November 2018: It was rainy season and so pregnant, 18-year-old Alinafe Isaac, was cooking in the kitchen rather than outdoors. Her family told us that she was hit by lightning which forced her into the cooking fire. She sustained severe burns on her upper limbs, back and bottom so she was taken to Ntcheu District Hospital where both of her arms were amputated above the elbow. A week later she was referred to the burns unit at Kamuzu Central Hospital for burns management.
February 2019: When Alinafe first visited 500 miles, her wounds were not fully healed. She had limited range of motion and her shoulders were stiff and turned in.
May 2019: When Alinafe returned, the amputation sites were fully healed and so our rehabilitation technician, Rabecca Mangani, gave Alinafe some counselling, range of motion exercises, positioned Alinafe’s shoulders and taught her how to transfer from one surface to another and how to manage at home.
September 2019: Our QIC, Sandy, was visiting when Alinafe next came to us to have casts for prosthetic arms. Sandy advised that, as Alinafe’s stumps are short, it would be difficult to use prostheses. Also, the burns on her back were not completely healed and she had not yet gained full range of motion and muscle strength in her shoulders.
Sandy told Alinafe they should first aim to get her using functional adaptive devices for ADLs which Alinafe could practice with at home in readiness for possible future prostheses, whilst also giving her time to heal completely and gain muscle strength.
At first Alinafe was reluctant, because she thought that what was being expected of her was too hard. But after Sandy comforted her and showed her videos of how other amputees all over the world are coping, she started to come round to the idea. To motivate her, we asked other patients at the centre to share their stories.
The first devices made for Alinafe were an adaptive feeding spoon and an adaptive feeding bottle. She was happy with the independence they gave her and was looking forward to the next stage.
December 2019: We invited Alinafe to visit again to coincide with Sandy’s next QMS visit when Alinafe was also encouraged by Silvester and Diquence’s stories. This time the focus was helping her to do all ADLs independently and to be able to take care of her baby. Rabecca and Sandy made her adaptive devices for cleaning, grooming and dressing herself and her daughter. The next step will be to make Alinafe sockets with hooks to use for carrying things and for doing housework and farm work. The priority for Alinafe will be maximum functionality which means that she may or may not progress to using upper limb prostheses.