Monday, March 08, 2010

From Things Made Easy March 05, 2010

Review the needs of any one type of disability group of Hong Kong. To what extent they could be integrated into the community and treated in equal opportunity.


The term amputee refers to an individual who have lost a limb or part of a limb. Your limbs are your arms and legs. Losing a limb or part of a limb may result from illness such as diabetes, cancer and vascular diseases, injury or accidents. If a limb or part of a limb threatens the health and life of the individual, amputation or surgical removal will be the resort. The common problem in amputation is the excessive pain on the missing limb. Other problems that could possibly occur include grief, surgical complications and skin problems if the patient wears an artificial limb. Many amputees wear artificial limbs though it takes time to learn. To help the patient adjust and adapt, physical therapies are suggested for the patient to undergo.


The Prosthetic and Orthotic Unit of the Kowloon Rehabilitation Centre, the first and largest rehabilitation centre in Hong Kong, conducted a 24-year retrospective study of amputees. The research conducted found out that the rising trend in amputee population Hong Kong was related to the population growth. The ratio of lower limb to upper limb amputees was 1.83 to 1. The commonest cause of upper limb amputation was trauma (89%) and of lower limb amputation was infection (35%). They also found out that the mean age of amputees in Hong Kong is 39 and that vascular diseases were not as common in Chinese as in Caucasian communities (Chan et al, 1984).

A separate research conducted by the Department of Orthopaedic Surgery at the University of Hong Kong found out that the orthopaedic care of an amputated patient does not stop after surgery. It is also comprised of integrating the patient back in society. There are several social problems that the patients could encounter which includes activities of daily living, ambulation, housing, employment, marriage and changes in their families. In helping them with their rehabilitation, the study also discovered the importance of the role of doctors, prosthetic services, physiotherapists, occupational therapists and the medical social workers (Chow 1982).

Base on these two studies, there is a clear manifestation of the needs of the amputee community in Hong Kong. More than the physical rehabilitation or the process of putting backs the lives of the patients into normalcy, there are other needs of the amputees as social, moral, spiritual, psychological, cognitive and others. Attention must be also given to sports, entertainment, amusements, education, employment and other areas of the same weight. Put simply, there is a general need for amputees to be integrated back into the community and be treated as equals.

Integration to the Community

The psychosocial domain of amputated individuals explains the relative time needed prior to reasonable experiences of medical and rehabilitative objectives. There are associated emotional and adaptational challenges to this following limb loss. Community reintegration is central to amputee rehabilitation. In particular, it includes the resumption of family roles and community activities, emotional equilibrium, healthy coping strategies and recreational activities (Meier and Atkins 2004, p. 79). The main purpose of community integration for amputee patients is the mobilisation and leisure activities outside the clinic setting allowing them to have fun at the same time as others.

Experiences of strong emotions that include horror, numbness, rage and suicidal tendencies are addressed by these immediate community reintegration programs. The amputees obviously need psychological and mental assistance, health assistance in general. Toward recovery, there must be immediate and competent medical care, appropriate mobility equipment and adequate rehabilitation programs. There is an evident need of experienced service providers including prosthetists, physical therapists, psychiatrists and physicians as well. The impact of amputee survivors’ physical functioning, in lieu with this, facilitates an effective social and economic integration.

Coping strategies needed must also comprise of psychological factors to help amputee patients to adjust to their new roles to the society in general. For many amputee patients, religious or spiritual beliefs contribute to finding meaning in their conditions and acceptance. Amputees are constantly reminded of their spirituality. Being spiritual means searching for meaning and purpose in your day-to-day life, connecting with others and moving beyond self-absorption. The social integration and sense of community and the support that the religious community offers enhances the effects of spiritual living hence, enhance the sense of connectedness of amputees in the society with which they function as individual members (Laux and Block 2006, pp. 54-55).

Base on this, there is a need for the patients to converge in recreational activities that could provide them the confidence they once had. These activities could be emotional therapy that includes stress management, activities on expressing oneself like drawing, painting, music and others. Aside from this, there are other needs as occupational needs for the amputees. These are basic personal hygiene, dressing, feeding, toileting and other complex tasks as writing, cooking manipulating objects and driving. On a broader sense, there is a wide need for amputees to be educated, if not in traditional way, through vocational trainings. This could bring them the moral encouragement to go on with life despite their abnormal conditions.

