Living as a person using a lower-limb prosthesis in Nepal.
PURPOSE: The purpose of this study is to explore experiences of persons in Nepal using lower-limb prostheses, in relation to specific articles in the Convention on the Rights of Persons with Disabilities that consider mobility, education, health, rehabilitation, and work and employment.
METHOD: Qualitative interviews were conducted with 16 persons using lower limb prostheses. Content analysis was applied to the data.
RESULTS: Six themes emerged: The lower-limb prosthesis is essential for mobility and daily life; Limited mobility in challenging terrain and request for reduced pain when using prosthesis; Difficulties in finding and sustaining employment emphasized the importance of vocational training; Appreciation of comprehensive rehabilitation together with other persons with amputations, but covering related costs is a struggle; Satisfied with health care, but concerned that it creates debt and dependence upon others; and finally, Limited ability creates negative self-image and varied attitudes in other people.
CONCLUSION: Persons with lower-limb amputations were restricted by poverty and wanted increased independence. Rehabilitation and prosthetic services in Nepal need to increase proportionally as they contribute to enabling those persons to a better daily life. Prostheses were essential but more advanced technology was requested. Access to education and vocational training has the potential to improve the socio-economic status of those with lower-limb amputations due lack of employment not requiring physical effort. Implications for rehabilitation To increase access for persons with lower-limb amputations in Nepal to rehabilitation services, these services need to increase proportionally, and the policy for financial compensation to enable those persons to afford transportation to the rehabilitation center should be implemented. The design and manufacture of the low-cost polypropylene technology for prostheses used in Nepal needs to be improved, directed towards increasing the ability to ambulate on uneven surfaces and hilly terrain, and the ability to walk long distances. Adjustments of employment for persons with physical disabilities in Nepal have the potential to strengthen their socio-economic status. Vocational training programs and educational opportunities for persons with physical disabilities have the potential to improve income-generating employment and need to increase proportionally in Nepal. The policies developed in accordance with the Convention on the Rights of Persons with Disabilities need to be further implemented to decrease existing barriers to access to general health care and rehabilitation and prosthetic services for persons with disabilities in Nepal.