Afghan Amputees Struggle to Access Services

Disabled people in the southeast Afghan province of Khost say the quality of care at their local orthopaedic centre has deteriorated drastically since it opened three years ago.

Rehabilitation programmes like the one in Khost are vital in a country where so many people have lost limbs in more than 30 years of conflict that has also involved the indiscriminate use of landmines.

Provincial health department head Hedayatullah Hamidi says that 8,600 people are registered as disabled in Khost, a figure that included 4,600 who have lost limbs.

Amputees were delighted when the centre opened in 2011, as they used to have to go all the way to Kabul for treatment – a difficult and expensive trip.

But now they complain that the prosthetics supplied by the Khost centre are of poor quality and break easily, other items like wheelchairs are in short supply, and staff are not always available.

Rahimullah Gorboz told IWPR that the clinic was often closed and that items made by the in-house workshop were poorly-fashioned.

“They made an artificial toe for my foot, but it broke after five days,” he said.

Jalil, an amputee who uses a crutch to walk, said the artificial leg the centre’s craftmen made for him recently was of worse quality than the prosthetics they produced in their first year of operation.

Officials say they are aware the orthopaedic centre has run into problems.

Sayed Karim Khaksar, chairman of the provincial council, acknowledged that there had been complaints.

“We are in touch with the governor’s office. God willing, we are also going to meet health ministry officials,” he said.

Mobarez Mohammad Zadran, spokesman for the governor of Khost province, said his office was trying to resolve the issues.

In Khost’s regional health department and at the clinic itself, staff say it comes down to funding crisis.

Provincial health department head Hedayatullah Hamidi said the orthopaedic workshop was designed to supply prosthetic limbs to Paktia, Paktika, Logar and Ghazni provinces as well as Khost, but its development budget soon ran out and it now survived on a smaller amount of funding.

The director of the workshop, Amanullah Amirzai, said current funding levels were wholly inadequate.

As well as making and fitting artificial limbs, the orthopaedic centre provides physiotherapy. Amirzai said the number of people seeking help had increased massively in recent months.

Since March, 8,000 patients had registered at the centre, whereas in the preceding 12 month, the centre treated a total of 2,100 people. Despite this increase, Amirzai said, most applicants had been given physiotherapy and artificial limbs.

“We are facing really difficult economic problems, but we continue to work because we have a great sense of responsibility,” he said.

On the quality of the prosthetic limbs, he said that people who broke them had failed to follow the instructions staff had given them. As for the lack of wheelchairs, Amirzai said the centre had asked the Red Crescent in Kabul to provide more, but none had arrived yet.

In the meantime, some disabled people like Ajmal have gone back to travelling to Kabul to get artificial limbs.

Ajmal said he could ill afford the trip but had to go because the artificial legs made in Khost were poor.

“I’m a shoemaker,” he said. “If I go to Kabul, I have to stop work for a few days. My family is already going hungry.”

Ahmad Shah is an IWPR-trained reporter in Khost Province.