The pilot implementation of the “TRIPLE E” model, launched in collaboration with UNDP and AYDER, contributed to the reintegration of individuals who underwent amputations due to the February 2023 earthquakes into socio-economic life

The “Collective Solution” initiative, implemented collaboratively by the United Nations Development Programme (UNDP) Türkiye and the Alternative Life Association (AYDER), aimed to facilitate the social and economic inclusion of individuals with earthquake-related amputations through the TRIPLE E model.

The earthquakes that struck southern Türkiye on 6 February 2023 resulted in the loss of more than 50,000 lives and the collapse of over 313,000 buildings. In 11 provinces with a population of 15.6 million, 3.3 million people lost their homes and living spaces. The economic and social impacts of the disaster were severe: 94,217 workplaces were damaged, and the destruction of public spaces significantly disrupted daily life.

As part of long-term recovery and reconstruction efforts, UNDP Türkiye collaborated with AYDER to launch the Collective Solution initiative. This pilot initiative aimed to develop a model that would provide individuals with amputations access to early treatment and support their reintegration into social and economic life.

In the final quarter of 2023, the pilot study supported the transportation of 20 individuals, identified through local initiatives as having disabilities and amputations in the earthquake region, to Izmir for comprehensive medical evaluation. Participants underwent thorough medical examinations at Izmir Metropolitan Municipality’s Eşrefpaşa Hospital, known as the first municipally operated hospital in Türkiye. Following this, they received secondary assessments from orthopedic and prosthetic-orthotic specialists. Each participant also engaged in one-on-one interviews with AYDER professionals to share their life stories and future perspectives. Their medical reports were reviewed, and personalized consultations were provided to identify the most appropriate type of prosthetic based on their social and occupational contexts. Through this process, their histories, prosthetic needs, and motivations for socio-economic participation were analyzed in detail. The goal was to create a model that addresses both medical needs and pathways to social inclusion for individuals with amputations or disabilities.

Following the pilot phase, the TRIPLE E methodology - Evaluation, Empowerment, Engagement - was formalized, incorporating a three-phase structure: comprehensive evaluation of physical, psychological, and socio-economic needs; empowerment through appropriate prosthetic and orthotic interventions to enhance functional independence; and engagement, supporting active social and economic participation.

During the implementation phase, a consultation team of eight experts, aligned with international standards, was formed to evaluate cases based on medical priorities. Physical assessments and measurements were conducted in Adana and Hatay, initiating the prosthetic production process. To support physical adaptation, video-guided exercise materials were developed, preparing patients for physical therapy. Logistical support from Hatay-Samandağ Municipality enhanced the efficiency of the process. The high level of satisfaction expressed by individuals who received prosthetic applications and the continuation of online follow-ups demonstrated the success of the project.

Thanks to the Collective Solution initiative, seven individuals received high-quality, functional prosthetic and orthotic interventions - four of which were financed by AYDER’s internal resources. The pilot demonstrated the feasibility and scalability of an early intervention model, boosting participants’ potential for social and economic integration. Of the seven recipients, four actively re-entered socio-economic life after treatment: one established her own business, two gained employment, and one experienced a significant personal transformation by starting a family. These outcomes underscore the model’s positive impact on social inclusion and economic reintegration, while high participant satisfaction and the dedication of volunteer medical teams further reinforce the model’s sustainability.

The pilot phase also highlighted the importance of adequate financial resources and local infrastructure for the long-term sustainability of such initiatives. The insights gained will inform future phases and enable a more robust and well-supported application of the TRIPLE E methodology for individuals with amputations in post-disaster recovery scenarios.