Security officer Vincent Kwananda (41) was on duty at a garage shop in Delmas, Mpumalanga, when three armed robbers stormed in and shot him, fracturing his T1 and T2 thoracic vertebrae, leaving him with critical injuries.
“When I woke up from a coma in hospital, they told me what had happened. I didn’t ask many questions. I couldn’t remember anything,” says Mr Kwananda of that fateful day in February last year that began a gruelling journey to a whole new way of life to regain his independence.
Speaking ahead of International Spinal Cord Injury Day on 5 September 2024, Dr Aneesa Khan, a general practitioner with a special interest in physical medicine and rehabilitation at the Netcare Rehabilitation Hospital, explains that Mr Kwananda had sustained serious, life changing injuries in the shooting.
| Pictured here is Netcare Rehabilitation Hospital physiotherapist Mike Alves with Vincent Kwanada. "When the physio is trying to teach you something you feel you can’t manage, recreate it into something you can do. Then, it becomes a step to help you succeed where you previously failed," says Vincent. "At the start of my rehabilitation, it seemed impossible to learn to sit up in bed, but now I have so many different ways I can do it. It’s all about creativity." |
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“Mr Kwananda’s injuries were addressed at the Netcare Alberton Hospital, and six weeks later, after he was medically stable, he came to us for rehabilitation,” she says.
“When patients first arrive, they’re only just starting to recover from an acute, traumatic event. They are often anxious and still in a physical state of recovery. Mr Kwananda experienced weakness from the chest downward as a result of the injury.”
Jessica Morris, a senior occupational therapist at the Netcare Rehabilitation Hospital, said Mr Kwananda had very limited movement in his fingers. “His occupational therapist taught him how to use assisted devices like universal cuffs and assistive devices to obtain more independence. A year later, he can extend his fingers a little and can form a grasp with his fingers mostly without these devices. We’re still exploring some other ways to help him. With any spinal cord injury there are lifelong changes and adaptations needed.”
Mr Kwananda has, against the odds, returned to work on adapted hours. “He was adamant he wanted to go back to work from his first day here. Our hope is that one day he will be able to be fully reintegrated back at work,” says Morris.
Not only concerned with his own rehabilitation, Mr Kwananda stepped in to act as a mentor to newer patients in the hospital, instilling hope for their rehabilitation journey. Morris said patients at the Netcare Rehabilitation Hospital often form mentor-mentee relationships, showing each other there is light at the end of this tunnel. “They support each other to regain lost independence and work together to build up their strength. They learn from each other and that’s really impactful in the rehabilitation journey.”
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Mr Kwananda recalls seeing some patients weeping because their lives had changed so dramatically. “I would talk to them and say, you know what guys, crying doesn’t change anything. When you change your mindset, things start to happen.”
For Mr Kwananda, part of his therapy included being taught selfcare and how to use his hands for things like eating, grooming, and dressing. Morris says the therapy team also taught him mobility tips like turning and rolling in the bed so he could move better by himself. “The team introduced him to using a wheelchair, which is difficult to master. Accepting that you must use a wheelchair is not easy, so to get to a stage where he’s able to confidently and competently use a wheelchair is something I really admire.
“Once a person has a better understanding of how to navigate their new body, we then look at ways in which they can better move within their home and community environments, and ultimately look at how we can reintegrate them back into the work place. This is when we can really say they have been successfully rehabilitated. Mr Kwananda played a very proactive role in this.
“While actively driving his own in-patient rehabilitation program, Mr Kwananda also bought himself a laptop and decided to start learning a new skill so that one day he’d be able to go back to work and continue providing for his family. Although he wasn’t completely computer literate before, his employers wanted to offer him an adapted position. They really wanted him back, and he was determined to offer them something new as well,” says Morris.
She describes how Mr Kwananda would sit in the gym for hours, trying to improve his typing speed and learn new ways to operate programs on the computer. “He was using his hands, which was hugely therapeutic for him. His occupational therapist also liaised with his employers to find out what kinds of work duties he would need to be able to perform, and this was incorporated into his therapy plan to allow him to build confidence and competency in these tasks.”
Morris says as with all spinal cord injury patients, a considerable focus was making sure he could cope emotionally and psychologically with his injury. Mr Kwananda says it was not easy to accept it. “But, I did. What got me to that point was when I was watching soccer and saw that football fly through the air, I’d feel like it was the bullet coming towards me. I even heard the sound of the bullet. Sometimes, I’d close my eyes and change the channel. I knew that if I wanted to live a normal life, I couldn’t be like this. I chose to accept what had happened and live positively, putting that into practice. That’s when things changed for the better.”
Mr Kwananda regards it as a privilege to return to work. “It helps me. To work as a security guard is not easy. To hear someone has been shot at their post is not easy. I help motivate others. When they see me, some of them can’t believe I’m alive. Some of them even cry when they see I’m in a wheelchair, and I comfort them. Even as I speak to you, I’m at my post at work. I’m teaching people because of my experience. That’s important to me.”
