NEW DELHI // Every day, Abdul Rahim, a captain in the Afghanistan army, makes his way to his physiotherapy appointment at the Amrita Institute of Medical Sciences in Kochi, where he tries to remember how he once used his hands.
Even to think of them as “his hands” is a challenge. He does control them, if a little clumsily, but he has only had them since last April, when they were transplanted on to his forearms in a marathon 15-hour surgery.
Mr Rahim’s hands still look like foreign objects, their darker brown colour a sharp contrast to the pale tone of his forearms. “But I can eat by myself now, and I can drink water, and I can dress myself, and I can write,” he told The National. He can also ride a bicycle and even steer a car.
“All of this is remarkable,” he said. “A year ago, I had no hands at all.”
Mr Rahim’s case was only the second double-hand transplant ever carried out in India, following the first – also performed at the Amrita Institute – four months earlier.
“The world’s first double-hand transplant was done 17 years ago, and around 80 have been done around the world since then,” said Subramania Iyer, the head of the hospital’s department of plastic and reconstructive surgery. “But they’ve all been in Europe and the US, and a couple in China.”
Dr Iyer’s department had been planning to venture into hand transplants for many months before taking on its first case, he said. “Prosthetics are not very good. They’re expensive and not always effective.”
At the same time, grafting a new hand onto a patient is tricky business. “You have to reattach a lot of small structures like nerves and blood vessels,” Dr Iyer said. “And the chances of a hand being rejected by a body is high, because skin is the part of the body that has the most potential to be rejected.”
Rehabilitation is also crucial. “A liver or a kidney, once transplanted, will begin working right away,” Dr Iyer said. “For a hand, you need to work for at least a year to get full function back. Abdul has 80 to 85 per cent of his hand function back. It’s almost as if he has his own hands again.”
For Mr Rahim, now 31 years old, the prospect of getting a new pair of hands once seemed impossible.
In April 2012, in his native province of Kandahar, Mr Rahim’s unit was clearing a road of ordnance, when an unexploded bomb went off. He lost both hands but suffered no other injuries.
Afghanistan did not possess the medical infrastructure to conduct hand transplants, so Mr Rahim looked overseas. His government helped him explore the possibilities of transplants in several countries, including Iran, but Mr Rahim found that the procedure was rare if not non-existent.
It was in Delhi, in late 2014, that Mr Rahim heard of the Amrita Institute and contacted Dr Iyer’s department. He was the second person on the hospital’s registry. Now he needed to wait for a donor.
One morning last April, TG Joseph, a 52-year-old construction worker in Kochi, left home to go to work. Hours later, his daughter Aleesha learnt that his motorcycle had been hit by another vehicle on the way, and that he had been declared brain-dead as soon as he arrived at hospital.
“When we were there, the doctors asked us if we wished to donate his organs,” Ms Joseph told The National. Her uncle, TG Cletus, had pledged his own organs already, so he persuaded the family to donate Mr Joseph’s cornea and liver.
“Then the doctors told us about Abdul Rahim,” Ms Joseph said. “They said: ‘We have a patient who has lost his hands,’ and they asked if we wished to donate those also. As a family, we made the decision to do it.”
The surgery cost 1.5 million rupees (Dh80,000) and was paid for by the Afghanistan government.
Dr Iyer described the complexities of the surgery: the connection of two bones, two arteries, four veins, 14 tendons, and numerous nerves and smaller blood vessels in each arm. Twenty surgeons and eight anaesthetists were in the theatre at various points through the 15-hour surgery.
The hands would look markedly different, Dr Iyer had already warned Mr Rahim. “When we were going into the theatre and he was being wheeled in for the surgery, I told him that TG Joseph was darker than him,” Dr Iyer said. “We had to tell him that. It’s our duty.”
“But he wasn’t bothered about it at all,” he added. “He was just worried about having functioning hands again, and being able to live on his own rather than depending on someone else all the time.”
Ms Joseph recalls the first time she met Mr Rahim once the transplant was finished. “I looked at him, and I was so sad at first, because I was reminded of how I had lost my father,” she said. “But then, when I touched his hands, I was happy.”
“I felt like some part of my father was still alive.”
After the surgery, Dr Iyer advised Mr Rahim to stay on in Kochi for at least a year, to work on rehabilitation. Mr Rahim found a flat for himself, his wife and his 12-year-old son, from where he could commute easily to the hospital for his exercises.
“Earlier, there was a language problem. Since he’s from Afghanistan, it was very difficult to communicate with him, and we had to use Google Translate to get through to him,” Dr Iyer recalled with a laugh. “But in all this time, he has managed to pick up English as well as Hindi, and he can understand us to some extent.”
In two months, Mr Rahim said, his physiotherapy will come to an end.
“I can finally go back home, to Afghanistan,” he said. “I am looking forward so much to beginning life again. For a long time, I thought I would remain without hands for the rest of my life. This still feels like a miracle every day.”
Even Dr Iyer, a veteran reconstructive surgeon, talks about the operation in an amazed tone.
“I remember when Abdul met Joseph’s wife and daughter,” he said. “It was an emotional moment, and he was so grateful to them.”
People have remarked to Dr Iyer, in the months following the transplant, about how this was a case in which a Hindu surgeon took a Christian man’s hands and put them on a Muslim man, he said.
“But religion, in this case, was so superficial,” Dr Iyer said. “When someone interprets it like that, you’re surprised. Of course it’s a good message. But I can tell you that, when it was all happening, no one gave it a thought. Everyone just did what they felt was right.”
