In 1982, two doctors working in refugee camps in Thailand started helping survivors of landmine explosions who had been injured fleeing across the heavily mined border. There they met Gniep, a young girl who had lost her leg after stepping on a landmine. Gniep was one of the first children ever supported by Humanity & Inclusion. This is her story.
I was 5 years old, living under the Khmer Rouge regime in Cambodia, four long years in absolute darkness of uncertainty, anguish and fear. In 1979, fleeing misery and hunger, I left my village with my aunt, leaving everything behind, believing that it was temporary.
Antipersonnel landmines were all over Cambodia. To this day they still kill and mutilate an alarmingly high number of people. At the time, we were not informed about the risk they posed. While in the camp, I went to fetch water and that’s when it happened: I stepped on a mine.
I remember it as if it were yesterday; the violence was such that I was thrown in the air. Stunned and dizzy by the shock of the explosion, I did not know that I had just stepped on a mine. I tried to get up and walk three times before understanding that my right leg was torn off at the calf, and that the left one was badly affected, too.
By instinct of survival, probably, I moved myself to a path, where two soldiers passing by found me and brought me on their motorcycle to a makeshift dispensary. There, the analgesic I was given was a stick that I had to bite on when the pain became too much.
Then, I was transferred to a refugee camp in Thailand commonly known as Khao I Dang. I had to undergo 17 operations because the surgeon wanted to preserve the joint, but my leg was gangrenous and I fell into a coma for a month.
Not long afterward, I met the founding members of HI. They were a small group of young people, who were friends, husbands and wives, full of enthusiasm, their heads full of dreams and ideals, animated by a crazy desire to help people like me who had been stripped of everything. With great humanity and respect, they put me back on my feet again.
My first prosthesis was very simple, made of recycled materials like wood, car tires, and resin. I admit that I had a hard time accepting it because it was heavy and hard to put on.
It's hard to believe that was 40 years ago. Today, despite my disability, I lead my life like everyone else. I am a night nurse, working for young people with multiple disabilities. And I am a mother of a young and beautiful girl. I am so very grateful to those women and men who helped me all those years ago. They gave me back my smile and dignity, which everyone should have!
Thwol, 60, had her leg amputated several years ago following complications from diabetes. At the Kalobeyei settlement in Kenya, Humanity & Inclusion offers her rehabilitation, an artificial limb and psychosocial support.
Thwol sits on a quilt, shaded by a tarp at the back of her home made of natural materials at Kalobeyei settlement in Kenya. A large piece of fabric is draped over her lap, with colorful and intricate patterns of beads that she’s added one by one. She counts each line, picking up the correct bead from the small tin beside her, threading it with a needle and placing it meticulously. Chickens, provided to her family by the World Food Program, peck the ground around her.
The beading is something she brought with her from Ethiopia, her home country that she left more than 10 years ago. Beading is “my culture,” she explains, simply.
Beading keeps Thwol busy. The repetition and creativity are therapeutic. The craft has given her a way to connect with her neighbors and generate income. Beading, along with rehabilitation and psychosocial support from Humanity & Inclusion, helped bring Thwol out of a dark place where she found herself after complications from diabetes required doctors to amputate her leg.
Providing artificial limbs
Thwol was living in Dadaab refugee camp in the eastern part of Kenya, when she began to notice peeling and swelling of her right foot. Humanity & Inclusion’s specialists referred her to a hospital, where her leg was amputated below the knee. She was fitted with crutches and an artificial limb.
When Thwol was moved from Dadaab to Kakuma, another refugee camp in northwestern Kenya, Humanity & Inclusion’s specialists working at both camps communicated to ensure she received follow-up care. By the time Thwol arrived at Kakuma, her crutches were in need of repair and she needed a new artificial limb. Humanity & Inclusion’s team equipped her with new crutches right away, and she was added to the list of people awaiting prosthetics-fitting.
“Humanity & Inclusion is the only organization providing prostheses at the camp,” says Andrew Mwangi, Humanity & Inclusion’s prosthetics and orthotics officer. “The funding is never enough for the need."
Humanity & Inclusion can guarantee new artificial limbs for about 25 people living in Kakuma every year. The process from the time a need is identified to when a person begins walking with their new leg can be long.
"We give people crutches first for walking as we strengthen their muscles of the affected limb, then we do stump-shaping and desensitization before booking them for fitting and gait training,” Mwangi adds.
Children need new artificial limbs every six months or so as they grow, though adults can typically get by with repairs in between necessary replacements.
