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Diquence is a 37-year-old Zambian who was hit by a car in June 2013 and dragged under it on his stomach for about 500 meters. Unconscious, he was rushed to intensive care. He sustained injuries to the right side of his head and he lost his right ear, his right arm at the shoulder and his left arm high through the humerus bone. His whole abdominal wall was burnt with friction and had to be skin grafted. He came round after 17 days but remained in hospital for 10 months for his wounds to be dressed.

Since then Diquence has struggled with day-to-day life. He lost his job as a grading officer in the Mines Geological department and found that he couldn’t travel long distances alone or participate in social gatherings. Diquence was able to eat directly from plate to mouth, to drink with straws and to write using his mouth. Amazingly he taught himself to do farm work using his feet but for a lot of ADLs, like washing, grooming and dressing, he needed help from his wife or father. In 2014 he managed to get a cosmetic prosthetic arm but he said it made him feel more disabled because it had no function.

Just then, a donor with experience of working between Malawi and Zambia in his youth in service to the celebrated philanthropist and doctor, Donald Brownlie, got in touch with a large donation. Olivia asked him what he thought about spending some of the Gift Aid on that donation on accommodation in Malawi for another man who needed to travel between Malawi and Zambia and he agreed. We encouraged Diquence to attend during the week in December that Sandy, our QIC, was teaching out staff about upper limb prosthetics.

And it all came together. Diquence was assessed as having a good range of motion and being very active for his condition. His left stump was cast , then fitted with a functional arm with a split hook to give him a grip. As well as the prosthesis, we made him an adaptive spoon on a functional angle with which he was able to eat his lunch, and an adaptive drinking bottle from which he could drink. Diquence had expressed his passion for writing and his difficulty in holding a pen in his mouth to write, so we made him an adaptive device to hold a pen. After a training session he was able write for a long time without getting tired. These devices were made from Velcro and elastic bands fitted round Diquence’s stump and designed by Rabecca with advice from Sandy. We also gave him strengthening exercises for the left stump and trunk, dynamic balance training, training in donning and doffing and caring for the devices and for feeding, writing, drinking and using a computer and phone.

Diquence wrote to Olivia from Zambia days after he got home asking if we would like videos of him working in his garden to inspire others.

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