Affordable prosthesis in Western Cape

If you are amputated in the Western Cape and make use of the government services to obtain a prosthesis, what can you expect? Heinrich Grimsehl investigated and was pleasantly surprised

The Western Cape Department of Health Orthotic and Prosthetic Centre services thousands of people every year to make their assistive devices. There is a dedicated team of 14 certified prosthetist or orthotists (CPOs), five footwear technicians and three assistants. The prosthetic department is made up of a chief CPO, another five CPOs and a assistant.

The Centre makes all sorts of prosthetics, including below knee, above knee, hip disarticulation and arm prosthetics. The lower- limb prosthetics that are manufactured and fitted to patients are usually quite basic to keep the cost down, but functional. These allow patients to walk (and sometimes run, with practice). The upper-limb prosthetics made at the Centre are onlycosmetic.

The team at the Western Cape Orthotics and Prosthetic Centre pride themselves in making colourful prosthetics for children who can enjoy wearing them.

The approval criteria to get a prosthesis through the Centre is quite strict as there aren’t any support staff available onsite to assist the patient with walking, for example a occupational or physiotherapist.

As a result, one of the shortlisting criteria is that the patient needs to be mobile on crutches to qualify for a prosthesis. This ensures that patients who do get a prosthesis are able to walk as opposed to them just sitting in a wheelchair. Some other approval criteria include:

• No flexion contractures;
• Stump bandaging;
• Good muscle strength;
• Healed and good scar mobility; and
• Patients need to be under 100 kg.

The components used to make the prosthesis at the Centre have a 100-kg weight limit; hence the weight requirement. An exception can be made if the patient has a special component ordered.

To get a prosthesis at the Centre, lower-limb amputees first need to be assessed by a physiotherapist at their local community health centre. The therapist will get the patient ready for a prosthesis in accordance with the above listed criteria.

Once the physiotherapist deems the patient ready for a prosthesis, they will be referred to an amputation clinic at Western Cape Rehabilitation Centre or Groote Schuur Hospital.

Once at the amputation clinic, the patient gets assessed by a physiotherapist and a prosthetist. If the patient is ready for a prosthesis, they get an appointment at the Centre to be measured.

A special thank you to Andrew Byett (Chief Medical Orthotist Prosthetist at Western Cape Department of Health) for preparing the information.