Kenya’s wound care crisis and the urgent need for early intervention to prevent amputations

The Epidemiological Patterns of Wounds in Kenya reveals that 4% of people are injured in road traffic crashes, and a staggering 10.9% face unintentional injuries, many of which lead to severe, often untreated wounds. In rural areas, 13% of people suffer from wounds.

Shilpa Mulki, a Diabetic Wound Care Specialist, explains: "Prevention is the first line of defense, screening, accessibility, and timely care can transform lives before they spiral into amputation or irreversible damage."

While these injuries may seem minor, for many, they spiral into chronic conditions, infections, and even amputations.

Among the most vulnerable are those with diabetes, where even the smallest wound can escalate into a severe health crisis, threatening limbs and lives. As a result, 22% of all wounds in Kenya show signs of secondary infections, showing the urgent need for proper wound care, grafting, and advanced treatments.

In a country where healthcare resources are stretched, these challenges demand immediate attention as every untreated wound is a potential crisis, and every patient is a person with a future that depends on the quality of care they receive today.

“It is only prayers. My brother is going for an amputation today at Mbale Hospital. We know doctors treat, but God heals,” I - Angela Kezengwa - stumbled upon this post while doom-scrolling Facebook on August 14, 2025.  

The words froze me. I knew I had to take action. With some knowledge of wounds, diabetes, and even maggot debridement therapy, I texted Caroline Lubuya, the lady who wrote the post.  She responded almost immediately, giving me her phone number.

As I made my way out for a breather after the 10 a.m. news brief, I called her. “What is the issue with your brother?” I asked. 

I knew him. He sells mandazi and tea at our village market. In primary school, he had been two years ahead of me.

In my mind, I pictured a burn — perhaps from the boiling oil he uses daily. But I was wrong.

What Caroline Lubuya described was not a sudden accident but a slow, silent disaster: a diabetic wound that had been ignored until amputation seemed the only option left. My thoughts were fixed on Amunavi’s livelihood, his children, and how one sweep of the blade could sever not just his limb, but his entire future.

When I finally saw him, his leg was tightly bandaged, the smell of antiseptic heavy in the air. The doctors had acted quickly. The foot, for now, was saved. He later underwent a grafting procedure at a hospital in Kakamega. Saving his whole limb from amputation.

Kennedy Chesi Amunavi’s story is far from unique. 

Across rural Kenya, families face the same struggle in silence. There is little awareness of wound care, few trained personnel to treat patients, and a dangerous apathy from individuals who downplay small wounds. Maybe because of a lack of awareness.

It is deadly. Each amputation is not just the loss of a limb, but of livelihood, dignity, and independence. In places like Mudete market- Vihiga County, where survival is earned day by day, one wound can collapse an entire family’s future.

Amunavi’s story is one of the neglected crises that demands urgent attention, not just prayers.

Melisa Ambogo Chesi is 47 years old and the wife of Amunavi. Together, they have five children. One is a first year at a local university in Kenya. Before going to campus, he was Amunavi’s primary caregiver.

On the morning of this interview, he was slated to travel to the Coast to enrol in campus.  “My son is even late for enrollment, and in my state, I do not know how he will cope because we are constrained financially and no sign of me going back to my livelihood soon,” Amunavi said, his worry lingering.

“Dad has been paying my school fees, and now, in this state, I do not know how it is going to be for us as a family. I hope he gets back on his feet,” Benedict Amunavi said.

Back home, the wife was left with the rest of the children to take care of. The youngest is in Preparatory Two. “My husband’s situation is weighing in on us; sometimes we go without food because I do not work,” she confessed.

The impact of a provider falling sick unable to provide, disrupting livelihoods.

How did they get here?

Melisa said that her husband got a small boil, “We applied local herbs, it later developed pus, which was compressed at home. I used a thorn to prick it.” Melisa added, “ I would chew shrubs and apply it,” she added. She had heard about that from other women in the village.

It started developing into a chronic wound.

“We went to a nearby clinic for cleaning and bandaging. Nothing changed. Instead, the wound grew larger by the day, and the foot turned darker,” Melisa recalled. 

She noted that they only learnt about Amunavi having diabetes and hypertension when he sought medical care at a government hospital.

They were unknowingly dealing with a diabetic wound all along. Worsened by the interventions they took to help.

