Cape Town - He was busy fixing a broken kettle when it happened.
The men walked into Luthando Xego’s house in Khayelitsha and shot him in his neck, then left him to bleed on the floor of his home. “I thought I was going to die,” Xego said.
Neighbours didn’t wait for an ambulance. Somebody put him in a car and drove him to hospital, where doctors found the bullet had entered the base of his neck on the left and hit his spine, leaving his left side weak and useless.
Xego, 32, lay in Tygerberg Hospital for a month being treated for his wound. He spent the time plotting how to make his attackers pay for the pain they had caused him.
“I don’t really know them. We just had a fight the day before that, then they came and shot me,” he said. “It was hard to deal with. I was thinking about getting revenge.”
As soon as he was healthy enough, Xego was transferred from Tygerberg to the Western Cape Rehabilitation Centre (WCRC) to begin regaining use of his lame left arm and leg.
But when he arrived, Xego was not interested in rehabilitation therapy.
“I wanted to go home and get back there,” he said. “Then in the second week, when I saw those guys playing volleyball and basketball (in wheelchairs), I saw that those guys are strong. I thought, who am I not to do that? I must stay here and recover.”
He’s been at the WCRC two months now and has made huge strides in his rehabilitation. Last week, he was stationed at the carpentry workshop on site, helping to make the wooden boards that patients use to transfer between their wheelchairs and beds. He stood unassisted at the bench, his once-weak hand holding the wood steady as he sanded.
Gunshot wound patient Luthando Xego puts his rehabilitated arm and leg to the test sanding transfer boards in the wood workshop at the Western Cape Rehabilitation Centre. Picture: David Ritchie/African News Agency(ANA)
“I didn’t know that my hand could come back to normal,” Xego said. “I didn’t expect that. I used to use a crutch, but I don’t use a crutch anymore, I’m just walking.”
His rehabilitation has been more than just physical.
“Through the sessions that I went to, I realised it’s not good to think of revenge. I don’t feel that pain so much. I’m not angry anymore. Now I see it was good for me to stay here. There are so many things I have learned here.”
On Friday, Xego will be discharged from the facility to go home, three months after a bullet changed the trajectory of his life.
He’ll leave in the way that all of the WCRC’s patients dream of, but which many cannot realistically aim for: walking out on his own two legs.
The WCRC is a specialised rehab centre for people with physical disabilities caused by injuries and disease, situated near Mitchells Plain District Hospital. More than half of its patients have spinal cord injuries, with 453 spinal cord patients admitted per year, most of whom are referred from Tygerberg and Groote Schuur hospitals.
“The main causes of spinal cord injuries treated at the WCRC are due to interpersonal violence, specifically gunshot and stab wounds,” said chief executive Jonathan Vaughan.
Related: Interpersonal violence is reaching new levels of brutality, says Occupational Therapist
The centre is spacious and well-equipped, boasting a hydro pool centre, gardens and multiple gyms. It feels like a cross between a retirement village and a health club, with only the hospital beds reminding you it’s a medical centre.
Patients wear their own clothes instead of hospital gowns and have home luxuries like DStv. They are
here for the long haul: spinal cord patients stay on average two to three months.
Each patient has a dedicated team of a physiotherapist, occupational therapist and social worker, with doctors, dieticians, speech therapists, nurses and a psychologist available if the case demands.
Occupational therapist Kagiso Gcanga works with a patient in the Western Cape Rehab Centre's gymnasium. Picture: David Ritchie / African News Agency (ANA)
All of these professionals collaborate for one purpose: to get the patient back home with as much independence as possible.
“People think we just push patients in wheelchairs and make them exercise,” said Dr Léan-Joyce Osborne. She was stationed at the centre for her community service year, fell in love with rehabilitating patients and has worked there for eight years since.
“You can get patients who will come, they’ve been shot or stabbed two or three times before and they’re not fazed,” she said. “But then you do have patients where this is a life-changing incident for them and they’re scared of going back (home to a violent area). It can happen to you again and now you’re even more vulnerable.”
Related: 10 percent of gunshot wound patients at Groote Schuur Hospital have been shot before
Many patients are young men, used to being highly mobile, who now have to contend with being paralysed, having no control over their bladders and bowels and relying on carers to survive.
“In the beginning, there’s a lot of counselling and psychological input,” Osborne said. “For some patients, you’re suffering a big loss, because you’re losing all your dreams.”
With spinal cord injuries, some of the damage is painfully evident in the form of paralysis, but there are many more issues to contend with internally.
“If a nerve in your spine is damaged, it’s not only your movement and sensation that gets affected,” Osborne said. “Those nerves that come out of the spine actually supply your bladder, bowel, autonomic nervous system that regulates your blood pressure and your temperature, sexual (organs) - so the medical management is quite broad.”
Dr Léan-Joyce Osborne tests sensation and reflexes in patient Kwanele Mkwakwi's leg. Picture: David Ritchie / African News Agency (ANA)
Staff have to contend with patients who are violent and have substance abuse problems. Being shot and paralysed doesn’t turn you into a different person, as veteran social worker Tertia McKee cautions.
“It doesn’t mean because you’re a gangster and now you’re shot and paralysed, now all of a sudden you sprout wings and a halo,” she said.
Each person responds differently and Osborne has seen all the possible outcomes.
“I’ve had patients who were in gangs, who have completely turned their lives around,” she said. “I’ve had patients who weren’t in gangs, but the way they’re surviving outside as a disabled person is by joining a gang.”
A key part of rehab is getting the patient back to life as they know it and sometimes that means putting them back in the same environment that made them turn to gangsterism in the first place, said chief physio Andrea Trout-Daniels, who has been a rehabilitation therapist for 25 years.
But the rewarding part of the job is seeing the profound difference rehabilitation can make in a patient’s life.
“Some of our patients come back and say they understand why this happened to them, because if not, they probably would’ve been dead.”
Chief physiotherapist Andrea Trout-Daniels works with a patient who has lost the use of his legs. Picture: David Ritchie / African News Agency (ANA)
One of Osborne’s patients even said that being paralysed had saved his life. It forced him away from violence and reconnected him with his children.
“He’s a tetraplegic, paralysed from the neck down, he can do nothing for himself,” she said. “He’s told me on several occasions that this is the best thing that’s ever happened to him because he knows if this hadn’t happened, he probably would’ve been dead.”
But as a social worker, McKee sees the immense financial and practical burden that caring for a tetraplegic places on family members. She said that news headlines always focus on those who have been killed in sprees of violence, but not the collateral damage of those who survive, severely compromised.
“Nobody’s talking about those who have been left disabled. It’s the disability that is actually so expensive and so life-altering for many.”
This is part three of a series in which writer Chelsea Geach and photographer David Ritchie (African News Agency) document the impact of violent crime on the Western Cape’s health services.
Part 1: The EMS paramedics who are first to respond to trauma victims
Part 2: The trauma surgeons on the frontlines of saving victims of violence