For Thwol, her artificial leg has given her a sense of independence.
“Before, I could not move from one place to another,” she says. “Now, I can go places, to the market, to church.”
Sense of community
Humanity & Inclusion’s psychosocial support team also works with Thwol, helping her to cope with her disability. Through counseling, Thwol came to realize the importance of channeling her energy into something productive like her beadwork.
“She can use her hands to make beading,” explains Wilkister Nyamweya, Humanity & Inclusion’s psychosocial support officer. “She meets with other women—with and without disabilities—to teach them this craft. It’s given her a sense of belonging and satisfaction.”
Thwol pulls herself across the quilt in her backyard, lifting herself into a chair and strapping into her artificial leg.
“My life has changed,” she says. “With all of the help from Humanity & Inclusion, I have a life now. I’m still alive.”
These activities are funded by the U.S. Department of State Bureau of Population, Refugees and Migration.
After surviving an explosive remnant of war accident, Enayatullah’s right leg was amputated. Now, he’s walking again with the help of an artificial limb and rehabilitation care provided by Humanity & Inclusion.
Enayatullah, 9, was playing with a group of children in his village in Afghanistan, when they came across some explosive remnants of war. The devices exploded, killing four of them and injuring six others—including Enayatullah and his eight-year-old cousin. No one knows for certain what kind of explosive remnants the children found, but they were most likely munitions left over from the fighting in the area in 2021.
Enayatullah was rushed 20 miles to Mirwais Regional Hospital in Kandahar where he stayed for 40 days. The surgeons tried to save his right leg, but it was too damaged and had to be amputated. When his health improved, he was referred to Humanity & Inclusion’s rehabilitation center, which first opened in 1996.
During the first sessions, he was very nervous, still traumatized by the accident. But he gradually learned to trust the team and worked hard on his physical therapy exercises.
Since his first consultation in November, he has visited the center five times for physical rehabilitation sessions. He was also given walking aids, had a cast made for his artificial leg and attended fittings until the device was finally ready for use. In the future, Enayatullah will return to the center to have his artificial limb repaired and replaced as he grows.
Today, Enayatullah is independent and able to walk on his own again. He can play with his friends, go to school and visit relatives. He likes to play with toy cars and wants to be a truck driver when he grows up.
Chue Por lost his arm in a landmine explosion 15 years ago. With the support of Humanity & Inclusion, he has regained his independence and advocates for explosive weapons to be banned.
In January 2007, Chue Por was fishing with friends in northeastern Laos when he pulled a landmine out of the water. It exploded in his hand. He was rushed to the hospital, where the doctors amputated his arm. His family sold all their livestock and borrowed money from their neighbors to save his life.
Chue Por, who was 18 at the time of the incident, dropped out of school because he felt too dependent and different from his friends. Because of his amputation, he could no longer work on his parents' farm or find other ways to help support his family.
Humanity & Inclusion met Chue Por in 2019 and referred him to a rehabilitation center, where he was fitted with an artificial hand and given physical therapy.
"Thanks to Humanity & Inclusion, I am supported both physically and psychologically,” Chue Por says.
Rediscovering sense of purpose
Today, Chue Por is receiving training to become a volunteer in his village and support people with mental health issues. He also participates in inclusion activities to help people with disabilities find their place in the community.
Chue Por grows rice and beans to sell, so he can support his family.
"Today I can clearly see the positive changes in my life,” he explains. “I am happy to be with my family and to look after my cattle.”
Chue Por is engaged in advocacy efforts supporting the Mine Ban Treaty, the Cluster Munitions Convention and other international frameworks to prevent the use of landmines and other explosive weapons during war.
When she was 2, Aminata contracted a disease in her left hand, the cause of which remains unknown. Despite numerous consultations in health centers and with traditional healers, her hand had to be amputated. Now 10, Aminata is enrolled in school and has a new artificial limb with support from Humanity & Inclusion.
"In 2014, my daughter was left with a missing upper limb,” says Youma, Aminata’s mother. “It was a terrible shock for the whole family, totally darkening our future.”
In 2019, a community agent referred Aminata’s family to Humanity & Inclusion. Teams encouraged Aminata's parents to enroll their daughter in an inclusive school that welcomes children with and without disabilities, where the teachers are trained to use adapted teaching methods and tools.
"Shortly after Aminata enrolled in school, her father died,” Youma explains. “We lost all hope for a while. Fortunately, together we had the strength to overcome this painful ordeal.”
With Humanity & Inclusion’s support, Aminata received an artificial arm. The organization accompanied her family throughout the medical process and paid related expenses.
