New hope for amputees

A high incidence of war injuries and poor medical facilities have left Angola with one of the world's largest populations of amputees, but peace is bringing greater access to organisations that can help them. In Luena, the provincial capital of Moxico in eastern Angola, the Vietnam Veterans of America Foundation (VVAF) runs one of eight orthopaedic centres that help amputees get prosthetic limbs, while the Angolan NGO, Centro de Apoio a Promocao e Desenvolvimento de Comunidades (CAPDC), provides psychosocial support. About 85 percent of the patients are landmine victims. Women, men and children of all ages are brought from three provinces – Moxico, Lunda Sul and Lunda Nord – to the VVAF workshop in Luena. After undergoing some physical training, between 30 and 40 patients receive prostheses from the centre each month. Almeida Manuel, a 44-year old photographer, has just begun his training in preparation for receiving his first prosthesis, which is being made in the factory in the same building. "I lost my leg in 1992 in Malanje. I drove out from the city without knowing that the front line of UNITA ran across the road - I hit a mine and it exploded under my car. It was around 2 pm when I got to the hospital. The doctor said he had much to do and left me there. When he came back the next day my whole leg was infected. He said he could no longer save it - all he could do was to amputate", Manuel said. He spent five months in hospital before he went home to the northeastern province of Lunda Norte, but two weeks later the war started again and he had to flee into the forest. Manuel did not see his home town again until 1998. By then he was used to walking with a stick, but earlier this year, when CAPDC approached him with a prosthesis, he did not hesitate. "My life is going to change when I get my new leg. I am a photographer and will be able to work properly - get closer to people and travel longer distances", said Manuel. "A person who has not used a leg for a month can lose 30 percent of his power. The ones that have not used their legs for over 10 years need a lot of training before they are ready, but it is possible," Graziella Lippolis, a physiotherapist at VVAF explained to IRIN. "Most of them will be able to walk, to run and to work with their prosthesis. Some might have problems and will have to walk with one crutch to feel comfortable." Manuel will probably spend around four weeks at the centre before he is ready to return home with his new leg. The greatest challenge is to teach the patients to put weight on the stump and get the muscles active again. "After such a long time without a leg, the mental image of the body has changed and the patients have to learn to adapt to it again," Lippolis commented. VVAF and CAPDC are conducting a survey to assess the impact of prostheses on the lives of amputees. A study conducted in 2000 provided negative feedback, showing that people who had lost a limb above the knee often only wore their prosthesis for aesthetic purposes, such as dressing up to go to church, and preferred crutches to cover long distances because it was quicker. People who were amputated below the knee usually used their prostheses. Lippolis expects this year's survey to provide a more positive picture, after the success of projects like Sports for Life, run by the VVAF, which have drawn keen interest from amputees. "Before, many amputee athletes came drunk to the sport clinics. Now they are coming more often, behaving, and their lives are improving", she said. "The dedication and change in attitude is already opening doors for them." Their basket ball team even tours around the country to play against provincial teams. According to Sports for Life programme manager, Anita Keller, the events are providing the amputees with opportunities to advocate for their needs to local government officials and members of the national assembly. Besides the physical and psychological trauma, female amputees face another social problem - their husbands often leave them because they are incapable of doing all the housework expected of them. CAPDC has started a microcredit project to help single women with children and, in many instances, the women's newly found financial independence has persuaded the husbands to return. The atmosphere at the centre is relaxed and friendly - men play board games, women chat, and the children, who seem to cope best with their disability, play in the courtyard. Among them is the orphaned 12-year-old Calala Baribanga, who fell out of a mango tree and broke his leg badly. For a long time he tried to sustain himself, but his new leg will bring other opportunities. "I hope I can go to school now. One hand will be free when I only need one crutch. That means I can hold my books with the other."