Thriving against all odds
While everyone was gearing up for a joyful festive season, Sophia Kiwiets describes 21 December 2019 as the worst day of her life. “I got the call that my child was hit by a car and time just stopped. We rushed to the hospital to be by his side,” says Sophia.
Simphiwe Swartz (17) was involved in a pedestrian-related car accident not far from his home in Eersterivier, Cape Town. The incident left him with severe traumatic brain injury, multiple fractures and soft tissue injuries. Sophia says doctors had very little hope that her son would pull through, but she didn’t stop keeping the faith. “Before the accident, my son was a larger-than-life character who enjoyed going to youth services at church; he loved to pray,” she says. “I kept my faith, just as he always did.”
After three weeks on a ventilator and a two-month stay in the hospital, Simphiwe was referred to St. Joseph’s Home for rehabilitation. Due to the extent of his brain injury, Simphiwe struggled with poor motor control, poor orientation to time, cognitive dysfunction and dysarthria (a motor-speech disorder in which speech is unclear due to injury to the part of the brain that controls the muscles that produce speech and sounds).
“On admission, Simphiwe was a very challenging patient. He became aggressive and frustrated. He would hit, bite and kick the nurses and was quite the screamer too,” says staff nurse Vinique Fortuin. All these reactions were related to his brain injury, but this didn’t stop the dedicated staff from doing what they loved most.
“He was fed via gastrostomy tube (also known as PEG tube) and it would take two nurses to get this done. One to do the feeding and another to hold him steady,” she explains. But as time passed, Simphiwe became familiar with his surroundings and the staff members, this meant giving him the care he needed became much easier. “As he became calmer, we would explain to him what was going to happen and he would agree,” says staff nurse Fortuin.
These challenges in day-to-day care meant Simphiwe’s road to recovery would be a long one. And his inability to communicate proved to be one of his biggest frustrations. “Simphiwe was a very social child and he loved to dream big,” says Sophia. “When he and his friends were sitting together or getting ready to go to youth, he would be the one doing all the talking. He was ambitious and compassionate, and always had a good fighting spirit.”
After one year and eight months at St. Joseph’s Home, Simphiwe’s fighting spirit proved to be stronger than ever. “He has made excellent progress,” says speech therapist, Megan Morrison. “On admission, he had a low level of consciousness and appeared agitated when seated in his wheelchair, but after oral stimulation to reintroduce oral feeding and increased stimulation for communication of basic needs, Simphiwe’s level of functioning improved,” explains Megan. Simphiwe is now able to safely swallow all food consistencies and his PEG tube has been removed.
If that’s not miraculous enough, Simphiwe has fast become the jokester in the Protea ward (teen boys ward). “He now understands figurative language and absurdities and would often make jokes in the ward,” says Megan. With all these developmental milestones in his recovery process, Simphiwe started attending St. Joseph’s Special School located on the premises of the home. “His class teacher informed the therapy team that Simphiwe has settled well into the class environment,” says occupational therapist Kashiefa Creighton. “He also let us know that his level of intellectual functioning is on the higher end compared to that of his peers.”
Kashiefa explains that upon admission Simphiwe was totally dependent on caregiver assistance for all activities of daily living. His initial therapy regime included positioning, splinting to prevent deformities, sensory stimulation and cognitive-motor stimulation. “To date, he has made good functional progress, in that he can actively participate in certain functional tasks such as eating, brushing his teeth and assisting with dressing his upper body,” she says. “His level of functional and cognitive recovery has made it possible for us to re-integrate him back into a school setting, albeit a special school. Simphiwe can tolerate active learning and participate in a classroom activity. His mode of learning is more verbal – in line with the adaptations of a special school curriculum as he struggles with writing,” Kashiefa explains. “Simphiwe has excellent verbal expression, which allows him to partake on a higher level of social engagement and enables access to his environment, family and peers.”
Due to his poor mobility, however, Simphiwe would see physiotherapist Vania van Wyk two to three times a week. “Simphiwe resisted treatment quite a bit in the beginning, but with the consistency, he was eventually able to sit independently on the side of his bed or in a chair. He was even able to have weight distributed through his right leg,” says Vania.
Simphiwe’s extended length of stay at St. Joseph’s enabled staff to reach a better level of functional recovery and re-integration back into his community and within a school setting. “This is the ultimate prize for us,” says Kashiefa. “The scope of the programme at St. Joseph’s Home and the generosity of funders enable us to reach such outcome levels. We are indeed grateful for this and wish to thank all those who make it possible for us to do our work to such an extent.”
After a very long treatment process and what seemed like an impossible task, Simphiwe was finally ready to leave St. Joseph’s to be with his family. “I always go back to that fateful day and remember how doctors told me ‘what I see now is what I will always get’. Look at him now! The staff at St. Joseph’s Home went over and above the call of duty to support Simphiwe,” says Sophia. “I will forever be grateful for that.”