Rwanda Students Build Smart Insole to Prevent Amputations

Prisca Nikuze never imagined she'd be making artificial limbs. She wanted to become a doctor to help her family member with diabetes, but life had different plans.

When medical school didn't work out, she enrolled in prosthetics and orthotics instead. At first, she couldn't see the connection to her goal of helping diabetes patients. Then she learned something that changed everything: diabetes is one of the leading causes of limb loss.

The reality hit hardest during her 2025 clinical internship at a hospital in Kigali. Of the 10 patients she treated, six had lost limbs to diabetes complications. Nikuze, now a licensed prosthetist, realized she didn't want to keep building artificial limbs for problems that could be prevented.

That urgency sparked NEEM, a health-tech initiative she co-founded with other young innovators. Their mission: catch diabetic foot problems before amputation becomes the only option.

The team is developing a smart insole embedded with sensors that track pressure, temperature, and blood oxygen levels in the feet. Diabetic neuropathy often causes patients to lose feeling in their feet, meaning they can injure themselves without knowing it. Poor blood flow then makes those wounds difficult to heal.

The insoles work by detecting changes before patients can feel them. Rising pressure can signal an impending injury. Temperature spikes indicate inflammation. Drops in oxygen saturation show poor circulation. When the sensors detect problems, they send alerts to both the patient and their healthcare provider.

The technology is still in testing phases at hospitals including Sayashika and Muhima Hospital, with consenting patients providing feedback. Nikuze is clear that extensive research is needed before widespread deployment, and the work requires significant funding.

But early results have given the team confidence. "We have been able to at least work with some people and get to see the signs that this can be something that can really change," she says.

The Ripple Effect

The impact of diabetic limb loss extends far beyond the physical. During her internship, Nikuze met a woman who didn't know she had diabetes until a foot wound led to amputation. By the time doctors diagnosed her, her other limb was already affected.

Prosthetic limbs cost millions of Rwandan francs, creating crushing financial burdens for families. They also can't fully replace natural limbs, making everyday activities challenging. For breadwinners, losing a limb can mean losing the ability to provide for loved ones.

Nikuze taught herself Internet of Things, artificial intelligence, and data analytics during university breaks, never knowing those skills would merge with her medical training. Now they're combining to potentially spare thousands of people from preventable amputations.

The work continues, but the vision is clear: a future where fewer families face the heartbreak she once feared for her own.