Sudan: new limb, new confidence and a life renewed

24-01-2011 Feature

Forty-five years after losing her leg in an accident, Apai Marceline is enjoying a new lease of life after receiving a new prosthesis, thanks to the expertise of staff at an ICRC-supported rehabilitation centre.

Apai Marceline walks gingerly around the Physical Rehabilitation Reference Centre (PRRC) in Juba, Southern Sudan, steadily getting used to her new prosthesis and seemingly unbothered by the noise from the newly built highway outside the facility that straddles the 50-bed institution. As one of 50 or so patients at the centre, she is looking forward to completing her rehabilitation and going home, having completed her course of treatment that ended with the fitting of a prosthesis to one of her legs.

The PRRC in Juba is located not too far from what could pass for the city centre, an area marked by a fountain that forms a roundabout and runs parallel to the famous Customs Market. Dwarfed by one of the several ‘jebels’ (mountains) that dot the Juba landscape, it was built, equipped and funded by the ICRC and started operations in 2009. It is now managed jointly by the ICRC and the Southern Sudan Ministry of Gender, Child and Social Welfare under a technical agreement that will run until 2014.

A memorable stay

Apai has been at the centre for three weeks, a period during which she, like every other patient, has been accommodated at the ICRC’s expense. This is the average time it takes a beneficiary to receive the appropriate service, and soon Apai will be on her way home after what has been a memorable stay at the PRRC.

“I have made friends here. When we eat together, practice walking with our new artificial legs or just laze around in the evenings waiting for the prosthesis to be fully customised, we socialise, and in those circumstances you're bound to make friends and share experiences.”

Apai’s experience is symptomatic of the challenges facing many of those caught up in the wars that have ravaged Africa. Fleeing the conflict in her native Democratic Republic of Congo (DRC) into neighbouring Sudan, she took shelter in Lasu Refugee Camp run by the UNHCR and continued to find herself in the throes of conflict.

Her flight was not made any easier by the fact that she had only one foot, her leg having been amputated at the age of five. “When I was a child,” she says, “I tripped over some wood while walking and got injured. The injury became infected and doctors had to amputate my leg as not doing so would have put my life at risk.”

Apai hobbled along on a homemade prosthesis for a while but had to abandon it when she outgrew it. She recalled being angry when she saw other children walking and playing but could do nothing to improve her mobility. She craved being able to do everything those kids did. She recalled developing the uncanny ability to ‘jump’ to school with the aid of a stick.

Her struggle with a 45-year-long mobility problem ended when a team from ACROSS-Sudan (a voluntary social benefit organisation) took her from the refugee camp in Lasu to the PRRC. Here, her condition was assessed before she underwent the full rehabilitation programme and proudly received her prosthesis.

''This is my first prosthesis and I am very happy. I will practice to use it properly. Here the staff are good and friendly, the atmosphere is nice and there is food and water. I feel confident.''

Rehabilitating those in need – cost free

The PRRC takes in patients requiring orthopaedic appliances and helps to rehabilitate them at no cost whatsoever. Patients come in and stay at the centre alone, without the intrusion of curious and often anxious family members. Cases treated at the centre by its 17 trained orthopaedic technologists mostly involve gunshot wounds (70%) or mine injuries (20%), while infections, snake bites, accidents and other ailments make up the rest.

As might be expected, the more than two decades of armed conflict between North and South Sudan which ended in 2005 have left a deadly legacy, not least the menace posed by the explosive remnants of war, especially mines. That South Sudan reportedly has some 41,000 people in need of orthopaedic appliances informed the decision to set up the PRRC. Its services include pre-fitting physiotherapy, disability assessment, limb prosthetics and orthotics, elbow crutches, walking frames and referral for medical treatment.

In 2010, over 1,200 people benefited from the centre’s facilities. The ICRC also supports similar centres in Khartoum and Nyala, managed by the Sudanese National Authority on Prosthetics and Orthotics (NAPO).

As Apai's case has shown, the PRRC provides prostheses for all those who need such treatment, whether war-wounded or not. If what Apai has said is anything to go by, a prosthesis does something more: it gives beneficiaries the confidence to get on with their lives as never before.



Physical Rehabilitation Reference Centre in Juba, Southern Sudan. Apai Marcelinereceives advice from an ICRC physiotherapist.
© ICRC / J. Warren


Physical Rehabilitation Reference Centre in Juba, Southern Sudan. Apai Marcelinepractises walking with her new prosthesis.
© ICRC / J. Warren