The amputees’ human interactions also gave them value towards their perception on reality in a social setting. When the family is unavailable, often patients find support from their peers. Interaction with other amputee patients empowers them to persevere, believe in their capabilities and enable them to think that they can take care of themselves physically or otherwise. The strong and supportive environment provides comfort and motivation in the post-amputation period.

Base on this premise, there is a need for effective and functional rehabilitation centers and amputee-friendly establishments that the amputees can go together to. This increases their chance to reintegrate themselves individually in the community. Through this, the patients could also have an outlet to express their anxieties and overcome depression without jeopardising the lives of other family members who have independent lives and individual concerns to take care of.

Equal Opportunities

Discrimination and rejection have direct impact on the ability of the amputees to reintegrate socially and economically and hence, impact their psychological being as well. Societal barriers play significant role in preventing amputees from feeling valued and belongingness both as a functional member of family and community. The chance of isolation is high in terms of accessing equal opportunities. Societal attitudes toward persons with bodily defects are the main sources to account for such feeling.

The sentiments of equal opportunity for amputees should be expressed in terms of several aspects. First, on prosthetics and orthotics, amputees must be given equal opportunities on the services regardless of their social status and financial capabilities. Benefits of using prostheses and orthoses are immense in making the life of the patients less miserable. Opportunity must be also provided in terms of information on the use and the adaptation of the new device, the further impact of impairments and arranging maintenance and repairs to prostheses and orthoses (WHO 2003).

Second, on car and motoring adaptations, amputees must be given equal opportunities to get license and permits and allow them to modify their vehicles. Driving is an important mean of independence for amputees. Without relying on to others, they could carry-out tasks and take part in social activities. Essential information that drives equality purports special devices that the vehicles require, special driver training, obtaining and renewing driver’s license and limited restrictions on license (National Amputee Centre 2008).

Third, on caring/nursing services, amputees must be given equal opportunities on professional health care services and be provided with necessary welfare. The carers and the nurses as well as the charities must serve as support mechanisms for the amputee patients. This includes the pre-operative to post-operative education to providing them informations about independent organisations that could assist them financially and emotionally that are locally connected to the hospital or clinic.

Fourth, on employment and benefits, amputees must be given equal opportunities regarding the working hours that directly affects remunerations. The reduction of work hours gives rise to poor economic returns to the employer and so the employer would choose to lay-off the patients. This has direct impact on financial benefits in terms of pension and insurance. Further, the amputee would find difficulty finding a new job (Delasau).

Fifth, on legal services, amputees must be given equal opportunities in areas of advocacy and representation before the law. The cause of amputation must pass through an extensive examination so that the family of the victim could possibly locate the person responsible in case of intentional misconducts so that the rehabilitation and maintenance cost and other needs of the patient would be settled.

Sixth, on sports and recreation, amputees must be given equal opportunities to participate regardless of the racial, political and national background. The main concern is the access to participate in these areas; safety is another. Entry to sports and recreation is a real challenge for amputees. Giving amputees equal opportunities mean to provide them an active lifestyle through plenty of choices wherein they can demonstrate their strengths and creativity that, in effect, enable them to gain spirit of team working and sense of self-expression.


Amputees 2008, MedlinePlus, Retrieved on 16 January 2008 from

Chan, K M, Cheung, D, Sher, A, Leung, P C Fu, K T & Lee, J 1984, A 24-year survey of amputees in Hong Kong, Prosthetics and Orthotic International, vol. 8, no. 3, pp. 155-158.

Chow, S P 1982, Social Problems of Lower Limb Amputees in Hong Kong – An Exploratory Study, Bulletin of the Hong Kong Medical Association, The, vol. 34, pp. 81-85.

Delasau, I The Impact of Amputation on Diabetic Patient in Fiji, Otago Diabetes Research Trust.

Laux, M & Block, M 2006, User’s Guide to the Top 10 Natural Therapies: Your Introductory Guide, Basic Health Publications, Inc.

National Amputee Centre 2008, License to Drive, retrieved on 16 January 2008 from

Meier, R H & Atkins, D J 2004, Functional Restoration of Adults and Children with Upper Extremity Amputation, Demos Medical Publishing, LLC.

World Health Organization 2003, The Relationship Between Prosthetics and Orthotics Services and Community-Based Rehabilitation (CBR), International Society for Prosthetics and Orthotics.

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