Perspective of a medical professional

Professor Johan Walters, the head of orthopaedic surgery at Groote Schuur Hospital, said that without seeing injured photojournalist João Silva and his medical records it would be difficult to predict what is in store for him.

Many factors influence how quickly patients heal after an amputation: age, weight, the type of wound and whether it is infected, and any other injuries.

However, Walters said that in general it could take anywhere between three months and a year for an amputation stump to heal, for the swelling to go down and for the stump to take on its final form.

Though an interim prosthesis could be used before then to help Silva learn to recover his balance, a definitive prosthesis could be fitted only after the stump had fully healed.

Learning to walk with prosthetics would take more time.

Such steps would come only after the photographer had been stabilised.

The most common complication in such a case is infection, Walters said. Silva’s wounds were not sustained cleanly, with a blade for example, but in an explosion.

“With a blast, grit and debris goes into the bone and there’s a peppering of the tissue and bone. If [his doctors] can excise all of that, the prognosis is good,” he said.

Walters said Silva should be able to regain a very active life. “But it’s probably not realistic to expect him to go back to what he was before,” he said.

As a war photographer, one has to be mobile and independent, with the ability to carry equipment, climb over obstacles and run if conditions demand it. This would pose challenges for someone with prosthetics.

Walters said the psychological trauma that came with such a violent experience and learning to live with a disability would require healing of an altogether different sort.