Ntsako Mathebula, a mother of three who sustained a bullet wound to her back while on duty as a police officer says that one year on, she is looking forward to going back to work in an administrative role where she can still do good and make a difference. 

When 34-year-old police officer Ntsako Mathebula set out for a routine patrol with her colleagues one quiet Spring morning in 2022, it felt like any other day. Little did this fit and active mother of three know that it would be the last day she would ever have use of her legs. 

While on duty, Ntsako sustained a bullet wound to her back, resulting in severe abdominal injuries, a collapsed lung and, most devastatingly, irreversible damage to her spinal cord, leaving her paralysed from the midback downwards, explains Dr Aneesa Khan, a general practitioner with special interest in physical medicine and rehabilitation who practises at Netcare Rehabilitation Hospital. 

Looking back one year later, Ntsako recalls the moment her life changed when she and her colleagues pulled up to a garage in a residential area where, unbeknownst to them, a robbery was underway. They immediately came under fire without any time to respond. While Ntsako and her partner survived, tragically, their commander was critically wounded and later died in hospital. 

“All the while, I was praying to God, saying, ‘I am not ready to come to you yet’. After the incident I was in a lot of pain and could not feel my legs, but I was grateful to be alive,” she says. 

Ntsako was taken to Netcare Milpark Hospital and once stabilised, underwent scans to assess the extent of her injuries. Professor Maeyane Moeng, Academic Head of Trauma at the University of Witwatersrand and a trauma surgeon, along with Dr Christos Profyris, a specialist neurosurgeon, noted that the bullet had gone right through Ntsako’s spine to her small intestine. 

Prof Moeng operated to remove the bullet and address the injuries to Ntsako’s abdomen, which were severe but from which she fully recovered. The damage to her spine however was irreversible and after moving to Netcare Rehabilitation Hospital, the reality of her journey began to sink in. 

“At first, I was in denial – I kept thinking the feeling would return to my legs and life would go back to normal. But the first time I was pushed in a wheelchair, it felt real. I tried to keep my spirits up, smiling every day and encouraging myself, but it was very hard, knowing how easy it was before to do something as simple as sitting up. As a previously fit and active person, I now had to learn how to sit up,” says Ntsako. 

Dr Khan points out that one of the primary concerns in rehabilitating paraplegic patients is sensory impairment, which prevents them from feeling pain or sensing limb position. This can lead to pressure sores, which occur when the skin and underlying tissue are subjected to ongoing pressure, such as when an individual’s legs remain in the same position for lengthy periods. 

“Pressure sores can become infected and can be fatal if left untreated. After sustaining an injury like Ntsako’s, it is important to get the patient out of bed and moving as soon as possible to avoid this. The lack of muscle movement in spinal cord injury patients leads to the development of osteoporosis very early on, which also makes you far more susceptible to bone fractures – again, you may not be immediately aware of this since you cannot feel the pain if you have a fall when moving yourself from one surface to another, such as from the bed to a wheelchair. 

“Lack of sensation also affects bladder and bowel control, and it is essential for patients to get onto a scheduled plan so that they can manage this. This is important for protecting the skin, digestive system and kidneys and preventing infections, as well as for feeling comfortable to participate in social situations.

“Nerve pain is another major concern and the medications for managing this pain are limited. Physical and psychological therapy are important in helping patients to manage their pain and the process of acceptance. The spinal cord injury experience is multi-faceted, and we therefore work in a multidisciplinary team with physiotherapists, occupational therapists, psychologists and social workers to give patients the strongest foundation for moving forward and having a full and happy life,” says Dr Khan. 

Trinesh Baroon, a physiotherapist practising at Netcare Rehabilitation Hospital who provides Ntsako with outpatient care, notes that the mental shift for spinal cord injury patients is an enormous challenge and that Ntsako has shown herself to be a remarkably tenacious, highly motivated person. 

“By the time I saw her, Ntsako had already made tremendous progress, but the move home can be challenging as it is a very different environment where you go from having round the clock care and ten physio sessions per week to being responsible for your daily needs and having just one session per week.

“In fact, she went in person to her healthcare funder to motivate her case to receive outpatient care as she is so determined to recover to the best of her ability. Her bravery and determination will influence the lives of people she will never even meet because she has helped to pave the way for others in similar circumstances,” says Baroon.

“We have worked a lot on strength and endurance and have been doing therapeutic standing to try to build up her blood pressure. Without this, there is the possibility that a patient can go into postural hypotension or low blood pressure and can have vertigo, which is a serious problem when you need to be able to safely move yourself from one surface to another. It requires continued commitment, and Ntsako has fully embraced that, asking questions when she needs to and taking ownership of her rehab – and this is when we see the most successful outcomes.”

Ntsako notes that while the adjustment to this new way of life is emotionally challenging, she feels a great sense of relief and comfort in being able to talk about it with her social worker and her loved ones. 

“Talking openly about my experience is helping me to relate to my family in a new way, and I feel that I have been able to process what has happened emotionally. My goal is now to master the physical aspects of living back at home so that I can care for myself and also my family. 

“I have learned from this experience that there are some things you cannot change, but you can always change your mind. It is all about attitude. I am so looking forward to going back to work in an administrative role. I am ready to start afresh, and I am still inspired to do good and to make a difference,” she concludes.