Like Amunavi, another resident of Vihiga, Beatrice Alividza, a retired teacher and former councillor, has been fighting a stubborn wound, one that has defied treatment for months

The first one healed after compression, while the second, which developed in May 2025 after she tripped and fell, became aseptic but painful. Despite visiting several medical facilities in rural Vihiga and Nairobi, she has found no relief. In desperation and unbearable pain, someone advised her to try a home remedy. “I got a Coke soda and applied it to the wound,” she admitted.

Nothing changed. Five months later, the wound is still stubborn.

Amunavi visits a Kakamega hospital for check-ups every fortnight, and has his wound cleaned and dressed by a nurse from a private clinic at home for Ksh.1,200. He hires a car to Kakamega for Ksh. 5,000 to avoid motorbike vibrations. 

Similarly, Beatrice Alividza’s nurse travels from Kakamega to Vihiga, charging Ksh.200 fare, Ksh.500 for materials, and Ksh.1,000 for service on Monday, Wednesday, and Friday. No care is given on weekends. This has been the arrangement for the last month.

Dr. Chris Kibiwott, a wound care expert, emphasises that chronic diabetic wounds require proper compression to facilitate healing. However, Kenya lacks a structured wound-care program within public hospitals, and specialists are few. 

Most counties rely on general clinicians with limited training in diabetic foot management, leading to symptomatic treatments like bandaging or antibiotics instead of comprehensive care that addresses underlying causes and promotes proper healing.

Dr. Kibiwott also underscores the broader gaps in managing chronic conditions like diabetes. "Our healthcare system, especially at the primary care level, is severely lacking in trained professionals such as nutritionists and laboratory technicians, which directly impacts the diagnosis and treatment of diabetic wounds," he says.

Recent reports confirm these concerns, showing that only 46% of NCD specialists are available, with nutritionists among the least represented. While medical equipment and diagnostic capacity are relatively high (73% and 64%, respectively), significant gaps in human resources remain, particularly in rural areas. 

Diabetic care improves at higher levels of care, but primary healthcare facilities, where most patients seek help, are ill-equipped to manage diabetes effectively.

"These shortages lead to preventable complications like amputations," Dr. Kibiwott adds. "With proper training, early diagnosis, integrated care, and techniques like proper compression, many of these outcomes can be avoided."

“We are unable to get a compression expert around Vihiga since the one I used for the first wound used to come from Eldoret Moi Teaching and Referral Hospital, but she relocated abroad,” Alividza says in surrender.

Evans Kivisi Muhali, a resident of Vihiga, faced immense loss when his son, Byron Muhando, 27 years old, a music producer known for the hit "Sipangwingwi," passed away suddenly in September 2023. 

Byron’s death was linked to a ruptured aortic aneurysm, a condition where the largest blood vessel in the body enlarges and bursts. The shock of this loss worsened Evans’ diabetes and hypertension, leading to severe health complications, including a diabetic wound that required amputation. 

He had to undergo the procedure at an Eldoret hospital in Uasin Gishu County. He now uses prosthetics.

According to Dr. Shilpa Mulki, treatments such as grafting, negative pressure therapy, and biological debridement are highly effective when performed by skilled professionals and should be taught to those willing to learn. 

“They also need to be made accessible across the country and more affordable than they currently are. “Look at your feet before you go to sleep,” is a message I often share with people living with diabetes and with their caregivers as a simple but vital habit,” says Dr. Mulki. 

The Diabetic Wound Care Specialist emphasizes that small daily habits can greatly reduce the risk of needless amputations. 

“If healthcare were a country, it would be the fifth leading cause of global warming — which is why prevention is not only the best practice for people living with diabetes but also vital for protecting our planet. Preventing complications means fewer hospital visits, surgeries, and less medical waste — much of it non-biodegradable plastics and dressings that harm the environment,” says Mulki.

It safeguards not just limbs and lives, but the earth itself. Beyond better clinical practices, innovative approaches like biotherapy or larval debridement therapy, along with offloading and the right footwear prescribed by podiatrists or orthopaedic technologists, can accelerate healing. Ultimately, multidisciplinary wound care, where experts work together, makes the greatest difference. So, she adds with a smile, “knock your socks off, and look at your feet.”

Kenya urgently needs to decentralize wound-care services, train more specialists, and raise community awareness about early screening, especially among people living with diabetes. County governments and the Ministry of Health must prioritise wound care in primary health programs. Prevention saves limbs, lives, and resources, and, as Dr. Mulki reminds us, even the planet.