SSubramanian@thenational.ae
Coal Black Mornings
Brett Anderson
Little Brown Book Group
The rules on fostering in the UAE
A foster couple or family must:
- be Muslim, Emirati and be residing in the UAE
- not be younger than 25 years old
- not have been convicted of offences or crimes involving moral turpitude
- be free of infectious diseases or psychological and mental disorders
- have the ability to support its members and the foster child financially
- undertake to treat and raise the child in a proper manner and take care of his or her health and well-being
- A single, divorced or widowed Muslim Emirati female, residing in the UAE may apply to foster a child if she is at least 30 years old and able to support the child financially
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
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Teaching your child to save
Pre-school (three - five years)
You can’t yet talk about investing or borrowing, but introduce a “classic” money bank and start putting gifts and allowances away. When the child wants a specific toy, have them save for it and help them track their progress.
Early childhood (six - eight years)
Replace the money bank with three jars labelled ‘saving’, ‘spending’ and ‘sharing’. Have the child divide their allowance into the three jars each week and explain their choices in splitting their pocket money. A guide could be 25 per cent saving, 50 per cent spending, 25 per cent for charity and gift-giving.
Middle childhood (nine - 11 years)
Open a bank savings account and help your child establish a budget and set a savings goal. Introduce the notion of ‘paying yourself first’ by putting away savings as soon as your allowance is paid.
Young teens (12 - 14 years)
Change your child’s allowance from weekly to monthly and help them pinpoint long-range goals such as a trip, so they can start longer-term saving and find new ways to increase their saving.
Teenage (15 - 18 years)
Discuss mutual expectations about university costs and identify what they can help fund and set goals. Don’t pay for everything, so they can experience the pride of contributing.
Young adulthood (19 - 22 years)
Discuss post-graduation plans and future life goals, quantify expenses such as first apartment, work wardrobe, holidays and help them continue to save towards these goals.
* JP Morgan Private Bank
The specs
Engine: four-litre V6 and 3.5-litre V6 twin-turbo
Transmission: six-speed and 10-speed
Power: 271 and 409 horsepower
Torque: 385 and 650Nm
Price: from Dh229,900 to Dh355,000
Key facilities
- Olympic-size swimming pool with a split bulkhead for multi-use configurations, including water polo and 50m/25m training lanes
- Premier League-standard football pitch
- 400m Olympic running track
- NBA-spec basketball court with auditorium
- 600-seat auditorium
- Spaces for historical and cultural exploration
- An elevated football field that doubles as a helipad
- Specialist robotics and science laboratories
- AR and VR-enabled learning centres
- Disruption Lab and Research Centre for developing entrepreneurial skills
Specs
Engine: Electric motor generating 54.2kWh (Cooper SE and Aceman SE), 64.6kW (Countryman All4 SE)
Power: 218hp (Cooper and Aceman), 313hp (Countryman)
Torque: 330Nm (Cooper and Aceman), 494Nm (Countryman)
On sale: Now
Price: From Dh158,000 (Cooper), Dh168,000 (Aceman), Dh190,000 (Countryman)
2025 Fifa Club World Cup groups
Group A: Palmeiras, Porto, Al Ahly, Inter Miami.
Group B: Paris Saint-Germain, Atletico Madrid, Botafogo, Seattle.
Group C: Bayern Munich, Auckland City, Boca Juniors, Benfica.
Group D: Flamengo, ES Tunis, Chelsea, Leon.
Group E: River Plate, Urawa, Monterrey, Inter Milan.
Group F: Fluminense, Borussia Dortmund, Ulsan, Mamelodi Sundowns.
Group G: Manchester City, Wydad, Al Ain, Juventus.
Group H: Real Madrid, Al Hilal, Pachuca, Salzburg.
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In numbers: PKK’s money network in Europe
Germany: PKK collectors typically bring in $18 million in cash a year – amount has trebled since 2010
Revolutionary tax: Investigators say about $2 million a year raised from ‘tax collection’ around Marseille
Extortion: Gunman convicted in 2023 of demanding $10,000 from Kurdish businessman in Stockholm
Drug trade: PKK income claimed by Turkish anti-drugs force in 2024 to be as high as $500 million a year
Denmark: PKK one of two terrorist groups along with Iranian separatists ASMLA to raise “two-digit million amounts”
Contributions: Hundreds of euros expected from typical Kurdish families and thousands from business owners
TV channel: Kurdish Roj TV accounts frozen and went bankrupt after Denmark fined it more than $1 million over PKK links in 2013
In numbers
1,000 tonnes of waste collected daily:
- 800 tonnes converted into alternative fuel
- 150 tonnes to landfill
- 50 tonnes sold as scrap metal
800 tonnes of RDF replaces 500 tonnes of coal
Two conveyor lines treat more than 350,000 tonnes of waste per year
25 staff on site
Company profile
Date started: January, 2014
Founders: Mike Dawson, Varuna Singh, and Benita Rowe
Based: Dubai
Sector: Education technology
Size: Five employees
Investment: $100,000 from the ExpoLive Innovation Grant programme in 2018 and an initial $30,000 pre-seed investment from the Turn8 Accelerator in 2014. Most of the projects are government funded.
Partners/incubators: Turn8 Accelerator; In5 Innovation Centre; Expo Live Innovation Impact Grant Programme; Dubai Future Accelerators; FHI 360; VSO and Consult and Coach for a Cause (C3)
Volvo ES90 Specs
Engine: Electric single motor (96kW), twin motor (106kW) and twin motor performance (106kW)
Power: 333hp, 449hp, 680hp
Torque: 480Nm, 670Nm, 870Nm
On sale: Later in 2025 or early 2026, depending on region
Price: Exact regional pricing TBA
Dunki
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