​What kinds of symptoms do patients experience before receiving treatment?

Patients are usually in a lot of pain. Depending on the location of the fracture, they may not be able to stand, walk, or use the affected limb. The affected limb may be distorted, and there may be swelling or bruising around the site of the break.

​What is the impact on patients’ lives of living with these conditions?

Fractures impact a person’s ability to work and complete normal daily activities. The patients often cannot go to school or work. Their inability to perform daily household activities prevents them from helping their families. In rural Uganda, many people avoid going to the hospital because they are concerned about costs. Instead, they may rely on local "bone setters." If not treated promptly and properly, a fracture can heal incorrectly, leaving the patient with a distorted limb.

What cultural or regional factors affect the treatment of these conditions?

Fractures often occur because of high-impact injuries. In the Bwindi area, such injuries often occur during traffic accidents. “Boda bodas,” or motorcycle taxis, are very common throughout Uganda. It is estimated that boda boda accidents account for up to 50% of road traffic accidents. Poorly maintained roads, the lack of helmets, and reckless driving all contribute to the high incidence of boda boda accidents. Other causes of injury are falls from heights, trees, and hills. People can also become injured if they work without safety gear.

What does the treatment process look like?

The first step is to take an x-ray of the injury to ascertain the number of breaks and to identify fractures requiring skin traction. If there are no complications, the fracture will be set through the closed reduction method, which does not require surgery. If the bone has multiple breaks, however, the open reduction method, which includes surgery, may be needed. A plaster of Paris cast will be applied. If an open reduction surgery is performed, a window will be left in the cast through which to treat the wound. A patient with a simple fracture will remain in the hospital for one to three days. If skin traction was required or open reduction surgery was used to set the bone, he or she may stay longer, allowing doctors to ensure the wound is healing properly. After discharge, the patient will wait for one month before returning to the hospital to have the cast removed or replaced. Recovery will continue at home until the fracture is completely healed.

What is the impact of this treatment on the patient’s life?

Prompt and proper treatment of fractures can prevent the malunion or nonunion of bones, and thus the need for further surgery. Malunion or nonunion can leave a patient disabled, cause a limp, or lead to other complications.

What potential side effects or risks come with this treatment?

There are no side effects, except the patient's inability to use the affected limb during healing. Delayed treatment, however, can make it much more difficult to set bones properly.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

Before reaching a hospital, patients may receive aid in the form of splints and slings. However, proper care of a fracture should be done at a hospital. The only other hospital is over two hours away by car.

What are the alternatives to this treatment?

Many people cannot afford to go to the hospital. They will attempt to treat the injury at home with a local bone setter or at a lower-level health facility. This often results in improperly healed fractures.