“Up, up, up, come on! Now balance! Hold … and down.” Raising a serious sweat, six patients are undergoing physiotherapy at Cape Town’s Groote Schuur Hospital. It’s a session with more meaning than most: these are lower-limb amputees, striving either to maintain muscle strength after having recently been fitted with a prosthetic leg, or in training to receive one as soon as the state’s resources allow. Supervising the session is Ruth Siebritz, who is tiny, but — like most physiotherapists — tough and demanding, which her charges clearly appreciate. Siebritz’s equipment is sparse, indicative that even in the country’s preeminent tertiary hospital, the budget is tight. This also translates, tragically, into the reality that more patients want a prosthesis than can be supplied. Groote Schuur assists predominantly with leg prosthetics, fitting only about 10 arm units annually. The need is lower because there are fewer arm amputations; major causes, such as diabetes and vascular diseases,...

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