Our Perspectives

Embracing limb difference with open arms


London-based startup Koalaa Soft Prosthetics provides soft, comfortable prosthetic arms and personalised support for babies, children, and adults. But its mission is so much more than that.

With social impact at its heart, Koalaa is building a community for people with limb difference and raising awareness of the challenges they face, as well as their amazing achievements. The team’s transformative products and life-affirming vision are why Howard Group chose to invest in this socially-driven business.

We spoke with Nate Macabuag, Founder of Koalaa, to explore the motivation behind the business, how they’re making meaningful change, and why long-term investors are the key to success.


Reinventing a decades-old design

“Essentially, we’re trying to improve access to assistive technology more widely but at the moment we are focussing on inventing a new way of doing prosthetic limbs,” says Nate. “21 million people in the world have a limb difference – they may have been born with a limb difference or have had a limb amputated due to accident, illness or injury. The statistic that blew me away though was that 93% of those people don’t have access to prosthetic services. It’s not that they have access and opt out, they literally don’t have the opportunity. That just felt like a massive problem. It seemed crazy that we fly space rockets and we have the world’s knowledge in our pockets and yet we can’t get prosthetic limbs, that have been around for thousands of years, to the people who need them.”

Often, the only prosthetic available to those with limb differences is an uncomfortable rigid plastic design that has remained unchanged for decades. Koalaa’s innovative upper-limb prosthetics are comfy, lightweight and breathable: “built like clothes from soft machine-washable material and super easy to put on” says Nate.

Made from fabric, the slip-on material sleeve also comes with various clip-on tool attachments depending on what the wearer needs, from holding a pen and cutlery to riding a bike, playing the drums, doing yoga moves and pushing up on a surf board.

“What we’re trying to do is make devices that people love, that they want to use, and that are actually useful in their lives. And that’s what we’ve been doing since a week before lockdown in 2020.”


Transformative change

There hasn’t been anything else like this on the market and it is changing lives. In fact, ‘life-changing’ is a phrase you see continually when you look at the feedback from people who now wear Koalaa’s sleeves.

Many children are now able to do things that are often taken for granted in childhood such as riding a bike, cutting up their own food or play an instrument, and adults say that they support them with day-to-day tasks such as cooking, writing and dressing, which has given them greater independence and confidence.

While standard prosthetic arms weigh two kilograms, the equivalent of having a standard size brick attached to your arm, Koalaa’s prosthetics weigh around 0.4 kilograms, the same as a trainer, offering a profound difference in comfort for children and adults alike.

“Wearing a rigid prosthetic is like having two bags of sugar hanging off the end of your arm while you’re trying to do everyday activities,” adds Nate. “Most people also have to wait up to six months to get one.”

During the pandemic, Koalaa’s virtual clinic allowed people to be measured, fitted, and supplied with prostheses remotely: “You can fit a person in 15 minutes. And you don’t even have to see them in-person. They send us some simple measurements, and like a shoe we get the right size and post it to them. This enabled us to reach more people across the globe.”

Nate says the other major difference between the dated artificial limbs and Koalaa’s soft prosthetics is the cost: “A traditional prosthetic can cost up to £25,000 not only because of the materials used but also because of the infrastructure and resources required to mould, fit and maintain them etc. This, at the scale required to address the 93% gap, is just not affordable or feasible for most Low- or Middle-Income Country (LMIC) governments and healthcare systems.”



Like-minded partners help to meet long-term goals

Nate says he feels lucky that most of the company’s investors are quite small and care more about the eventual long term outcome than quick wins: “I’ve seen people who have entered the VC world perhaps too early, and they get pulled in different directions at speed to hit milestones quickly. It’s not anyone’s intention but it’s good to constantly push against it and carry on down the long-term path, even if it’s slower in some people’s eyes.

“Howard Group was our very first investor. They got us off the ground and allowed us to develop prototypes and test them.

“When we met the Howard Group team, it was the first time I’d come across a corporate entity who were up-front about their approach and direction - they wanted to have a profitable business and use the funds to make meaningful change. That really sung to us, that they wanted to do good in the world - a perfect fit for us.

“It also showed us that these people and businesses do exist and gave us the clout and confidence to talk to others. Before Howard Group, we were only really talking to individual angel investors who had already made their money and were looking to do something good.

“Howard Group should be a role model for other investors and I wish there were more like them. If you care about something, there are many ways to create change; you can set up a charity or a start-up to achieve it, or you can enable the people who are already genuinely doing it – and that’s the exciting part.

It's honestly quite rare to meet people like Howard Group who genuinely mean what they say. It gives you an example to point to when you’re talking to other investors – that you can achieve all three of Howard Group’s strands (people, planet, profit) at the same time. I don’t see a tension between the three.

“I’m regularly asked why we aren’t a charity but I’m glad we made the decision to be a business. You need a social idea, otherwise what’s the point? Ultimately, the point should be to serve and enrich others collectively. But there’s no point doing that if you consume more value that you put out. So, you need to create actual value and capture some of that value, that’s what business is. Yes, there’s a social benefit but there are also economic benefits – our way is cheaper than what any health system does, yet we can look after more people. If you make something that’s attractive, compelling and does a lot of good in the world then you should be able to commercialise it. Which is great because you can use that commercial income to do more of the good thing.

“Like Howard Group, we live and breathe our social, economic and environment responsibilities and goals. Some people just talk the talk. There’s a lot of greenwashing for example, or people claiming they’re super-diverse because they’ve hired one person from an unrepresented group.

“For us, our products are made for people who are completely underserved, that’s the nature of what we do; we are a business so we need to be profitable to survive; and we don’t have the resources to waste so we reuse a lot of material and are mindful of our environmental obligations - as a start-up that’s baked in.”


Bringing more than just money to the table

In additional to funding, Nate says the thing they needed a lot of help with was raising awareness and letting people know Koalaa exists: “People already involved in prosthetics have heard of Koalaa, but the challenge is being able to stretch outside of the industry and reach the 21 million people with limb differences globally. As well as giving us credibility, our partnership with Howard Group really benefitted us with reaching policy makers and advisors who can influence change.

“They have given us access to groups of people that we otherwise wouldn’t have contact with. They share our story at events and include us in presentations. That’s invaluable.

“We’ve also really benefitted from developing relationships with Howard Group’s other investments and ventures such as mOm incubators. James, founder of mOm, is a few years ahead of us, so I will look to him for advice, he’s brilliant, and Howard Group facilitate this networking. A lot of the problems we face, although we are offering different products and services, are really similar. It’s a win-win as we can share our experiences of being a start-up as there are so many parallels in our stories. There’s a power in that connectivity and bringing people together in this way.”

Nate concludes: “It’s the worst kept secret in the world! If you are genuine and care and focus more on the eventual outcome in the long-term rather than trying to maximise short term returns, inevitably it all comes. People sense you’re sincere and want to provide support which means more output, more people see you, and more people are helped – it’s wonderfully self-fulfilling.”


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