"When Aminata received her prosthesis, we were very relieved that she had been fitted,” Youma remembers. “It was as if she had a 'new arm'. My daughter was really happy to have this prosthesis.”
As part of the project, Aminata also received a complete school kit, including a school bag, pens and notebooks. This was a relief for her family, who could not afford to pay for the young girl's supplies.
In December 2021, Aminata's family moved more than a mile away from the school she attends in Mali.
"I was worried because I thought she would drop out of school because of the distance to our new home," Youma explains. "But Aminata was never discouraged, and she continues to go to school."
Since her enrollment, Aminata has been attending school regularly. Currently in fifth grade, she dreams of becoming a police officer.
"Today, Aminata is my greatest hope," Youma adds.
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.
Tok, 27, lost his leg in a work accident. Over the last two years, Humanity & Inclusion has provided him with an artificial limb and rehabilitation care in Laos.
Five years ago, Tok was hired to cut down a tree that was touching a power line. When the tree fell, it crushed his left leg. Tok managed to call his brother, who rushed him to hospital, but his leg was too badly damaged and had to be amputated. Tok’s acquired disability presented challenges and prevented him from performing certain everyday tasks.
In 2020, Humanity & Inclusion referred Tok to its rehabilitation center, where he received physical therapy and an artificial limb. Since then, Tok has regained independence.
Today, Tok’s living conditions have improved significantly. He can work again and has started to raise livestock. He is also employed by the Lao electricity board, collecting data on electricity consumption, distributing bills and collecting dues.
Tok has also joined a group of red mushroom producers and received training in the bamboo value chain, which has helped boost his income. In the future, he hopes to expand his farm and keep goats.
Advocating for disability rights
Tok has also received training from Humanity & Inclusion and Group for Research and Technology Exchanges (GRET) on disability rights and inclusion.
Now a community volunteer, he advocates against discrimination and promotes understanding, acceptance and awareness of the rights of people with disabilities and the importance of their inclusion. He also provides peer support.
His goal is to remove the physical barriers encountered by people with disabilities.
"People with disabilities need support to access public services and opportunities to improve their lives," Tok explains. "I have received a lot of support and it has changed my life."
Amina, 7, was seriously injured in a missile attack during heavy fighting in Afghanistan in July 2021. She’s learned to walk again, with rehabilitation care and an artificial limb from Humanity & Inclusion.
Amina was walking to school with her parents and sisters when the missiles struck. Her mother and two of her sisters were killed in the attack.
Her father was also injured, causing paralysis of his right arm. He lost his job. To survive, he now sells chewing gum and cookies from a cart outside his house and is supported by relatives and neighbors. (Amina and her father are pictured above.)
Amina is close with her father, who is now a single parent after his wife’s untimely death. He promises to be there for his daughter, to play with her and to help her overcome the trauma of losing her mother and sisters.
Learning to walk again
Amina’s right leg was so severely injured that she required a surgical amputation. Since January 2022, Humanity & Inclusion’s physical therapy specialists have been teaching her to walk again.
The team measured her leg to make a customized artificial limb, and gave her mobility exercises to do at home. She was also given a walking frame to help her get around on her own until her artificial leg was ready.
After a few weeks, Amina received her artificial limb and began rehabilitation sessions at Humanity & Inclusion’s rehabilitation center in Kandahar to help her adapt to it.
When she started her rehabilitation, Amina was sad and frustrated. She found it challenging to walk with her artificial limb without the help of a walking frame. But the many exercises paid off, and today she can walk on her own.
Amina’s most recent visit to the rehabilitation center was in March for a consultation and some minor repairs to her artificial limb. She will continue to visit the center regularly to replace and repair her artificial leg.
Humanity & Inclusion’s physical rehabilitation center in Kandahar is the only facility in the area where people with disabilities are provided with services free of charge.
HI's rehabilitation center
Located in Kandahar, Humanity & Inclusion's rehabilitation center treats people with conflict-related injuries, often caused by explosive devices. Survivors of serious accidents, patients with diabetes-related amputations and people with polio are also among those receive physical therapy services. The center is staffed by 52 professionals specializing in physical therapy or psychosocial support work. It is the only rehabilitation center in southern Afghanistan.
For 18 months, Longini was unable to walk; he had outgrown his artificial limbs and Covid-19 lockdowns prevented him from getting new ones. If he was going to get back on track, Longini needed replacements as soon as possible.
