Low- to middle- income countries like South Africa have a high burden of patients with hand injuries. The impact of hand injuries is magnified when many people rely on informal trade and manual labour to earn a living, and where basic services such as running water and electricity may be unavailable.

In a setting where regaining hand function is so essential to daily life, patients are typically seen by generalist occupational and physiotherapists who do not have any formal hand therapy education and who lack mentorship and support.

These therapists also face a lot of challenges in the settings where they work, such as late referrals, delayed surgeries, a lack of basic hand therapy supplies and poor access to healthcare.