A clinic making artificial limbs in CAR – the country’s only centre of its kind – is changing lives devastated by conflict

Exaucé Bagaza can’t keep his eyes off his feet. A moment ago the five-year-old boy had one foot and now he has two: they are tucked into a pair of white tennis shoes adorned with flecks of green glitter.

Wobbling a little, the child presses his right hip on to his new leg, a prosthesis made of polypropylene. His physiotherapist leans forward, reaching for his hands: “Come here,” he says.

Exaucé has been an amputee for most of his life. He was a baby when a stray rebel bullet shattered his thighbone, says his mother, Nadja Demango. “I was breastfeeding him when it happened,” she says, adding that her son’s body protected her own, possibly saving her life.

Moments earlier, the family had fled their home in Kaga-Bandoro, 330km (205 miles) north of the capital, Bangui, as fighting engulfed the area.

Since conflict broke out in Central African Republic (CAR) just over six years ago, the number of amputees has risen considerably, says Godefroy Bombaida, director of the national association of re-education and equipment in CAR (Anrac), a prosthetics workshop in central Bangui that also operates as a rehabilitation centre.

There is no national data available on amputees, Bombaida says, but he feels that they are busier now than they’ve ever been.

This small premises in the heart of Bangui is the only place in CAR where prosthetics are manufactured and distributed. At the front of the building, patients receive consultations and try on prosthetics. At the back, technical staff mould, saw and hammer artificial limbs on a long wooden workbench.

Mathias Siobendo’s new leg is getting a final polish before it’s ready to try on. Last May, Siobendo was severely injured when gunmen attacked the Notre Dame de Fatima church during Mass. Grasping the parallel walking bars, the former corporal studies his new leg in the mirror. “I’ll get by,” he says, “little by little.”

Now 25, Juvénal Baganito lost his leg in a car accident as a teenager and says it wasn’t until he received his first prosthesis, a rigid device made of wood, that he “felt alive again”. As a technician at Anrac, he has made dozens of prosthetic limbs, including his own. But amputees in CAR are often stigmatised, he says. “It’s every man for himself here.”

Facebook Twitter Pinterest Giovanni Mougounou, 10, near his home in Bangui, is one of many children who have lost limbs due to conflict in CAR. Photograph: Siegfried Modola/Reuters

“We regret that disabled people are often victims of discrimination,” says Aline Gisèle Pana, minister for the advancement of women, family and child protection. She admits that there is not much she can do about this, even though her ministry’s remit is the wellbeing of vulnerable people. “Unfortunately, [the government’s] priority lies with peace and security. All social issues are sort of put on hold,” she says.

The health minister, Dr Pierre Somse, is less pessimistic, citing a recent government act that ensures people with disabilities are integrated into the public workforce and adding that the government is working on a national strategy for disabled people. “It’s a medical question that preoccupies us. Being disabled shouldn’t be a condemnation for life.”

A huge challenge is the country’s deteriorating humanitarian situation. In November, the UN raised the alarm, warning that more than six in 10 people in CAR require urgent humanitarian assistance.

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In 2013 a largely Muslim alliance of rebels seized much of the country and toppled the government, atrocities triggering revenge attacks from predominantly Christian militias. A brief calm followed elections in 2016, but violence has returned as the rebel coalition disintegrates into rival factions.

“The fact is that the security situation outside the capital is so precarious and fluid – people with disabilities continue to be suffering the worst of some of these consequences,” says Lewis Mudge, Africa researcher with Human Rights Watch.

According to HRW, many people with disabilities are being neglected in the humanitarian response, especially those living in internal displacement camps. Organisations are facing a chronic lack of funds and struggling to access areas controlled by armed groups.

Back at Anrac, shelves are stacked with cardboard boxes containing artificial limbs flown in from Switzerland. “Without exaggerating,” says Bombaida, “almost everything here has been imported. We can’t find anything in this country.”

The centre relies heavily on the International Committee of the Red Cross (ICRC), which funds materials as well as the technicians’ training and salaries. A prosthesis costs between 160,000 CFA francs (£212) and 380,000 CFA francs (£504), a staggering sum for the average citizen.

Last year 353 patients received an artificial limb, a fraction of the number of amputees who are still waiting for treatment. As the small centre is bursting at the seams, Anrac is planning to build a new premises this year, which is set to be 15 times as big and will include dormitories for those who travel from afar, supported by the ICRC and the government.

While Exaucé learns how to take his first steps with his new foot, his mother wants to know when they can take his prosthetic leg home. In a few more days, the physiotherapist assures her. She and her other three children are staying with relatives in Bangui. Her husband works as a farmer and is often away. Going back to Kaga-Bandoro is not an option as the north is still mired in armed fighting.

But at least a son with two legs is one less thing to worry about – for now. Exaucé is likely to outgrow his prothesis every six months, which means they will have to visit the Anrac many times during the rest of his childhood. But Exaucé doesn’t look beyond next week, when he can finally go to school. He has one question, though: can he keep the shoes?