Name
Thomas Iwalla
Role
Training Co-Ordinator – International Committee of the Red Cross ICRC
Institution
Sana'a University's Faculty of Applied Medical Sciences
Country
Yemen
Years in O&P / Rehabilitation
Over 30 years of experience in Orthotics, Prosthetics, and Rehabilitation.
What first drew you into prosthetics, orthotics, or rehabilitation?
In prosthetics and orthotics, some careers begin in classrooms, others in workshops, and a few in carefully mapped institutional pathways.
Thomas Iwalla’s began in a war zone.
Nearly three decades ago, as conflict escalated in South Sudan, a young nineteen-year-old Thomas watched waves of amputees and severely injured civilians transported across the Kenya–South Sudan border into Nairobi in search of rehabilitation. Many arrived from Lokichokio, exhausted from conflict, displacement, and delayed medical attention. They came with traumatic limb loss, spinal injuries, and complex mobility impairments—human reminders of what happens when violence outpaces health systems.
At the time, Thomas had just completed high school and was preparing for priestly novitiate while teaching mathematics and English grammar. Prosthetics and orthotics was not yet a career he had imagined for himself.
But humanitarian need has a way of redirecting vocation.
The few rehabilitation providers available then were quickly overwhelmed. Existing centres struggled under the sheer volume of demand, and the burden of transporting patients long distances for care became unsustainable. In many cases, the costs of travel, accommodation, feeding, and logistics exceeded the rehabilitation intervention itself.
A difficult but practical realization emerged: if rehabilitation services could not adequately reach people, then rehabilitation capacity had to be taken closer to where people lived.
It was within this moment that Thomas stepped into what would become his life’s work.
He became one of the first resident staff members to receive on-the-job prosthetics and orthotics training in Lokichokio, learning alongside South Sudanese trainees in an improvised but urgent model of humanitarian workforce development. What began as a response to crisis soon evolved into a professional calling defined by one central conviction: mobility, dignity, and function should never be luxuries reserved for those living near well-funded hospitals.
“War revealed to me that disability becomes even more devastating when systems are unprepared. Rehabilitation was not simply technical work—it was a means of restoring human dignity.”
What does your current role involve day to day?
Today, twenty-eight years later, Thomas Iwalla stands as one of the region’s seasoned Certified Prosthetist-Orthotists and educators, currently serving as Prosthetics and Orthotics Training Coordinator under the International Committee of the Red Cross in partnership with Sana’a University Faculty of Applied Medical Sciences.
Working in Yemen—a country where prolonged instability has placed immense strain on physical rehabilitation services—his daily responsibilities stretch far beyond classroom teaching. He coordinates academic lecturing, practical clinical demonstrations, curriculum design, programme implementation, institutional evaluation, and mentorship of resident faculty. His teaching areas include Orthotics, Orthopaedic Biomechanics, Material Science, Research Methodology, and Clinical Leadership.
What has been the most important lesson you have learned as a department head or educator?
If asked what truly defines his work, Thomas does not begin with lectures or laboratories.
He speaks instead about systems.
LEADING WHEN SYSTEMS ARE FRAGILE
Leadership in prosthetics and orthotics is often imagined as departmental administration or academic oversight. But in many low-resource and conflict-affected settings, leadership means something much more fundamental: holding programmes together while the larger system around them remains unstable.
Thomas has spent much of his professional life doing precisely that.
What mistakes or false assumptions taught you the most early in your leadership journey?
“The most important lesson,” he reflects, “has been learning to remain calm and level-headed in the face of persistent systemic failures.”
Those failures are rarely dramatic in a single moment, but corrosive over time: inadequate budgeting, weak policy attention, poor representation to decision-makers, fragmented professional networks, and the continued struggle for prosthetist-orthotists to be fully recognized as healthcare providers.
What are the biggest gaps you see in current O&P education or clinical training?
In some environments, he notes candidly, prosthetist-orthotists are still misunderstood as technical fabricators rather than clinical specialists—“shoe makers,” as he describes the stereotype, or at times merely assistants attached to other professions.
That professional invisibility carries consequences. When a workforce is poorly understood, it is poorly funded. When it is poorly funded, it remains too small. And when it remains too small, millions continue to live without access to assistive rehabilitation.
Thomas has watched this cycle repeat itself across countries, institutions, and humanitarian settings.
And he believes this remains the profession’s greatest unfinished challenge.
What skills do you believe are still under-taught in today’s training environment?
EDUCATING FAR MORE THAN FABRICATION
This conviction has shaped Thomas’s teaching philosophy.
