Andrew Mwangi is a Prosthetics and Orthotics Officer at Humanity & Inclusion in Kenya. In the Kakuma refugee camp and the Kalobeyei settlement, he helps people with disabilities access artificial limbs.
When Andrew was younger, he saw someone wearing an artificial limb for the first time.
“I was captivated,” he recalls. “I wanted to know how it was made.”
He turned his fascination into a career, learning how to fabricate and fit artificial limbs, braces and other assistance devices. In December 2021, he joined Humanity & Inclusion to work with refugees and host communities in Kakuma.
“I had not done humanitarian work before, but I was interested in working in that context,” he explains.
Daily life in the field
Andrew is one of 36 full-time Kenyan staff who live at Humanity & Inclusion’s compound near the refugee camp. Staff rotate through 8-week cycles at Kakuma, with 2-week breaks to visit home and decompress, before returning for another two months.
Andrew is the only full-time prosthetics and orthotics officer working at the camp, which has a population of more than 240,000 people. He spends each day of the week visiting one of Humanity & Inclusion’s three rehabilitation centers that are spread throughout the refugee camp, as well as its facility in the nearby Kalobeyei settlement.
“The demand for our services is quite high,” Andrew explains. “I’m covering the four camps and host community. In a given week, I will only visit each place once.”
Andrew does have the support of six technical aid workers—refugees who have been trained in basic fabrication and repair of mobility devices—who staff the workshop at each rehabilitation center. Each workshop includes a cabinet stocked with basic tools and supplies. Crutches of all sizes line the walls. Walkers, wheelchairs, orthopedic shoes, toilet seats, wooden scooters and other mobility devices can also be found.
Journey to fitting
Once someone in need of an artificial limb is identified and assessed—either at the reception center or by staff in the community, the person’s amputated limb is routinely measured and shaped, to ensure proper fitting. The individual also participates in rehabilitation sessions to strengthen their muscles, and learns how to care for their stump and mobility device. Once a person receives their artificial limb, they complete training so they can walk, balance, climb stairs and complete other movements.
Andrew and his team see people who have required amputations for a number of reasons: gunshot wounds, explosions, snake bites, road traffic accidents, diabetes.
The waiting list for artificial limbs and braces is long, and funding is limited. In an average year, Andrew explains that Humanity & Inclusion's program at Kakuma has the budget to provide new artificial limbs for 20 to 25 people, and orthotics—such as special shoes or leg braces—for around 85 people. The waiting process can take more than a year because artificial limbs must travel over 125 miles to reach people who are being fitted with them.
Gatkuoth, 17, pictured with Andrew in the lead image, is on the waiting list for an artificial limb.
The boy’s leg was recently amputated after he sustained a gunshot wound in September 2021. Initially identified at the reception center when he arrived in Kakuma from South Sudan, Gatkuoth is undergoing three months of stump-shaping. Andrew and his team measure the circumference at different points along Gatkuoth’s residual stump, taking note of changes over time.
“Once it stabilizes, we will know it won’t shrink any further, and then he can be fitted,” Andrew explains, showing Gatkuoth how to wrap a bandage around his leg. Andrew undoes the bandage so Gatkuoth can give it a try himself. Gatkuoth is expected to receive his artificial limb in September 2022.
Provision of artificial limbs, braces and other assistive devices is based on a selection with emphasis on disability, gender and age.
“If fitting someone with an artificial limb will help them enroll in school, we will make them a priority,” Andrew explains.
These actions are supported by the U.S. Department of State Bureau of Population, Refugees and Migration.