Tanzania faces surge in diabetes-related limb amputations

About 60 percent of all amputations involve diabetic patients, with 100 percent of amputees requiring prosthetic limbs.

These revelations were made by a Prosthetics and Assistive Devices Specialist at CCBRT Hospital, Donald Mchihiyo, during an interview with The Citizen on Wednesday, March 6, 2025.

"Excluding the 60 percent of elderly diabetic patients, the remaining 40 percent amputations result from birth defects and accidents,” Mr Mchihiyo.

He further detailed that 35 percent of this 40 percent consists of young people aged between 20 and 45 who lose limbs due to accidents, while 5 percent are those born with congenital disabilities.

"Most of the accidents leading to amputations occur in industries and through motorcycle (bodaboda) crashes, which account for 35 percent of the percentage," he said.

Furthermore, Mr Mchihiyo stated that many diabetic patients suffer amputations due to undiagnosed or poorly managed diabetes, leading to wounds and ulcers that do not heal properly.

"There are many causes of non-healing wounds, including injuries from sticks, nails, and ulcers. These are the main reasons why diabetic patients end up undergoing amputations, resulting in permanent disabilities," he explained.

He further explained that diabetic wounds tend to last longer and can result in the deterioration of affected limbs, leaving bones exposed due to the lack of tissue regeneration.

"In order to prevent the problem from worsening, we conduct tests to determine the areas with proper blood circulation, and those areas are chosen for amputation to remove the affected parts," he explained.

CCBRT Hospital aims to provide prosthetic limbs to a specific number of patients each month and year, depending on available resources.

“Our target is to assist nine individuals per month. However, due to financial constraints, we sometimes manage to provide only four or five prosthetic limbs unless sponsors step in,” said Mr Mchihiyo.

“When funding is available, we can produce up to 11 or 12 prosthetic limbs per month. However, we only have five specialized professionals working in this field,” he added.

Children born with limb deformities or missing limbs are eligible for prosthetic limbs as soon as they reach two years of age or start walking and standing.

“If a child lacks a limb or has one shorter than the other, they should be brought to the hospital for assessment. They will receive prosthetic support to ensure they develop normally like other children,” explained Mr Mchihiyo.

Before receiving a prosthetic limb, patients undergo psychological counselling to help them adjust to their new reality.

"We explain to patients the severity of their condition, the risks of retaining an infected limb, and the benefits of amputation and transitioning to an assistive device," he said.

Though counselling is handled by a separate department, prosthetics specialists participate to help patients understand the best choices for their situation.

Once a patient agrees to proceed, they undergo testing to determine the appropriate prosthetic fit, according to the specialist.

They are then trained on how to use the device before receiving it, with follow-up clinic appointments scheduled every three to six months.

“We monitor factors like weight gain, changes in limb width, and height, which can affect the prosthetic’s fit over time,” he added.

Despite the hospital’s efforts, several challenges persist, including a shortage of sponsors and the unavailability of locally manufactured prosthetic materials.

"There are no factories in Tanzania specialised in prosthetic production, so we have to import the materials, which causes delays," he explained.

High import taxes also contribute to the challenges, as customs charges increase costs, “It takes about six weeks for the materials to arrive, and sometimes, services are delayed while waiting for supplies.”

According to Mr Mchihiyo, the cost of prosthetic limbs varies depending on the level of amputation or congenital limb loss.

He said above-the-knee prosthetic limbs come in three categories: one costing Sh2.4 million, another at Sh3.5 million, and a high-end option priced at Sh20 million, saying only two types are commonly used in Tanzania.

For those amputated below the knee, costs also vary based on quality and specifications.

"There is a prosthetic limb costing Sh1.2 million and another at Sh2.5 million, with higher prices depending on the patient’s needs and the quality of the device," he explained.

He said for below-the-knee prosthetics, costs range from Sh1.2 million to Sh2.5 million, depending on the patient’s needs and device quality, “A partial foot prosthetic costs around Sh500, 000.”