“It was like a bad dream”: Making sense of violent hand amputation and replantation in South Africa

Abstract

Background: South Africa is faced with one of the highest rates of violent crime in the world. Accordingly, therapists treat high numbers of deliberate hand injuries. There is, however, a paucity of literature exploring the lived experiences of these survivors. Purpose: The aim of this study was to describe and interpret the meaning of living through a violent hand amputation and replantation, the impact on occupational adaptation and to reflect on therapeutic intervention, within the context of South Africa. Study Design: An exploratory embedded single case study using a qualitative approach. Methods: Interpretative phenomenological analysis was used to analyze data from: 8 interviews with the primary participant, over a period of 33 months; an interview with his work colleague; interviews with 5 health professionals; a review of the occupational therapy rehabilitation file and a review of the audiovisuals, recorded over 2-years. Results: This narrative reveals a man who understood his terrifying assault to be part of a southern African ritual of spiritual origin -using human body parts for traditional medicine (muti crime) or witchcraft. He perceived his expensive hand replantation and therapy as surreal and violence as normal. Challenges highlighted the importance of being attentive to the psychosocial sequelae of violence; and the most valuable part of therapy was perceived as occupational engagement. Conclusions: The perception of attempted muti murder situates this extreme and unusual case study as a novel contribution to the medical and rehabilitation literature. South African therapists are urged to be actively involved in changing the culture of violence, and hand therapists are reminded of the importance of applying holistic and occupation-based intervention.

Law Beyond Israel

“…Understanding the passage's first prohibition (in Q 4:22) as that of descending first-degree consanguinity between a woman's spouses, that is a woman marrying a man and his son (which we will designate as a), allows us to see how this prohib ition structurally corresponds to the three laws we find in the fourth category of prohibitions, on the grounds of affinity, towards the end of the verse Q 4:23, beginning with wa-ummahātu nisāʾikum wa-rabāʾibukum. 79 The ascending prohib ition in Q 4:23 against a man marrying both a woman and her mother ( wa-ummahātu nisāʾikum), which we will designate b, constitutes our passage's second instance of the prohibition of first-degree consanguinity between ego's spouses, evoking the same legal principle we have already encountered in v. 22. The Qur'an then immediately extends this second prohibition to the descending generation by forbidding a man from marrying both a woman and her daughter (i.e.…”

“…This last prohibition constitutes a cognate of a, according to Héritier's system: the descending prohibition against a woman marrying both a man and his son in v. 22 is the gender cognate of the descending prohibition against a man marrying both a woman and her daughter in v. 23, which we will thus designate aʹ. 80 The next prohibition is that against a man marrying "the wives of your sons who are from your loins" (wa-ḥ alāʾilu abnāʾikumu lladhīna min aṣ lābikum).81 If we mirror this law from a female point of view, as the ascending prohibition against a 79 The terms ascending and ascendants denote all of the prior generations of either ego or ego's spouses, and the terms descending and descendants denote all the subsequent generations of ego or ego's spouses.…”

“…in Exod 29:33 and Lev 22:10. For a detailed discussion see Goy,[27][28][29][30][31][32][33][34][35][36][37][38][39] Rites and Rank,[74][75][76][77][78][79][80][81]…”

Patient perspectives of recovery following major musculoskeletal trauma: A systematic review and qualitative synthesis

“…The remaining seventeen studies used semi-structured interviews exclusively. Studies collected the qualitative data face-to-face, 21,[42][43][44]46,47,[50][51][52][53]56 via telephone, 20,54 a combination of face-to-face and telephone, 8,45 or not recorded. 49,55,57 Where provided, the duration of the interviews ranged from 12 min 47 to 86 min.…”

“…Participants across all studies described the emotional and physical labour associated with working towards recovery. 8,20,21,[42][43][44][45][46][47][49][50][51][52][53][54][55][56][57] Many participants were shocked that they did not 'bounce' [Wiseman, Forster and Curtis 51 , p. 1986, participant information not provided] back from their injures as quickly as they had expected, due to unanticipated effects of injuries.…”