Living as a person requiring prosthetics in Nepal

Abstract

Background: The landlocked mountain country of Nepal has an extreme topography and is one of the poorest and least developed countries in the world. Nepal has ratified and signed the Convention on the Rights of Persons with Disabilities (CRPD). To understand what is required to improve prosthetic provision and services for persons living with an amputation in low-income countries, it is of interest to explore their experiences of ability to participate in daily life activities. Aim: The aim of this study was to explore experiences of persons requiring prosthetic services in Nepal, in relation to specific articles of the CRPD that consider mobility, education, health, rehabilitation, and work and employment.Method: Data were collected through qualitative interviews using an interview guide and an interpreter at the Green Pastures Health and Rehabilitation Centre in Pokhara, Nepal. Sixteen persons above 18 years with a lower limb amputation in the western region of Nepal were interviewed. Content analysis was applied to the data.Results: Five themes emerged during data analysis: The prosthesis is essential for mobility and daily life; The prosthesis and vocational training are essential for work; Comprehensive gait training together with other persons with amputations; Satisfied with health care but struggling with finances; and Negative self-image and varied attitudes of others.Discussion & Conclusion: Participants were limited by poverty and wanted increased independence. Rehabilitation contributed to enabling persons with amputations. Participants stressed that access to education and vocational training had the potential to improve their living situation. Lack of adjusted employment opportunities contributed to unemployment and low socio-economic status. Prostheses were essential, but more advanced technology was requested. The study population did not includepersons with amputations who had not received rehabilitation or a prosthesis, which limits generalization to all persons with amputations in Nepal.Reference: Fransson A, Andersson B, Wagle P R, Magnusson L. Living as a person requiring prosthetics in Nepal. Submitted for publication 2016