(image: jivdayafound.org)
In the bustling streets of Bengaluru, Raghavendra limps forward with an amputated leg. Once a daily wage worker, the 34-year-old lost his limb after a road accident—a fate shared by millions across India. In a country with the highest number of traumatic amputations in the world, his story is tragically common.
According to a global study on amputations, India witnessed a staggering two million amputations in 2019 alone, leading the world in the number of traumatic limb losses. The total number of amputees in the country stands at a staggering 75.6 million, a number that reflects both the severity of the crisis and the failures of India’s healthcare system.
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A Crisis Rooted in Systemic Failures
At first glance, the cause of this epidemic seems simple—India has the highest number of road accidents in the world. A 2021 study found that 85.4 percent of traumatic amputations were due to road traffic accidents. Yet, a deeper dive into the issue reveals more sinister problems—lack of adequate trauma care, poor medical infrastructure, and an alarming deficit of specialists who could prevent amputations.
Murali, who oversees the KMYF Limb Centre at Bhagwan Mahaveer Jain Hospital in Bengaluru, encounters these systemic failures daily. “We see between eight and fifteen patients a day, the majority from rural areas, who say they couldn’t save their limbs because the hospital they visited didn’t have enough doctors or resources,” he told Scroll.in. The lack of specialised trauma centres and vascular surgeons often leads to unnecessary amputations that could have easily been avoided with timely intervention.
Dr Sidharth Viswanathan, a vascular and endovascular surgeon at Amrita Hospital in Kochi, explained that misdiagnosis plays a significant role. “Doctors in smaller hospitals don’t always recognise that foot ulcers or discolouration are due to poor blood circulation,” he said, as quoted by Scroll. “Instead of restoring blood flow through vascular surgery, they keep removing infected tissue until the patient is left with no choice but amputation.”
Even trained medical professionals struggle due to insufficient facilities. In government hospitals, doctors like Viswanathan once treated foot infections in a small room with minimal resources. “The solution was always to keep cutting until the wound healed. No one considered alternatives,” he admitted.
The Poor Suffer the Most
The brunt of India’s amputation crisis is borne by the country’s poor, who often cannot afford proper medical care. A 2021 study found that among 3,047 trauma patients at a level-one trauma centre, 125 required amputations. The majority belonged to low-income backgrounds, with little access to quality healthcare. A similar 2006 study revealed that 8 percent of rural diabetes patients required amputations, compared to just 3 percent in urban areas.
The financial burden leads many to seek short-term fixes instead of long-term solutions. Rather than undergoing expensive vascular surgery, which costs approximately Rs 1 lakh, many opt for repeated wound dressings or traditional bone setters, whose crude methods often worsen the problem. “Bone setters sometimes tie bandages too tightly, stopping blood flow and causing permanent damage,” explained Dr Madan Ballal, director of the Sanjay Gandhi Institute of Trauma and Orthopaedics.
But even when patients do reach hospitals, they are not always referred to specialists. Viswanathan emphasised that several hospitals don’t even have vascular surgeons who could offer alternatives.
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The Unseen Cost of Amputation
For those who undergo amputations, survival itself becomes a battle. Research indicates that life expectancy post-amputation is shockingly low—worse than that of many cancer patients. One study found that mortality rates for amputees range from 13 percent to 40 percent within the first year, rising to 80 percent after five years.
Since mobility is drastically reduced after an amputation, patients who were once active suddenly stop moving, leading to deterioration in their cardiovascular and vascular health, observed Viswanathan. The misconception that an amputation will resolve health issues often leads to a downward spiral instead.
A Healthcare System in Need of Urgent Reform
The sheer scale of India’s amputation crisis reflects a fundamental gap in healthcare infrastructure. Even in major hospitals, understaffing and overburdened operating rooms lead to high rates of complications. A 2022 study found that 28.7 percent of amputees required revision surgeries due to poor outcomes—a figure higher than in many developing countries in Asia and Africa.
Government efforts to address the problem have been insufficient. In 2019, a national trauma care plan proposed setting up trauma centres every 100 kilometres along highways. While states like Tamil Nadu have made progress, others have failed to implement this initiative. Karnataka, for example, had only one dedicated government trauma centre as of 2019, despite having some of the country’s busiest roads.
Experts like Dr Muralikrishna, head of vascular surgery at Sri Jayadeva Institute of Cardiovascular Sciences and Research, believe that investing in specialised healthcare is the only solution. “We need more super-speciality care centres so patients don’t have to travel so far for treatment,” he said.
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Despite the grim statistics, small changes have shown promising results. When a medical team from Hassan received training in vascular diagnosis at Bengaluru’s Sri Jayadeva Institute of Cardiovascular Sciences and Research, their hospital’s amputation rate dropped by 95 percent reported Scroll.
India’s amputation crisis is not just a medical issue—it is a social and economic catastrophe. Without urgent intervention, millions more will continue to lose their limbs, their livelihoods, and, ultimately, their lives. The question remains: how long will India allow its hidden epidemic to persist?
