A GNA feature by Laudia Sawer
Tema, March 24, GNA – In 2020, a seemingly ordinary day during his mother’s funeral in northern Ghana changed everything for 62-year-old Maalneriba-Tia.
While sitting under a tree, a casual observation by his brother of an unexplained deep cut on his toe marked the beginning of his harrowing medical journey.
Maalneriba-Tia, who had no prior pain or warning signs, had to rush down south to see his doctor at the Tema General Hospital. The wound, however, did not heal despite the series of prescribed medications.
When the wound worsened and the left foot swelled, further tests revealed a diagnosis: diabetes.
From hospital prescriptions to alternative herbal treatments, the fight to save the leg was intense but ultimately unsuccessful. When the condition spread to the right foot, when that of the left improved with herbal medicine, amputation became the only option.
This is not just one person’s story; it’s a reality faced by many diabetic patients in Ghana and beyond. Could early intervention have prevented this? What solutions exist to stop minor wounds from escalating into amputations?
Diabetes
The World Health Organisation (WHO) described diabetes as a chronic, metabolic disease characterised by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys, and nerves.
Data from the International Diabetes Federation (IDF) revealed that 537 million people have diabetes in the world as of 2012 and are expected to increase to about 55 million by 2045.
Ghana is one of the 48 countries of the IDF African region. Some symptoms of diabetes are feeling more thirsty than usual, frequent urinating, losing weight without trying, presence of ketones in the urine, feeling tired and weak, blurry vision, and slow-healing sores, among others.
Diabetic-related amputations
One of the most dreaded complications of diabetes is amputation, a consequence of uncontrolled blood sugar levels that lead to nerve damage (neuropathy) and poor circulation.
Experts explain that when left untreated, minor foot injuries can develop into ulcers and infections, ultimately necessitating amputation.
Shockingly, the IDF reports that every 30 seconds, somewhere in the world, a lower limb is lost due to diabetes-related complications.
A study in Poland by Walicka et al. (2021) found that the number of amputations in patients with diabetes increased substantially between the years 2010 and 2019 from 5,049 to 7,759, compared with the number of amputations in patients without diabetes, which was stable, indicating that the mean percentage of amputations in patients with diabetes accounts for 68.6 per cent of all amputations.
“This number slowly increased year over year, beginning at 61.1% in the year 2010 and reaching 71.4% in the year 2019.”
Beyaz, S., Güler, Ü. Ö., & Bağır, G. Ş. (2017), looking at the mortality rate among diabetes amputations, revealed that mortality following amputation ranges from 13 to 40 percent in one year, 35–65 percent in three years, and 39–80 percent in five years, being worse than most malignancies, stressing that amputation-free survival is important in assessing the management of diabetic foot problems.
Life after amputation
Maalneriba-Tia, having lived with the amputation for the past four years, was lucky to have had the Ghana China Friendship Association (GHACHIFA) provide support for him to have a prosthesis after using crutches for two years.
Life, however, cannot be the same for him, as walking with an artificial limb requires significant physical and mental adaptation.
“Being diagnosed with diabetes and being a candidate for amputation was alarming and psychologically not easy. The greatest fear is how to survive after that as you become disabled and must rely on others. Before the amputation I lived a normal life, but now I am managing,” he said, recalling that “when I came out from admission and using the crutches, the shock people expressed, and the many questions people were asking me was not easy at all.”
Podiatry- preventing amputation
Early detection of diabetes is said to help in preserving the limbs of patients from amputations.
This, according to Madam Amanda Mawudoku, a podiatrist (foot and ankle doctor), can be easily achieved with podiatry, which is the study of the treatment of problems of the feet, ankle, and lower leg.
Madam Mawudoku noted that “Most amputations are preventable by checking your feet daily, visiting your podiatrist, and wearing proper footwear.” Explaining that the connection between diabetes and the feet is important, as the disease can cause nerve damage and reduce circulation, ultimately leading to limb loss and other complications.
Podiatrists, she said can spot potential problems before they become serious and offer treatments to prevent complications, stressing that “Our routine foot inspections and examinations detect issues like ulcers, corns, calluses, and other warning signs to prevent amputation.
We look for neuropathy (nerve damage), arthropathy (joint damage), and vasculopathy (blood vessel damage).
She added that neuropathy can be a potentially serious condition, especially if it is left undiagnosed, giving the assurance that podiatry could help manage diabetic neuropathy by monitoring the health of diabetics feet, prescribing orthotics (devices inserted in shoes to treat foot and ankle conditions), taking care of any injuries or foot wounds, and much more.
“Complications can be avoided or delayed with regular and comprehensive foot exams and treatment. Prevention of amputation can help improve the quality of life of diabetics.”
The podiatrist emphasised that taking very good care of the feet is critical to maintain mobility, reduce pain, and improve overall quality of life.
“Lifelong foot health is achievable with the help of regular podiatric care. With the right foot care, you can keep your feet healthy and continue to be active for years to come.”
Conclusion: Prioritising podiatric care to prevent amputations
Maalneriba-Tia’s story is not unique-it reflects a growing crisis in Ghana where diabetes-related amputations are on the rise. Every year, countless Ghanaians lose their limbs due to preventable complications, leaving them physically, emotionally, and financially burdened. With the increasing prevalence of diabetes, Ghana can no longer afford to ignore the urgent need for podiatric care.
In countries with well-established podiatric services, amputation rates have significantly dropped due to early detection, specialised foot care, and timely interventions. However, in Ghana, podiatry remains an underdeveloped and underutilised field, putting millions of diabetic patients at risk.
A call to action
The establishment of podiatric clinics across Ghana, alongside government-supported diabetic foot care programmes, public awareness campaigns, and affordable treatment options, is essential to reversing this alarming trend. A national policy must prioritise regular foot screenings, access to podiatric specialists, and preventive care measures to safeguard lives and livelihoods.
For individuals living with diabetes, prevention is key. Routine foot examinations, proper footwear, daily self-checks, and early medical intervention at the first sign of trouble can mean the difference between healthy mobility and irreversible amputation.
Diabetic amputations are not inevitable; they are preventable. Ghana must act now to ensure that fewer people face the trauma, disability, and financial hardship of losing a limb.
A limb loss affects not only the individual but also their families, carers, and the healthcare system. By prioritising podiatric care, Ghana can take a crucial step towards reducing amputations, preserving mobility, and improving the quality of life for thousands of its citizens.
The time for action is now. Podiatric care must become a fundamental part of Ghana’s healthcare system-because saving limbs means saving lives.
GNA
LS/GRB