In Indonesia, Health Minister asks for more prosthetics, orthotics manufacturers to meet the needs of growing number of amputees

From The Jakarta Post:

Indonesia needs better orthotics and prosthetics services due to the vast increase in the number of disabled people, a minister says.

Health Minister Endang Sedyaningsih said Indonesian disabled persons who needed orthotics and prosthetics continued to increase, as many diseases developed into more complex structures, severely affecting their health.

Unfortunately, only a few domestic manufacturers provide quality prosthetics and orthotics equipment at affordable prices due to a lack of infrastructure, facilities and skills.

“We should improve prosthetics and orthotics services, direly needed to raise the quality of life and productivity of the disabled,” Endang said on Friday at a two-day conference on prosthetics and orthotics.

According to the 2004 National Social and Economic Survey (Susenas), Indonesia’s disabled population reached 6 million people, comprised of 1.8 million blind people, 1.7 million physically handicapped people, 1.3 million people with mental handicaps, 602,784 deaf people and an additional 1.3 million people who suffered from chronic diseases.

The minister reported that the country’s disability cases have been caused by accidents, disasters and diseases, such as leprosy, stroke, heart attack and especially diabetes mellitus.

Ida Ayu Krishanti, an internist from Fatmawati Hospital, said many people with diabetes mellitus had to undergo amputations after suffering serious tissue damage in their organs from the disease.

“Diabetes mellitus may cause tissue damage, leading to serious long-term complications in many human organs, including feet,” she said.

Many people with severe diabetes mellitus suffer from neuropathy, damage to their peripheral nerve system.

“They will lose their body’s sensitivity,” Ida said.

Citing an example, she said a diabetic person’s feet could not feel the heat of the sun or pain when they walked barefoot on a street covered with rocks.

“They won’t know that they have cuts or scrapes, making them more susceptible to infections. When bacteria gets into a wound, it can get infected. People with serious infections in their legs should undergo an amputation,” she said.

Neuropathy is a common complication of diabetes, affecting between 30 to 70 percent of patients.

Ida said a comprehensive treatment of diabetic peoples’ feet could prevent amputations.

“We should measure risks on diabetic people’s feet,” she said.

Wearing proper footwear is the most appropriate way to protect diabetic people from wounds.

“People who have long suffered from diabetes will lose their sensitivity; therefore, we should be able to protect their feet from scrapes and cuts,” Ida said.

However, few domestic manufacturers can produce quality footwear for diabetic feet at affordable prices. A pair of shoes for diabetic feet cost more than Rp 500,000 (US$56.5) on average.

“It is too expensive, especially for those who come from low-income families,” Ida said.

Producing adequate prosthetics and orthotics equipment, including footwear for diabetic feet, is urgent, as Indonesia faces a vastly increased number of people with diabetes mellitus.

The number of people with diabetes has rapidly increased throughout the world. In 2000, about 171 million people suffered from diabetes.

In 2030, people with diabetes are projected to reach 366 million. More than 82 million people aged over 64 years old in developing countries will suffer from diabetes in 2030, while 48 million diabetic people will come from developed countries.

Diabetes mellitus is a disease on the rise in Indonesia. Some provinces have high a prevalence of diabetes, such as West Kalimantan, 11.1 percent, and North Maluku, 11.1 percent. Meanwhile, Papua and East Nusa Tenggara (NTT) are two provinces with the smallest diabetes prevalence in Indonesia, reaching only 1.7 percent and 1.8 percent respectively.

For someone who has had an arm or a leg amputated, life may never return to normal.

“They can have a quality independent life with adequate prosthetics and orthotics support,” said Ida.

Endang said the government was committed to improving prosthetics and orthotics services nation-wide.

“It will help disabled people be more independent so they can have a better quality life,” she said.