Mr Kwananda says his wife has accepted his injury, too. “She resigned from work to come and assist me and has been a big support for me. She’s never complained, not for a single day.”
When asked his secret to learning all these new skills, Mr Kwananda says creativity is key. “When the physio is trying to teach you something you feel you can’t manage, recreate it into something you can do. Then, it becomes a step to help you succeed where you previously failed. At the start of my rehabilitation, it seemed impossible to learn to sit up in bed, but now I have so many different ways I can do it. It’s all about creativity.”
Asked how he’s adapted to life in a wheelchair, he laughs. “The first day, I couldn’t even sit in a wheelchair, and they had to take me to the gym in my bed. My body was not strong enough. At first, I found it very difficult to push myself in the wheelchair, but because I accepted the situation, I coped. Today I can push the chair for five kilometres because I accepted what the physiotherapist wanted to teach me. It’s given me confidence and helped me become independent.”
Morris concludes: “Mr Kwananda reminds me how much the human spirit can accomplish when the person has that fight within them. The world could have given him a million reasons to give up, and he showed us a million reasons to fight harder. If he keeps that fighting spirit, he’ll continue to achieve great things.”
Focus on ending violence, a major cause of spinal injury
The theme for this year’s International Spinal Cord Injury Awareness Day, which will be marked on 5 September, is “End Violence – Protect Spinal Cord.”
Dr Aneesa Khan, a general practitioner with a special interest in physical medicine and rehabilitation, says from the cases seen at Netcare Rehabilitation Hospital, incidents of violence, especially involving younger men, are on the increase.
“There’s a lot of crime and gender-based violence related injuries. Some of our patients have suffered devastating, lifechanging injuries by being caught in the crossfire.
“A spinal cord injury can alter the path of a person’s life dramatically. It can be very damaging to their mental health and can take a huge toll on the entire family. There’s often loss of income, and in some instances, the patient’s spouse stops working to care for their injured partner, which can have a massive financial effect on the family,” says Dr Khan.
“It’s such a complex process to rehabilitate these patients because so many different areas of their lives are affected. In our hospital, we are fortunate that our multidisciplinary team has many practitioners who contribute to treating spinal cord injury patients. It’s so critical to get a successful rehabilitation.”
Dr Khan explains that the spinal cord regulates movement, sensation, and automatic bodily functions.
“It controls your heart rate, blood pressure, temperature control, bowel and bladder, and metabolism – it’s all affected. For example, people with quadriplegia may need to learn to regulate their body temperature. They’ll learn how to sit up so they don’t just pass out because suddenly their blood pressure has dropped so low.
“These are things that all have a massive role in our ability to get going and live life, without considering all the complexities that come with trying to be a mom, father, husband, or employee. You’re faced with a whole new image of yourself. A person may think, ‘My body doesn’t work the way I want it to, and it doesn’t cooperate the way I want it to’. There’s so much that needs to be addressed.”
This is the benefit of a multidisciplinary team that includes doctors, nurses, physiotherapists, occupational therapists, speech therapists, a prosthetist, a dietician, social workers, and psychologists who prioritise dignity, respect, and compassion for their patients.
The senior occupational therapist at the Netcare Rehabilitation Hospital, Jessica Morris, says patients who come to their unit don’t have to manage their journey alone.
“We have a great multidisciplinary team they can rely on, including a psychologist and social worker. I’m very grateful that we are in a unit where I can call on any of our colleagues if a patient needs help outside the ambit of what I can give them.”
Morris stresses how important it is to ensure the people who come through their doors understand their injuries and how their treatment plan is structured to ensure the rehabilitation programs can be client-centered and so that patients can be actively involved in driving their own rehabilitation programs.
. “We tell them what their days will consist of and get them involved as early as possible to try and do things for themselves so that they can carry over these learned skills to their home and community environments and ultimately into their work environments. The layman’s initial thought is they’re going to want to learn to walk again, but for patients like Mr Kwananda, it’s even more devastating when you can’t use your hands,” she says.
“We also teach our patients to find their voice and to be able to direct people to help them when needed. We teach them how to take charge of the recovery process.”
Morris says it’s very important to focus on reintegration, not only in work and home environments but also in community environments. Care at the Netcare Rehabilitation Hospital extends beyond the patients’ stay there, as the outpatient rehabilitation centre continues to provide rehabilitation therapy to patients after their discharge.
For Morris, learning is a two-way process between the patient and the health practitioner. “At the beginning of rehabilitation, our patients rely on us to learn how to cope and manage with everyday life again, but we watch them progress with their rehabilitation, we end up learning so much more from them.”
Ends
Notes to editors
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Issued by: MNA on behalf of Netcare Rehabilitation Hospital
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or Clementine Forsthofer
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