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Just days after the first “paraastronaut” moved a step closer to approval for space station missions, a new study says space exploration’s efforts to increase diversity hold valuable lessons for health professionals on Earth.
European Space Agency (ESA) reserve astronaut, surgeon and former Paralympic runner John McFall could be considered for space in the future International Space Station Following a recent feasibility analysis of (ISS) missions, an ESA-led effort found no significant issues that posed a mission risk when an ISS astronaut used a prosthesis. While not guaranteed spaceflight, McFall could become the first person to board the ISS with a prosthesis in a quarter-century of operations.
“This is a potential opportunity to send a strong message to society and to humanity and to challenge the narrative that exists around people’s expectations of what people with physical disabilities can do,” McFall told reporters during a live-streamed press conference last week. (A recording was provided to Space.com by ESA.)
Inclusion is the theme explored in a new study published Thursday (July 25) in the journal Communications Medicine, the day before National Disability Independence Day today (July 26). The study argues that McFall’s example is a moment for health care organizations to promote accessibility through initiatives such as upgrading equipment, changing training and improving selection criteria for employees.
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The Communication Medicine study is not directly linked to McFall’s feasibility analysis, but one of its authors (Jennifer Ngo-Anh) was coordinating ESA science activities, including the ISS. Ngo-Anh recently moved to ESA’s directorate for commercialization, industry and competitiveness.
Lead author Fahran Asrar, a clinician and associate professor at the University of Toronto, says the team was inspired by ESA’s paraastronaut program and prosthetic-wearing cancer survivor Hayley Arceneaux, who flew on the privately funded Inspiration4 mission with SpaceX in 2021.
“We are looking at how space technology and the space sector can make a positive difference to challenges we face on Earth, such as public health, environmental health or other social aspects that can help our patients,” Asrar told Space.com.
Asrar said McFall is a striking example of a healthcare sector that has struggled with inclusivity; that inclusivity can always be improved in the space, but that other sectors, such as healthcare, need to keep pace with this development.
“There’s a lot of research that shows that people with disabilities are less likely to be employed than people without disabilities,” he said. “Other statistics and information make a lot of references to what we call ableism, where individuals just assume, ‘Oh, this individual can’t do it’ or ‘They can’t do medical training and medical roles.’”
Asrar’s team includes Dana Bolles, an engineer and communications specialist who lost both legs during an interview with her employer NASA. Initially inspired by the astronaut program, Bolles later earned a degree in mechanical engineering not only because of her interest but also because she uses a wheelchair and medical equipment: “I thought having that skill and knowledge would be useful not only in my work life but also in my daily life.”
Bolles is an ambassador for the nonprofit AstroAccess program, which places people with disabilities on parabolic aircraft to conduct scientific research. The 2021 flight examined assistive devices for spaceflight.
One of the biggest challenges in Bolles’ career, he said, has been people “making assumptions about what I can’t do,” which can reduce opportunities for meetings or conversations. “That can be tough to overcome, depending on who that person is,” he said.
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Asrar’s inclusion study rightly highlights the fact that spaceflight is in itself disabling. Despite precautions, all people flying on the ISS experience muscle weakness, fluid shifts, and other body changes. If the mission lasts for weeks or months, long-term rehabilitation under medical supervision occurs after the flight.
On the other hand, the microgravity of space could provide greater accessibility for some people with disabilities, Asrar said. Perhaps, he thought, it might be possible to use McFall’s (if he gets one), Arceneaux’s and others’ missions “to translate all that experience — technological capabilities to help in space [to] “For the benefit of people with disabilities around the world.”
According to his biography, McFall’s leg was amputated in a motorcycle accident when he was 19 years old. He later went on to win a medal as a sprinter at the 2008 Paralympics, but also earned several medical certifications, including general surgery, urology, and basic surgical training covering trauma and orthopedics. McFall wears a prosthetic when necessary; this prosthetic is available for training activities and any spaceflights he may be selected for.
“I will need to wear a prosthetic during launch, which means wearing it inside a spacesuit. And that’s to meet the minimum emergency requirements that come up during launch,” McFall said, referring to evacuation procedures. “I will also need to wear a prosthetic in orbit to take exercise countermeasures to protect my body from the effects of microgravity.”
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The feasibility analysis covered many aspects of McFall’s prosthesis, including making sure it was compatible with ISS exercise equipment such as a treadmill and bike, and whether changes in the volume of his stump would affect how his prosthesis fits his body. McFall said the analysis has only examined the ISS environment so far, but future efforts could also consider spacewalking.
“If we can show how methodically and thoroughly we did this study and present the results in a very logical and reasoned way, there’s really a lot of power for people to be more open-minded to participating in these types of studies in the future,” McFall said. “We’re really setting a precedent.”
McFall is not a full-time ESA astronaut and has not received all the agency’s basic training. Instead, he is part of the agency’s reserve group for possible short-term opportunities in spaceflight and has undergone familiarization classes. One reserve astronaut from McFall’s group has recently been to space: Swede Marcus Wandt flew to the ISS on the weeks-long Axiom Space Ax-3 special mission earlier this year.