reflected. "The people are your clients. I have to work with patients and ask for feedback from doctors. That part of these trips was great because I got exposure to building that relationship with the client as an engineer."

Walker was responsible for designing and building a knee that could be easily produced in the Dominican Republic. He came up with a single-axis knee that is less bulky, although less stable, than multiple-axis knees typically used by commercial manufacturers. He decided to go with the sleeker design after receiving feedback that it is preferred by Dominican patients and more compatible with social norms.

While he didn't have an opportunity to travel to the Dominican Republic, his experience on a team charged with devising a solution was a valuable aspect of his education.

"It's helped me learn a lot more of how to take lead of a team," he said. "It was a great experience because I got to learn how to go through designing, prototyping, building, testing, all that stuff that engineers do. So I really got to see everything in a practical application."