For a person living with an amputation, a well-fitting prosthesis can be life-changing, allowing greater independence and freedom of movement. However, for some, socioeconomic circumstances are a barrier to accessing this form of care.

It was this harsh reality that drove the founding of nonprofit Zimele in 2020 – an organisation in Cape Town that provides prosthetics as well as physical and psychological rehabilitation services for amputees from disadvantaged backgrounds.

“We decided on our name, Zimele, which means independence [in Xhosa] because that is our objective – to provide an amputee with the ability to… integrate into society on their own terms as an independent individual,” explained Jayson Chin, an orthotist/prosthetist and co-founder of Zimele.

The first four beneficiaries of nonprofit Zimele – Noxolo Langa, Hilton Abrahams, Yushree Isaacs and Lerato Lesoetsa – received their prostheses through the organisation in 2022. (Photo: Supplied / Zimele)

Chin co-founded Zimele alongside Dr Sarah Whitehead, a medical doctor with a PhD focused on disability inclusion in medical education. The two were working together at the Cape Amputee Clinic – a support group Chin started in 2007 – when they decided to set up the nonprofit.

Whitehead herself is living with a disability. This, combined with her medical degree, has put her in a unique position where she can be a voice for others with disabilities, she told Maverick Citizen.

“Most doctors love saving lives in acute life or death situations, and while I do find this rewarding, I have always found changing [lives] more rewarding,” said Whitehead. 

It changed the way I am… It brought back the Noxolo that was before.

“My personal experience with my own disability and my professional work in clinical physical rehabilitation medicine strengthened this desire, and also I became intimately aware of the challenges a predominately ableist world poses for people with disabilities.”

Carbon fibre below-knee prosthetic sockets on a workbench. (Photo: Tamsin Metelerkamp)

Zimele provided prostheses for its first cohort of four amputees in 2022. All beneficiaries were adults from homes with a family or household income of R8,000 or less, according to Chin.

“We focused on the severely disadvantaged individuals… We mean people who have very little to no income and no access to government support,” he said. 

The beneficiaries were assisted by a multidisciplinary team, including a social worker, physiotherapist and occupational therapist. Chin noted that most had never spent time “debriefing the trauma of amputation”.

Yushree Isaacs (left) and Noxolo Langa (right), who received prosthetics through nonprofit Zimele, with Dr Sarah Whitehead, co-director of the organisation. (Photo: Sourced / Zimele)

One of the people assisted by Zimele was Noxolo Langa, a mother of four from Gugulethu. Langa’s leg was amputated in 2014 after a long battle with infection. Her attempts to get a prosthesis through the public health system were denied due to her weight exceeding the qualifying limit.

Between 2014 and 2022, when she became a beneficiary of Zimele’s inaugural programme, Langa lived without a prosthesis.

“[The prosthesis] changed my whole life… from my family to my community… because when you don’t have a leg, then they think that there’s something wrong,” she said. 

“It changed the way I am, it changed my attitude. It brought back the Noxolo that was before… My dream was like, ‘I have my leg back – even if it’s a prosthetic leg, I have it back, so I can do anything’.”

Prosthetic foot and a lower-limb cast on a workbench in the laboratory at Chin and Partners, where Zimele’s prostheses are manufactured. (Photo: Tamsin Metelerkamp)

Since getting her prosthesis, Langa has attained a paid business administration learnership, with support from Zimele. Beyond physical rehabilitation, the nonprofit aims to help beneficiaries get sustainable work.

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“When Noxolo [Langa] got her paid learnership, I felt like a proud family member because that’s what Zimele is – a big family,” said Whitehead.

Chin and Whitehead are working to build partnerships with other nonprofits that can assist with upskilling and job placements for beneficiaries.

Increasing access to prosthetics

The Western Cape is one of the most functional provinces in South Africa when it comes to the provision of prosthetics, says Chin. However, those who are successfully referred to the Orthotics and Prosthetics Centre in Pinelands, from primary healthcare level, need to meet certain criteria to qualify for a prosthesis.

The Orthotics and Prosthetics Centre is the only public health facility in the Western Cape that provides prosthetics, according to the provincial health department. It conducts outreach clinics at the Western Cape Rehabilitation Centre and Groote Schuur Hospital, thus allowing access to these services at three facilities.  

“Clients present with varying conditions which require aids such as prosthetics. These are reviewed per condition, with additional screening done to ensure the patient is healthy enough for a prosthesis,” the department said.

There are about 80 patients on the waiting list for prosthetics across the province, facing a six-month wait. The Orthotics and Prosthetics Centre provides about 320 new prosthetic devices a year.

“As experienced across the health platform, there is a need for increased budget and staffing, but this is restricted to the overall available budget envelope – which in itself is shrinking – to service a broad context of health service requirements,” the department said.

“… the department is going to have to do more with fewer available resources. Despite this, we remain committed to ensuring that our residents’ healthcare needs are addressed.”

Zimele is funded by private donors. It costs the organisation about R100,000 to assist each patient, according to Chin. This includes the fitting of the prosthesis, rehabilitation support and help with finding work.

While the nonprofit focuses on helping amputees, it also aims to highlight the lack of structure and support for people living with disabilities more generally, he added.

“We’re focusing on amputees, but a lot of this is to acknowledge… the way the disabled are perceived,” he said. “There’s so much ability that doesn’t [get support], and that’s across the board.” DM/MC