26 Mar

Steeper Prosthetist Assists Opening of Prosthetic Service at Kagando Hospital in Uganda

Steeper Prosthetist Assists Opening of Prosthetic Service at Kagando Hospital in Uganda Steeper Prosthetist Assists Opening of Prosthetic Service at Kagando Hospital in Uganda Steeper Prosthetist Assists Opening of Prosthetic Service at Kagando Hospital in Uganda
The World Health Organisation (WHO) estimated that 80% of the world’s disabled population live in developing countries. Disability is often considered to lead to stigmatisation by wider society, with many disabled people, including amputees, unable to lead normal lives.

In Uganda alone, there are thousands of people who require a prosthetic or orthotic device, which combined with an average daily wage of 98p, has resulted in many disabled people unable to access the health and rehabilitation services they require - as well as finding it difficult to work and marry. Against this background of need, Uganda’s prosthetic and orthotic services themselves are struggling with under-resourced facilities, weak supply chains and a lack of national strategy.

90% of amputations in Uganda are due to trauma, many of which are the result of road traffic accidents or landmines. There has also been a sharp rise in Type 2 Diabetes along with Leprosy still being a significant issue in this area of Africa, with many children being affected. One Ugandan hospital reported performing almost 100 amputations in one year, most made up of children abducted and forced to fight as child soldiers.

About the Kagando Hospital
The Kagando Hospital is situated on the equator, close to the border of the Democratic Republic of Congo (DRC). Kagando is a General Hospital treating all types of medical conditions and carrying out routine surgical procedures. It is also a teaching hospital, and provides health services including palliative care and specialist seating for the community. Patients will often cross the border from Congo to access treatment at the hospital.

Charity Support
Friends of Kagando is a registered UK charity who were set up to support Kagando Hospital in Western Uganda, by raising vital funds, providing equipment and creating a support network for those who work there.

Nine years ago I visited Kagando with the charity and realised the need for a Prosthetic and Orthotic service in the area. The Red Cross had previously run a rehabilitation clinic several hours away in Fort Portal, but this closed down several years ago and there has been no prosthetic service in Western Uganda since.

My visit led to some detailed researched and I eventually approached Rotary International, who agreed to fund a new prosthetic service at Kagando Hospital. Working in partnership with the hospital and the local Rotary Club, funding was used to build a new Jaipur Limb Workshop - complete with equipment and materials.

The Jaipur Limb Initiative
The Jaipur limb was developed in India, and consists of a socket and shin made from Pelite (foam), water pipe, and a foot manufactured from recycled tyres. Transfemoral prostheses have a plastic thigh section also made from water pipes, and side steels with locking knee joints. These prostheses are waterproof, very durable, and the foot is compliant when walking on slopes and over uneven ground.
The Limb Workshop
Keen to support this project, Kagando Hospital recently appointed Ronald, a technician who has trained in both prosthetics and orthotics at the main hospital in Kampala. The Kagando Prosthetic Workshop was then officially opened on 28th January this year, where Ronald has already started to treat patients and produce prostheses.

Patients are assessed, cast, and the prostheses manufactured by Ronald on site. He uses a GRADIA laser alignment system to ensure the correct bench alignment of the prostheses, and can also be used to align both transfemoral prostheses and orthoses. As well as prosthetics, the centre also provides specialist seating, footwear for Leprosy patients, and in the future is hoping to develop an orthotic clinic.

Patient Success
Uganda has a relatively young population, with many amputees being children who have been born with congenital deformities that are not commonly found in the UK. One particular case has stuck in my mind of a young five-year-old boy whose mother bought him to one of the rural outreach clinics run by the rehabilitation team. He had managed to get a prosthesis when he was three, but this was now too small and the patient was unable to walk due to the discomfort of the socket. Also at some point, the prosthesis has been repaired using part of a tree to replace the shin and foot.

It was a positive experience to work with Ronald to assess the child and know that he was to be invited to the Prosthetic Centre at Kagando to receive a new prosthesis. The Kagando Prosthetic Service although only operational for a few weeks, is already making a difference to people’s lives.

A Huge Thanks and Future Support
Friends of Kagando are very grateful to the Rotary Club for the funding of the centre, and Kagando Hospital is now responsible for all costs going forward. This includes Ronald’s monthly salary and the cost of each new prosthesis. On average, a below-knee prosthesis costs them £58 to produce, and an above-knee prosthesis £89, with each device intended to last approximately five years.

The hope is that each patient would pay for their prosthesis which would make the service self-sustainable, but unfortunately with the level of poverty in Uganda it is unlikely that many patients will be able to afford the full cost. This presents an ongoing challenge for the hospital.

If you would like to receive updates on the service at Kagando Hospital, or would like to know how you could support the prosthetic centre, please contact me via: Gradia.prosthetics@gmail.com

Want to find out more about Friends of Kagando? Visit their website: