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Walking again, despite losing a leg

An official of the International Committee of the Red Cross helps 11-year-old Akuch Ajak Bol with fitting an artificial leg to replace one that was amputated in 2006. Around 80,000 people in Southern Sudan are thought to require artificial limbs, mainly a Anne Kilimo/ICRC
Akuch Ajak Bol lost a leg after his parents, lacking the money for medical treatment, administered herbs to treat a swelling. The result was a severe infection and ultimately, amputation.

"When the leg was cut, I was not sad," Bol, who was nine when the operation was done in Malakal in 2006, said. "I was relieved because it was so much pain."

In November 2008, he was fitted with an artificial leg at a centre built by the International Committee of the Red Cross (ICRC) and the Southern Sudanese government.

Walking up the stairs at the centre, unsupported by crutches, he smiled, aware that only two years ago he had only one leg.

There are an estimated 80,000 people needing artificial limbs in Southern Sudan. About 80 percent, according to the ICRC, were victims of gunshots, mines and shells.

The statistic is a grim reminder of the devastation wrought by the North-South war. The 21-year conflict ended with the signing of the Comprehensive Peace Agreement (CPA) in Nairobi in January 2005.

At that time, Southern Sudanese authorities estimated that 15,000 people needed artificial limbs. In 2006, the Ministry of Gender and Social Welfare revised the estimate to 50,000.

The Commission on War Disabled, Orphans and Widows has lately revised this to 80,000, as remote areas become accessible.

"Many people were injured [but] some were not able to get treatment and have been unable to walk since they were injured in, say, 1994," said Mary Kiden, the Gender, Women and Social Welfare Minister.

Over 19 years to March 2006, some 4,300 patients were fitted with artificial limbs and 2,000 with orthoses - devices that support or correct damaged parts of the body. Another 9,000 received crutches at the ICRC’s centre in Lopiding in neighbouring Kenya.

[Sudan] An example of one of the most commonly used anti-personnel mines in southern Sudan.
Photo: Stevie Mann/UNICEF
A lot of people in southern Sudan need artificial limbs because of landmines
Expanded facilities


To tackle the backlog, it was decided to construct a physical rehabilitation centre in the Southern capital, Juba. After two years, the US$1.8 million, 1,200 sqm centre is up and running.

Aid workers said it had the capacity to fit limbs for thousands of people in a few years. But even then, it would take 40 years to reach all those needing artificial limbs.

As a result, satellite sites in Rumbek to the northwest, Bor to the west and Malakal to the north are planned, officials said. The sites are necessary given the widely dispersed population in a region hardly serviced by roads.

Days before the 5 January opening, Kiden visited the facility. Construction had been sporadic, with officials worried whether the centre would ever be completed.

"He is the fifth head of mission I am meeting," Kiden, said of Marc Ducrey, ICRC head of mission in Southern Sudan, adding that the centre took so long the disabled complained that the government had forgotten them. "I always wanted the work to go very quickly."

Ducrey said: "You have many, many thousands of disabled [people] to whom we will offer a service. It took a long time, but this is a great step we have reached."

An employee of Norwegian People’s Aid tries to detect a land mine, on the Juba-Yei road. Southern Sudan, 29 June 2007. Sudan is a huge country with poor infrastructure. Mine victims are most often from rural areas many hundreds of miles from the nearest
Photo: Manoocher Deghati/IRIN
Mine victims are most often from rural areas of southern Sudan, many hundreds of miles from the nearest treatment centre.
Training


The ICRC stopped evacuating patients to Lopiding one month after the peace agreement was signed. Lopiding was its largest field hospital in the region, with up to 500 beds at the height of the war.

In November 2006, the ICRC and Southern government resolved to relocate the rehabilitation programme to Juba where a small workshop existed. Established by the health department in 1982, it produced 40 appliances a month before the war.

"We said, if we can add more technicians from those already in Lopiding, we can boost production at that centre to maybe 60," Kiden explained.

However, the centre in Juba turned out to be too small. According to the ICRC, only 282 people were fitted with prostheses between July 2006 and December 2008.

The new facilities will significantly increase beneficiaries and cut costs. Each artificial limb costs between $200 and $250 and patients must return every two to three years for servicing and a new device.

Skills would also be passed on to local staff. In 2007, five Kenyan technicians started work at the centre while 26 southerners were training in Rwanda, Tanzania, Khartoum and Kenya to both manufacture and fit limbs.

Ultimately, the facilities, once fully established, should enable more southerners like Bol to contribute to the development of their homeland.

"I want to be a doctor, if only I could be well," Bol said. "Doctors help people to do a lot of things."

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This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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