Emmanuel Rutema couldn't keep the smile off his face as he tested out his new prosthetic arm and promptly knocked himself on the nose.
"Be careful with your face!" the hospital prosthetist told the boy whose grin just grew wider.
Rutema is one of four Tanzanian children with albinism visiting the United States to get prosthetic limbs to replace those hacked off in brutal superstition-driven attacks in their East African homeland.
At Shriners Hospital for Children in Philadelphia on Tuesday, three of them got the new limbs that will help them do everyday tasks most people take for granted.
Rutema, the oldest at 15, speaks with difficulty. His attackers chopped off one arm and the fingers of the other hand and tried to pull out his tongue and teeth.
Also getting prosthetics were Baraka Lusambo, 7, and Mwigulu Magesa, 14, each of whom lost parts of their arms in attacks.
People with albinism live in danger in Tanzania, where their body parts are used in witchcraft and can fetch a high price.
Superstition leads many to believe they are ghosts and bad luck.
Albinism is a congenital disorder affecting about one in 20,000 people worldwide who lack pigment in their skin, hair and eyes, but it is more common in sub-Saharan Africa and affects about one Tanzanian in 1,400.
The Tanzanian children are getting treatment in the United States with support from the Global Medical Relief Fund (GMRF), a New York-based charity that hosts children from around the world who have been injured in conflict or disaster.
Threats and murder
Elissa Montanti, founder of GMRF, called the children from Tanzania "gentle souls."
"When they come here, they have lost so much. They have lost part of their youth and part of their dignity," Montanti told Reuters at the Philadelphia hospital.
"We put them back together. When they go back, they have a stronger sense of empowerment. I see such a difference."
For these children, this is the second trip to the United States for prosthetics and they leave next week. They first came two years ago, and they have returned for larger limbs because they have grown. They could return again for larger equipment.
Their new arms are attached with shoulder harnesses, and the elbows and fingers are controlled with cables.
Within minutes, Lusambo, the youngest, was clowning around, using his new hand to erect a tower of plastic building blocks and chomping on a candy lollipop.
Magesa was more serious, and stood stiffly as the prosthetist tugged at his harness straps and tightened its buckles.
Asked what he would be doing at home in Tanzania with his new arm, he said: "Washing clothes."
The children attend boarding school and live in so-called safe houses in Tanzania. They rarely go out in public because it frightens them and could put them in danger, said Ester Rwela, a social worker with the charity Under the Same Sun who came with them to the United States.
United Nations officials estimate at least 75 albinos were killed in the east African nation between 2000 and 2015, but fear the number of reported attacks represent just a small fraction of the total, as most are secretive rituals in rural areas.
Under the Same Sun runs a public awareness campaign to dispel notions that the bodies of people with albinism have special powers or should be sacrificed for their limbs.
Superstition holds that having a piece of a person with albinism can bring luck finding a well-stocked fishing site or a plentiful gold mine or bring a victory in politics, Rwela said.
"What we are fighting with is the mindset of the people," she said. "When a witch doctor says, 'Bring me a part of an albino and you will be successful,' they go and do it. Someone can be educated, but they believe in superstition to be successful."