Longini, now 9, was born with lower limb deformities. When he was 3 months old, his mother, Elisabeth, took him to the nearest hospital, and he was referred to an orthopedic hospital in Ririma. As other children took their first steps, Longini was still unable to walk. When he was 3 years old, doctors performed a double amputation so he could wear artificial limbs later in life.
In between working odd jobs to support Longini and his younger brother, Elisabeth sought out educational opportunities for Longini. After years of searching, she found HVP-Gatagara—a leading center for the rehabilitation and education of people with disabilities in Rwanda. More than 30 miles from their home, the center includes an inclusive boarding school. At 6 years old, Longini was finally enrolled in school.
But Longini’s greatest dream was to learn to walk.
At nearly $900 each, artificial limbs are particularly expensive in Rwanda. Few patients can afford the assistance devices, including Longini’s family. Humanity & Inclusion stepped up to help. The complex housing Longini’s school also includes a rehabilitation center and orthopedic-fitting workshop supported by Humanity & Inclusion. For families unable to afford care, Humanity & Inclusion provides financial assistance.
Fitted with two custom-made artificial limbs, Longini took his first ever steps as a 7-year-old. In no time, he was running around and playing enthusiastically with his friends. His life changed completely.
As a growing boy, Longini regularly needs new artificial limbs. Unfortunately, the Covid-19 pandemic and the strict measures taken by the government to protect the population meant the orthopedic center had to close its doors. Longini outgrew his worn devices, and it was 18 months before he could be fitted with new ones in November 2021. Longini will need rehabilitation care and artificial limbs for the rest of his life.
‘A joy to watch him now’
Longini is in his second year of primary school, where he lives most of the time.
“When he comes home for the holidays, he can do small jobs around the house, like the dishes or sweeping the courtyard,” Elisabeth adds. “He loves being with other people, going out and running about the local streets with them. All children like him.”
A hard-working student, Longini repeatedly tells his mother he wants to finish his studies so he can get a good job, earn money and support his family.
“My son’s life hasn’t always been easy but it’s a joy to watch him now,” Elisabeth says. “It’s wonderful he’s included with other children. It’s so uplifting.”
After losing his leg in a road accident, Sandip was fitted with an artificial limb by Humanity & Inclusion and its partners.
In Nepal, road accidents are the second most common cause of injury. When he was 14, the truck Sandip was riding in was involved in a traffic crash in Chitwan. He was seriously injured.
“Doctors had to amputate his leg above the knee immediately to prevent further infection,” his mother Sukumaya explains.
Trials of isolation
The accident caused Sandip to have limited mobility. A sixth grader, he ultimately dropped out of school.
“Having lost my leg, I was ashamed to go out or to school,” Sandip says. “I did not see myself going anywhere as I could not walk. As a result, I started staying home, playing games on my phone, and cutting myself off from the outside world.”
Fortunately, Sandip’s family heard about an upcoming health screening camp in their community, providing different services for children with disabilities. These services were implemented by Humanity & Inclusion and its local partners, including Autism Care Chitwan Society, as part of the UK-funded Inclusive Futures Program.
The power of rehabilitation
After the health screening camp, Sandip was referred to the National Disabled Fund, Humanity & Inclusion’s partner, which provides rehabilitation services. The teenager was fitted with an artificial limb, but he didn’t believe he would ever walk again.
“Initially when we met Sandip, he wasn’t convinced by the idea of having rehabilitation care,” says Ramesh Baral, an inclusion officer working with Humanity & Inclusion. “He didn’t trust anyone. He didn’t even believe that an artificial limb and exercises would help him walk.”
“During counseling, we showed him some videos of people with disabilities who have achieved milestones in their lives through rehabilitation care, like walking, going to school, working and dreaming big,” Baral adds.
The counseling helped Sandip understand the power of rehabilitation and realize his own potential. Sandip is determined and making massive improvements. After just four days with his new artificial limb, he found it easy to walk by himself with the parallel bar. Through a 15-day process, Sandip learned how to use his artificial limb through. He completed gait training and learned to balance, stand, shift weight, sit and stand from a chair, and go up and down stairs.
“Training to walk with my new limb is hard work and sometimes painful, but I am confident that when it is over, it will be okay,” he told us.
Sandip’s parents now see a positive future for him. They have seen a change in their son’s attitude, and now Sandip smiles and shares his ambitions and his love of learning.
“Now, I want to read and get help to improve my mobility,” Sandip explains. “Education is my new ambition! I need to study hard so I can get a job and become independent. I have to turn my dreams into reality. I plan to open a mobile repair shop or start working after I complete my education.”