Another successful surgery. KNH doctors Successfully reattach 7-year-old's hand

Sunday, October 4 started like any other normal day for the Iticha family. But at 8am, things turned bloody for the Kiambu County family in an unexpected turn of events.

Anthony Iticha had tasked his seven-year-old son, Benevolence, to feed the cows. He left him on the chaff cutter as he went to fetch grass. Shortly afterward, he heard a scream that left him frozen.

“I ran towards my son and saw blood flowing from his right hand as the upper part of the hand was lying on the gound. I froze. He rushed to his mother who started screaming,” Iticha explains.

The screams attracted the attention of a neighbour, Maudlin Gachuri, who came and tried to calm the situation.

“I didn’t know what to do. I felt like my heart had stopped beating. I was crying with blood all over me. Our neighbour, Gachuri, came and asked where the hand had dropped. She rushed and found it on the ground, picked it up, and told us to rush to the hospital,” said Lydia, Benevolence’s mother.

She said when the neighbour handed her the severed hand, she put it in a paper bag that was on the floor. She then wrapped her son’s injured arm in a clean cloth and rushed him to hospital.

“I just picked up the bag, dropped the hand inside and rushed to Nazareth Hospital where they did first aid, put the hand in a cooler box and referred us to Kenyatta National Hospital (KNH) in Nairobi,” she said.

On Wednesday this week, the story was different. At KNH where he underwent surgery to re-attach his hand, a lively Benevolence was on a wheelchair dressed in a green hospital gown and covered in a blue bedsheet. His curious seven-year-old mind seemed to wonder why journalists’ cameras were flashing and all attention was on him.

As doctors spoke to journalists about how they managed to re-attach the severed arm, Benevolence was more curious about the cameras, scratching his head, and then whispering in his father’s ears before smiling again and facing the cameras.

Benjamin Wabwire, consultant plastic and reconstructive surgeon at KNH, said Benevolence’s age was an advantage because his nerves will grow back faster.

“We are optimistic he will return to full function and his brain will be able to adapt faster. He is also undergoing occupational therapy and physiotherapy. At the moment, he may not have sensational feelings in the fingers as the nerves grow back,” he said.

Wabwire said the masses should know what to do when such accidents happen.

What to do

“When an accident occurs, the first thing to do is keep the severed part in a cool box then rush to hospital. Benevolence’s case was a bit easier since he was in Kiambu and it took three hours to Nairobi,” he said.

Wabwire said they receive so many cases but sometimes they come a bit too late.

“We get cases from Kwale, Kisumu, Kisii but by the time they get here the cells have died, so there is nothing much we can do. I hope as time goes by, we can get experts in those areas or faster means of transport,” he said.

What if one cannot afford a cool box? In such cases, Wabwire said, the severed limb can be preserved in a clean polythene bag.

“Wrap the severed part in a clean cloth then put it in a plastic polythene bag. If a bag is not available, you can put it in a container like a hotpot to maintain the same temperature,” he said.

The close to 10-hour surgery involved a multi-disciplinary medical team made up of surgeons, orthopaedic surgeons, aneasthetists, and nurses.

During the reattachment, the damaged tissue is carefully removed. Bone ends are shortened and rejoined with pins, wires, or plates and screws. This holds the part in place to allow the rest of the tissues to be restored. Muscles, tendons, arteries, nerves, and veins are then repaired. Sometimes, grafts or artificial spacers of bone, skin, tendons, and blood vessels may be needed. The grafts can be from your own body or from a tissue bank.

This is the fifth successful reattachment surgery since the first one that happened in February 2018 on 17-year-old Joseph Thairu from Kiambaa, Kiambu County, whose arm was accidentally cut off while he was cleaning a chaff cutter.

Thairu has gone back to his daily routine and his hand is functioning normally.

During the Wednesday interview, Benevolence was excited and moved his bandaged hand and fingers. He smiled as he lifted his hand: “When I am older, I want to be president.”