He is deeply concerned that some modern training environments still reward technical replication over analytical reasoning. Students may learn to fabricate devices, yet remain underprepared to defend why a certain design, alignment, material, or biomechanical strategy is clinically appropriate.
For him, confident clinicians are not produced by workshop repetition alone.
They are developed when students learn to gather evidence, document outcomes, measure intervention impact, and translate theory into practical solutions for real human mobility problems.
Just as importantly, he believes several competencies remain persistently under-taught across the profession:
critical thinking,
effective communication,
research literacy,
documentation,
and innovation.
These skills, though less visible than fabrication, determine whether future prosthetist-orthotists can influence policy, contribute to scholarship, justify service budgets, and communicate the value of rehabilitation to ministries of health and hospital administrators.
In short, they determine whether the profession can lead rather than merely serve.
What do you see as the biggest challenge facing O&P departments over the next five years?
For all the excitement surrounding digital manufacturing, artificial intelligence, and advanced materials, Thomas insists that the biggest issue facing prosthetics and orthotics over the next five years is neither technological adaptation nor innovation fatigue.
It is workforce collapse.
There are too few trained prosthetist-orthotists globally. Those available are unevenly distributed. Low- and middle-income countries—where the burden of untreated disability is often greatest—continue to experience the harshest shortages. Even in wealthier nations, rural communities remain underserved while urban centres absorb most specialists.
The result is a familiar and troubling picture:
long waiting times,
delayed intervention,
preventable deformity progression,
reduced functional independence,
and widening inequity in access to rehabilitation.
For Thomas, these are not isolated service inefficiencies. They are symptoms of a deeper systems failure rooted in underinvestment and weak long-term planning.
How should educators prepare students for a future shaped by digital workflows, AI, and advanced manufacturing?
“Technology alone will not solve this,” he says. “You can have scanners, CAD/CAM systems, or 3D printers, but without trained people, regulated systems, and policy commitment, the access gap remains.”
His argument is strikingly simple: the future of O&P depends less on what machines can fabricate and more on whether nations are willing to build, distribute, and retain the professionals who use them.
What is one change you would most like to see in the IMEA O&P sector?
Thomas describes current service limitations as a “human resource scarcity loop”—a cycle in which too few professionals lead to weak services, weak services lead to low visibility, low visibility leads to poor funding, and poor funding produces too few professionals again.
Breaking that loop, he argues, requires deliberate creation of a virtuous cycle:
stronger rehabilitation policy,
dedicated financing,
expansion of accredited programmes into underserved regions,
faculty development pathways,
title protection and professional regulation,
mandatory licensing with continuing professional development,
and national workforce planning.
This is not glamorous reform. It is patient institutional work.
But Thomas knows from experience that sustainable rehabilitation has never been built through isolated heroics. It is built through systems that continue functioning long after individual experts have moved on.
What part of your work gives you the greatest satisfaction?
THE QUIET REWARD OF SEEING OTHERS RISE
Ask Thomas what gives him the greatest satisfaction after twenty-eight years, and the answer is immediate.
Not the devices.
Not the titles.
Not the humanitarian deployments.
His greatest joy, he says, comes from watching former students and graduates step into leadership roles of their own—becoming department heads, clinical managers, educators, and national service providers who begin strengthening their countries from within.
For an educator, there is no clearer evidence that the work has multiplied.
One graduate becomes many patients served.
One faculty member becomes an entire future training cohort.
One leader becomes an institutional culture.
This, perhaps, explains why Thomas remains hopeful even amid professional frustrations.
What keeps you optimistic about the future of the profession?
He has witnessed prosthetics and orthotics move steadily from craft toward science—from plaster and improvisation toward biomechanics, biomaterials, bionics, digital workflows, and evidence-based rehabilitation. He sees a profession increasingly defined by intellectual curiosity, technological possibility, and an expanding commitment to quality of life.
But he also knows that progress cannot happen in isolation.
His one wish for the IMEA prosthetics and orthotics community is both modest and profound:
greater connectedness.
Stronger professional networks.
Shared mentorship.
Cross-border collaboration.
A sense that no department is solving these problems alone.
Because if Thomas Iwalla’s career has demonstrated anything, it is that the future of rehabilitation has never depended on individual craftsmanship alone.
It depends on whether a profession learns to build itself together.
Best advice ever received:
Stay calm when systems are chaotic; competence has its own endurance.
One resource every young clinician should read:
ABC of Clinical Leadership and current evidence-based rehabilitation literature.
One skill every future CPO must master:
Critical clinical reasoning grounded in biomechanics.
Biggest frustration in the sector:
Persistent professional invisibility despite overwhelming service demand.
One reason to stay hopeful:
The profession is rapidly evolving from craft to globally respected science.