Amputees in Sahrawi refugee camps to receive artificial limbs

29-05-2008 Interview

On 15 May 2008 the ICRC began manufacturing artificial limbs for Sahrawi amputees living in the refugee camps around the town of Tindouf, in south-western Algeria. Monhem Arab, an ICRC limb-fitting technician, explains how he and a physiotherapist have been working in Tindouf for the past year on a project to help the disabled. Monhem Arab, who is Lebanese, has been fitting people with artificial limbs for over 20 years, about half that time for the ICRC.


Monhem Arab during the inauguration of the centre in Tindouf    
     What prompted the ICRC to start making artificial limbs for the victims of mines and other munitions here?  


We estimate that between 350 and 450 people living in the refuge camps around here need prostheses. Many of them have been disabled by antipersonnel mines or explosive remnants of the figh ting, in some cases long after it stopped in 1991 following the ceasefire between Morocco and the Polisario Front.

When a device like a mine or a mortar shell explodes, it can kill a person. Even if it doesn't kill, it can cause grave wounds requiring amputation of one or more limbs, disablement and psychological trauma. The victims require physical rehabilitation for long periods.

This new limb-fitting and rehabilitation centre will enable local people to be trained in techniques of limb-fitting and physiotherapy, which is essential to sustaining the project over the long term. Any artificial limb needs to be repaired, adjusted and ultimately replaced. Once fitted, therefore, a person needs follow-up for the rest of his life.

Since 1979, the ICRC has operated or supported 85 limb-fitting and rehabilitation projects in 26 countries. In 2007, the organization furnished such services for over 150,000 people throughout the world, fitting 22,309 prostheses and 32,123 orthoses, manufacturing 36,850 pairs of crutches and 2,909 wheelchairs, providing physiotherapy and repairing artificial limbs and orthotic appliances. In the Middle East and North Africa, the ICRC has supported 15 projects, including one in Algeria, 10 in Iraq, one in Lebanon, one in Syria and two in Yemen. 
The project is the first step in the ICRC's'contribution to alleviating the effects of contamination by mines and other unexploded munitions throughout the area affected by the Western Sahara conflict.

 What will this project do for disabled people?  

We'll be using polypropylene technology – it's simple and the material is resistant, cheap and recyclable.

Being close to the patients is also very important. By operating a centre right here – the only one anywhere near Tindouf – we can take rapid action where needed and we can do a lot to keep costs down. Until now, the disabled people here had to travel abroad have prostheses made, and again later every time maintenance was needed. This was difficult, and in some cases maintenance was impossible. By the way, during their stay the patients will be accommodated in the new centre itself.

 How does a limb-fitting and rehabilitation centre work?  

The first thing we do is assess the patient's needs. He may be a mine victim, for example, but he may instead be a polio victim. This is done by the technician and the physiotherapist together, who then decide on the devices that have to be made for the patient. A file is opened on each individual and a record is kept of everything done in connection with him. Most people don't stay longer than five days, but some need more adjustments than others. The physiotherapist has a special role to play in strengthening certain muscles and helping the patient to remaster everyday tasks.

The process of fitting an artificial leg lasts two to three months for adults and between three and six months for children. Since a child is growing, the prosthesis needs more adjustment. After this initial fitting phase, the patient returns for regular repair and adjustment.

 You have cared for thousands of disabled people in your career, in places like Tajikistan, the Caucasus, Africa and recently Iraq. What memories stand out.  


Seeing an amputee who arrived at the centre in a wheelchair walk out unassisted, tha t's extremely satisfying. The happiness you see on the patients face always makes you forget whatever difficult conditions have to be dealt with in your work, here in Tindouf as everywhere else..