Experiences of attitudes in Sierra Leone from the perspective of people with poliomyelitis and amputations using orthotics and prosthetics

Background: About 73% of the population in Sierra Leone live in multidimensional poverty which makes Sierra Leone to be one of the poorest countries in the world. Sierra Leone suffered from a decade long civil war, 1991-2002, where humiliating methods were used such as machete amputations of civilians and the progress of eradicating poliomyelitis was hindered. Purpose: The aim of this study was to describe experiences of attitudes in the society of Sierra Leone from the perspective of poliomyelitis victims and people with amputations using orthotic and prosthetic devices.Methods: Individual interviews were conducted using open-ended questions. Twelve participants with polio and amputations were included. Content analysis was applied to the data.Results: The following six themes emerged during data analysis: Experience of negative attitudes; Neglected and respected by family; Traditional beliefs; The importance of assistive devices; People with disability struggle with poverty; and The need for governmental and international support. Participants experienced being discriminated in the society and the community but wanted to be treated as equals. Due to stigmatisation participants preferred living together in segregated communities. Half of the participants experienced being rejected by their families due to disability and half experienced being respected and included in their families. Traditionally the mentality in Sierra Leone was that disability is due to witchcraft. Participants experienced being more accepted in society when not being recognised as persons with disabilities and therefore preferred to use orthotics and prosthetics which also improved the possibility to walk and stand up straight. They expressed being stressed and discouraged since not being financial independent and felt forced in to begging. People with polio and amputations expect help by the government and international support to receive education and health care.Conclusions: In Sierra Leone, people with disabilities face severe discrimination. They need to be included, recognized and supported to a greater extent by the society, the community, and the family, as well as by the government and international organizations. Traditional beliefs have a negative impact on people with physical disabilities and are a cause of discrimination in Sierra Leone. Prosthetic and orthotic devices are vital for people with physical disability and offer increased dignity. Prosthetic and orthotic services need to be accessible and affordable. Poverty affects access to education, employment and health care for Sierra Leoneans with physical disabilities. They have to resort to begging to cover basic living needs.Reference: Andregård E, Magnusson L. Experiences of attitudes in Sierra Leone from the perspective of people with poliomyelitis and amputations using orthotics and prosthetics. Submitted for publication 2016