Finding 1: The devices were wrong for this context. The prosthetics deployed were heavy myoelectric devices: sophisticated technology that requires muscular signal control and significant clinical training to use effectively. For a population with no access to ongoing clinical support, they were functionally unusable in practice. The device choice had been made on clinical grounds without accounting for the actual use environment.

Finding 2: No one had asked about functional needs before fitting. Across our interview sample, almost none of the participants had been asked about their daily tasks, work requirements, or personal priorities before being assigned a device. Physiological fit had been considered; functional fit had not.

Finding 3: Training infrastructure was completely absent. Advanced devices had been provided with no guidance on how to use them. One participant, a young man in his twenties who had lost an arm and a leg, had been given a technologically sophisticated upper-limb prosthesis but had never received any training. He wore it for cosmetic reasons only and rarely used its functional capabilities.

Finding 4: The result was abandonment by default,. Participants weren't rejecting their devices. They were defaulting to not using them because using them was too difficult without support — compounded by devices that were the wrong fit for the context to begin with. A systems failure at two levels simultaneously.