How delayed diabetes diagnosis cost former Kampala mechanic both legs

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By  Betty Mudondo  &  SYLVIA NAMAGEMBE

A former mechanic at Kisekka Market in downtown Kampala spent years treating unexplained illnesses with over-the-counter painkillers and traditional remedies before a delayed diabetes diagnosis led to the amputation of both his legs.

At 58, Bonney Byamukama spends most of his days in a wheelchair at his home in Bulenga Sombwe Village, Wakiso District, unable to return to the trade that once supported his family.

His ordeal began nearly five years ago when he began suffering from persistent fevers and fatigue, which he initially managed using basic pain medication.

“About five years ago, I started getting fevers and feeling sick all the time. I relied on painkillers like Panadol until my condition worsened and I could no longer work. My eyesight became blurry, I grew very weak and eventually became bedridden for three months,” Mr Byamukama said.

He said he delayed seeking formal medical attention partly because he was raising his children alone following the sudden death of his wife in 2017.

“My wife died from hypertension after collapsing at offices in Wakiso, where she had gone to collect her national identity card,” he said. “I was afraid of going to hospital because I did not want to leave the children alone. I believe this contributed to the delay in my diagnosis.”

In 2021, a small crack developed on his foot and began producing a foul-smelling discharge. Unaware of his underlying condition, Mr Byamukama initially turned to local remedies and herbal treatments, including avocado leaves and Chinese herbs, which depleted his savings without clearing the infection.

“My foot became swollen, discoloured and started rotting,” he recalled. “We continued using herbs because I was desperate to save my leg, but my condition kept getting worse.”

Community members in Bulenga eventually raised funds to send him for emergency medical treatment. He was referred to a hospital in Masaka where he was officially diagnosed with diabetes, before later being admitted to a facility in Kisubi. However, doctors had to perform a high-thigh amputation on his right leg due to extensive tissue damage.

“When I regained consciousness, my leg had already been amputated,” Mr Byamukama said. “Because I had gone to hospital late, the amputation had to be done high up in the thigh because the entire leg was badly affected.”

Shortly after the operation, he noticed a tingling sensation in his remaining leg. The infection progressed, and despite subsequent care at Kiruddu National Referral Hospital, doctors were forced to perform a second amputation to save his life.

To avoid leaving his children unattended, Mr Byamukama requested early discharge after the second surgery, opting for outpatient dressing appointments. However, exorbitant transport costs soon made regular hospital visits impossible.

Immobility and difficult terrain around his home led to further health complications. After suffering two falls at his doorway, he confined himself indoors, where he developed severe pressure sores on his lower back and spine.

To finance his care, Mr Byamukama sold off most of his personal assets, including land.

“I had already sold most of my property, including pieces of land. We therefore settled for outpatient treatment,” he said.

The burden of daily care has since fallen on his children. His primary-school-aged son modified a plastic chair with a bucket underneath to serve as an improvised commode for his father.

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Financial constraints have also made it difficult for Mr Byamukama to afford blood-sugar testing strips, insulin refills, and the specialized diet recommended by healthcare professionals.

“Doctors advised me to eat protein-rich foods such as chicken and fish and reduce foods such as posho, cassava, sweet potatoes and rice, but I cannot afford them,” he said. “There are days when I wake up without food. Sometimes people from church give me flour and I eat posho or whatever is available.”

Medical experts emphasize that Mr Byamukama’s experience highlights the severe risks of unmanaged high blood sugar.

Dr Agaba Gidio, a consultant endocrinologist, explained that long-term high blood sugar damages both nerves and blood vessels, leading to serious complications.

Consultant endocrinologist Dr Agaba Gidio

“Diabetes leads to amputations due to a dangerous combination of nerve damage and poor blood circulation,” Dr Agaba said. “A minor and otherwise harmless foot injury can quickly escalate into a life-threatening infection that requires surgical removal of a toe, foot or lower leg.”

Dr Ibrahim Semirimu, a surgeon at Kiruddu National Referral Hospital, noted that amputation is strictly considered a last resort when tissue is dead or severely diseased. He added that post-surgical rehabilitation is critical to helping patients adjust to life using assistive devices.

Nutritionist Paul Kasenene stressed that dietary discipline and lifestyle adjustments are vital to maintaining stable blood sugar levels over time and avoiding systemic damage.

According to data from the Ministry of Health and the World Health Organisation (WHO), diabetes prevalence in Uganda nearly doubled over the past decade, rising from 1.4 percent in 2014 to 2.6 percent in 2023. Non-communicable diseases (NCDs) now account for 35 percent of all deaths in the country.

Dr Charles Oyoo Akiya, Commissioner for NCDs at the Ministry of Health, acknowledged challenges in the delivery of diabetes care across health facilities.

“Many of these patients are being mismanaged at different levels of care,” Dr Oyoo said. “We have the Uganda diabetes management guidelines in place that provide clear, evidence-based rules to help healthcare workers prevent, diagnose, and treat diabetes across all levels of Uganda’s health system.”

Reflecting on his journey, Mr Byamukama urged the public to take early symptoms seriously and seek routine screening.

“It is very important to have your blood sugar tested,” he said. “If I had gone for a test when I first noticed the warning signs, I might not have reached this point. Take care of yourself, watch what you eat and follow your medication.”

Despite his physical loss, his primary focus remains on his children’s education and well-being.

“I cannot get my legs back, but my biggest prayer is to get support to keep my children in school and to acquire a piece of land where I can raise them,” he said.

Dr Ibrahim Semirimu, a surgeon at Kiruddu National Referral Hospital

To support or reach Bonney Byamukama, please call +256 706 905 925 or +256 772 937 568.

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