Reconditioned prostheses: In Madagascar, HI addresses the needs of people with amputations

Nanut is a young man of 22. His leg was amputated when he was a child. He now lives in Antananarivo, the capital of Madagascar, where he moved to continue his studies in 2020 after obtaining his high school diploma. Despite passing competitive entrance exams for university, the COVID-19 pandemic prevented him from attending, as it plunged his family into financial difficulties and he had to adapt. Today, he works as a carpenter for a company in Ampasampito, a neighbourhood of Antananarivo. He was fitted a prosthesis in 2022 via the Liimba project, and tells us the story of how a child with an amputation built himself up into the happy and positive young adult he is today.

A good intention that went wrong…

I was just a little boy when I lost my leg, and most of my memories are made of what my mother told me as I was growing up. I was a baby like any other, and when I was 2, my parents took me to the doctor to get vaccinated. A few months later, my right foot started to deform until it became a clubfoot. We never found out whether or not the vaccine had anything to do with it. I continued to grow up with this clubfoot like all the other children, but my parents went on looking for a solution to cure me.

When I was five, they took me to see a practitioner who claimed he could cure clubfoot with massage. After a few weeks of treatment, and with no change in the condition of my foot, the practitioner told my parents that he could perform a kind of operation. This involved making an incision in my ankle, then manually straightening the foot by pushing on the bone. I have no memory of the pain, only that he asked my parents to put my foot in a kind of shoe for a week to maintain the position he had given it during his operation.

A few days later, the wound became infected and my parents rushed me to hospital to have the infection treated. Seeing that the treatment wasn't working and that the infection was starting to spread up my leg, the doctors decided to transfer me to a hospital in the north of Madagascar for a below-the-knee amputation.

My mother told me that it was done quickly, but that she was very sad, not because she knew I would be disabled, but because she was afraid I would die during the operation to amputate my leg.... All I remember is that I loved playing football, and suddenly I couldn't play anymore because my leg had been removed. That's when I realised that I wasn't like my classmates, although I was lucky enough never to have been discriminated against or made fun of at school.

Getting by while waiting for a prosthesis

After my operation, when we left the hospital to go home, the doctors didn’t provide my parents with a crutch or prosthesis - I had nothing to help me get around! Once I'd recovered from the operation, and as I was quite a handyman even at a very young age, I decided to make myself a crutch from a few pieces of metal. It was a start, and I continued to grow up with crutches so that I could go about my life like everyone else.

I received my first prosthesis in 2022 when I turned 20! I'd always wanted one to make my daily life a little easier, and I'd watched videos of people living with prostheses to motivate myself, but they're very expensive and quite rare here... I was so happy when the moment finally arrived! At first, while I was getting used to it, the prosthesis did bother me a bit, but I didn't see that as a negative thing. For me, it was just part of the process, and I was very happy!

During the first two weeks after my fitting, I went back to see the professionals regularly so they could make all the necessary adjustments to my prosthesis. I also had to do exercises to learn to walk properly with it. I remember learning to climb the stairs: the good leg goes first when you’re going up and it's the other way round when you’re going down - the prosthesis goes first! Since then, I've returned regularly to the Centre Hospitalier Universitaire d'Appareillage de Madagascar (CHUAM) in Antananarivo for adjustments and minor repairs.

Supporting the community in his own way

Today, I'm very happy. I can work like everyone else and when people look at me, they can't tell that I have a prosthesis, so I'm not embarrassed. I really feel like I'm the same as everyone else!

I also try to do my bit. When I meet people with disabilities and amputations, I encourage them to have goals and to fight to achieve them, and not to despair. I go to meet them to explain where the CHUAM is and what they do for people who need prostheses, I tell them about my experience. The doctors ask us to spread the word, and it's great to play this ambassadorial role! When people are open to discussion, I also try to encourage them to get in touch with associations. They're a valuable source of information and have links to the institutions, so it's always useful.

At some point on, I'd like to go back to studying languages to improve my French and learn English. I'm also very sporty so, a few weeks ago, I asked CHUAM if they had any prostheses specifically for sports. As luck would have it, they did! I train with it every day, and I hope to be able to play an individual sport in a Paralympic competition one day. But above all, I'd like to set up a sports association for people with amputations! I feel that sport is a good way of opening up to others and helping people with disabilities to fulfil their potential.