Abderamane Issa, 40, raises cattle in the town of Boya, 40 miles from Bambari, in the west of the Central African Republic. After having both of his legs amputated following a severe infection, Abderamane was cared for by HI's specialists and fitted with a pair and artificial limbs. He can now stand again and has returned to his village and his family.
Overcoming fear, stigma
At the end of 2021, Abderamane noticed a worrying lump on his right leg and consulted a number of traditional healers in the region. They diagnosed him with poisoning and tried to treat the wound. The result was an infection that made Abderamane's situation even worse. In excruciating pain and with no other solution, Abderamane finally went to Bambari Regional Hospital. After a series of examinations, the doctors had no choice but to prescribe an urgent amputation, as the infection in his leg was very advanced and had become life-threatening.
Initially, Abderamane was reluctant to accept the doctors' recommendations; he was afraid that he would have to stop raising livestock – his only source of income. He met HI’s rehabilitation and psychosocial support teams when he arrived at the hospital.
Saddam-Bi Chaouaibou, HI's social mediator in Central African Republic who has been working closely with Abderamane, describes how he helped him come to terms with his amputation:
"During the sessions, Abderamane was very worried about the consequences of the operation. He was afraid he would no longer be able to go about his daily life and that he might be stigmatized. The HI team supported him with personalized psycho-education sessions and talked to his parents to explain that the amputation was crucial – the only thing that could save his life. This support reassured him and he was able to accept the idea of the operation.”
"The HI team often came to visit me. They made me smile and above all, they reassured me by explaining the procedure I was about to undergo. Sometimes they just came to say hello, and that cheered me up," adds Abderamane.
Despite their precautions, because of Abderamane's very fragile state of health and the progress of the infection, the surgeons had no choice but to amputate his second leg.
After his operation, Abderamane was reunited with HI's team. They supported him during his rehabilitation and the preparation for his future artificial limbs.
"I had never heard of devices that could help amputees walk again. After my operation, I started to lose motivation. The HI teams explained to me what a prosthesis was and what it would do for me, but I wasn’t convinced. Then one day, on my way to the HI rehabilitation center to do my exercises, I saw a woman who had just returned from Bangui and had a prosthesis. From that moment on, I started to hope again."
After the operation, HI’s team supported Abderamane throughout the treatment process, with sessions to motivate him and help him maintain a positive mindset. A witness to Abderamane's determination and renewed taste for life, Saddam-Bi Chaouaibou explains:
"As soon as he saw this woman walking with a prosthesis, he immediately regained hope and was so motivated that he kept urging us to go to Bangui to get him fitted."
In June 2023, Abderamane was finally able to join the teams in Bangui, more than 300 miles from home, to be fitted with his two artificial limbs. He spent three weeks getting used to them. The Association Nationale de Rééducation et d'Appareillage de Centrafrique (ANRAC), HI's partner, made the prostheses and supported him as he took his first steps. Abderamane then returned to Bambari Hospital to present his devices to the HI team. He was already able to walk without crutches and was eager to return to his village to be reunited with his family and cattle.
Preparing for a return to everyday life
Abderamane had to be patient while the HI rehabilitation team made sure he had adapted to the new devices. The psychosocial support team made the most of his presence to prepare him for his return home so he would be able to cope with the stares and react as well as possible to any potentially cruel reactions to his artificial limbs.
"When I was first amputated, my family's attitude towards me changed a little. My father took my new physical condition very badly. I was an extra burden and I had the impression that he was angry with me. But when I came back with my prostheses and he saw that I could walk again, I felt that he looked at me differently and was reassured."
Preparing the return home is an important component of the support process. Abderamane participated in motivational discussions and psycho-education sessions to alleviate his fears and doubts and boost his self-confidence. Psycho-education sessions were then organized with his family to explain the importance of his artificial limbs and the care and support he would need on a daily basis.
"This preparation is also to help prevent any risks and complications by explaining how to avoid them. Amputees will be starting their life from scratch, so it's important that they adapt to this new situation and that they take care of themselves and their prostheses," adds Saddam-Bi.
When HI members asked him what advice he would give to people in the same situation as him, Abderamane replied that he would explain to them that the first thing to do is go to the hospital to see doctors rather than ask healers for advice. For those with mobility problems, he would reassure them by sharing his experience:
"I'd tell them that there are other solutions, like the prostheses I received thanks to HI."
|The RIMSCASSA project, which combines integrated physical and functional rehabilitation and stimulation therapy with mental health and psychosocial support activities at the Bambari Hospital, was launched in July 2022 in six countries: Mali, Central African Republic, Democratic Republic of Congo, Rwanda, Chad and Somaliland. It was funded by the German Ministry of Foreign Affairs. Between July 2022 and June 2023, the RIMSCASSA project provided 6,054 patients with rehabilitation treatment (including 1,086 in CAR), 1,818 children with stimulation therapy (including 555 in CAR) and supported 28,669 people suffering from psychological distress (including 1,745 in CAR).