Background: Peripheral vascular disease (PVD) presenting with irreversible lower limb pathology has a high morbidity and mortality rate. This study aimed to determine the outcome of patients who underwent lower limb amputations (LLAs) because of PVD at Pelonomi Hospital, Bloemfontein, 2008-2011. Methods: Prospective data collection of a retrospective cohort study group was performed. Included were patients with PVDinduced LLAs. Demographic and contact information was collected from Meditech. Living status (alive or dead) was determined using the Department of Home Affairs database and interviews with relatives. Results: Of the study population (n = 224), 119 had contact information. Data of 158 people were available to determine living status: 71.5% had died by follow-up in 2014. Forty-nine interviews were possible, 31 patients had died, with cause of death reported to be primarily vascular related. The cumulative mortality showed that 16.1% died within a month and 48.4% within one year post-amputation. Among the 18 living amputees, 50.0% became unemployed, 77.8% used wheelchairs, 11.1% used crutches and 11.1% a prosthesis. Conclusion: Lower limb amputation due to PVD is indicative of a poor prognosis. In our study only 28.5% of patients survived 3-6 years post-amputation. Restoration to ideal mobility was achieved in a minority of cases. Keywords Bloemfonteinlower limb amputationspatient outcomeperipheral vascular disease

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The apartheid history of South Africa contains racial and religious discrimination, both running parallel to and supporting each other. South Africa's exodus from a society of forced religious homogeneity to one of celebrating religious pluralism adds valuable and unique patterns of thought to the promotion of religious pluralism and religious freedom. A brief history is presented of religion within the context of racial discrimination and eventual democracy in South Africa. The current plural religious demography of South Africa is presented to create a sense of the extent of diversity in the country and the extent of religious pluralism that should be considered for today. This demographical position necessitates an investigation into the current legal position on dealing with such a religiously plural state as well as the challenges it presents. This is also necessary in order to present the evolution of religious pluralism in an oppressive state to the right to religious freedom in democratic South Africa. This evolution can also serve as an example internationally to countries struggling with the issue of religious pluralism. The article is also of importance to sensitise South Africa to existing and escalating challenges against religious pluralism within the country.1. J. D. van der Vyver, "Constitutional Perspective of Church-State Relations in South Africa," Brigham Young University Law Review 2 (1999): 670-671. 2. Although the concept "religious pluralism" in itself is contested, it is used in this article as an indication of the religious diversity that exists in South Africa and the attempts made to reconcile and balance the existence and flourishing of religions within all spheres of the South African society.

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