Persons with physical disabilities have asked to be catered for in the national community based health insurance (Mutuelle de Santé) coverage to ease access to prosthetic limbs.
The disabled persons say that this will enable them to access cheaper health services especially in the countryside where such limbs which cost between Rwf200,000 to Rwf360,000.
A 2012 National Institute of Statistics survey shows that there were over 446,000 people with disabilities, excluding children and so far only 160,000 have been classified as disabled but many continue to lack prosthetic healthcare due to financial constraints.
The Kigali-based Mulindi One Love project which has since 1996 provided over 8,000 Rwandans with free prosthetic limbs has blamed government for poor mobilisation in the districts to take advantage of the services.
In 2015, the National Council of Persons with Disability recommended mainstreaming disability and influence decision makers to take the lead in planning, implementation and monitoring of the inclusion of persons with disabilities (PwD) through related PwD policies, programmes and strategies.
This has however not been implemented and according to some providers has denied many disabled persons access to these limbs.
“We wrote to the government stating that we would provide free prosthetic limbs through the district. We have the products and material and districts should discuss the way forward” Mr Gatera said.
Mr Gatera says that though it is costly to produce the limbs, in the standing agreements with the local government, “The project provides 40 per cent of the cost coverage and the other percentage by the districts, but you find that some districts don’t have the money,” he said.
The State Minister in charge of Social Affairs, Alvera Mukabaranga said that a study has been conducted to add this programme to Mutuelle de Santé but the costs remain a challenge.
“This issue has been approved and a team is on the ground to study how the disabled can be assisted but we have to look at the costs so that it can be covered in the health insurance” Ms Mukabaranga said.
Adding this service to Mutuelle de Santé may however strain the current programme, which stood at 79 per cent, by January and has failed to meet the 100 per cent subscription. It has been under pressure to increase citizen’s subscription ever since the programme was placed under Rwanda social security Board (RSSB).
Rwanda has seen foreign companies like Ottobock, open shop in the local market to fill the gap of lack of access to prosthetic limbs but their prices remain high compared with local providers.
According Kingsley Diores, the area manager, Rwandans need access to proper specialised medical equipment that is patient based, not money based.
“The prices may be high but these limbs are high quality and effectively address a specific handicap compared with the cheap ones” Mr Diores said during the recent national conference on Non-communicable diseases held in Kigali.
For example, an Otto Bock 3R49 prosthetic legs economic security type titanium bearing self-locking uniaxial knee -1M10 would cost over Rwf23, million if purchased online.
Besides lack of limbs inclusion in priority sectors such as education, health, social protection, accessibility, communication, employment and the fight against violence have remained of concern.