Michael Panther: Lost ability to walk at 10 due to spinal TB

At 10 years old, Michael Panther could no longer run. “I remember getting tired very easily,” he says quietly. “My back hurts. My legs felt weak. Slowly, I could not move the way I used to.”

He was growing up in South Sudan at a time when war had hollowed out health systems and torn families apart. What began as fatigue and back pain slowly became something far more serious. “It did not happen in one day,” he says. “It was gradual. I just kept losing strength.”

By the time he could no longer walk, there was no functioning hospital nearby that could tell his family why. Years later, doctors would diagnose him with tuberculosis of the spine. The damage was already done.

“If I had been given treatment early, it might have been different,” Michael says. “By the time I reached a proper hospital, it was too late.”

Tuberculosis (TB) is one of the oldest infectious diseases known to humankind. It remains one of the deadliest. According to the World Health Organisation (WHO), TB killed an estimated 1.25 million people globally in 2023. It remains the leading cause of death from a single infectious agent worldwide.

Dr Juma Bwika, a pulmonologist, explains that many people still associate TB only with the lungs. “Tuberculosis is a serious bacterial infection caused by Mycobacterium tuberculosis,” he says. “It usually starts in the lungs. It spreads when an infected person coughs, speaks or sneezes, releasing tiny droplets into the air.”

Yet the lungs are only part of the story. “TB can spread to almost any organ in the body,” Dr Bwika explains. “The bacteria can travel through the bloodstream or lymphatic system. In the spine, it can destroy the bones of the vertebrae and may press on the spinal cord.”

Tuberculosis of the spine is also known as Pott’s disease. It is part of what doctors call extra-pulmonary TB. According to the WHO, about 10 to 15 per cent of TB cases occur outside the lungs. Of these, bone and joint TB form a significant proportion. The spine is the most commonly affected site within the skeleton.

“In the spine, the infection causes the bones to break down over time,” Dr Bwika says. “This can lead to deformity such as a curved back, abscesses and nerve damage. If diagnosed late, it can cause paralysis.”

Spinal TB often develops slowly. Early symptoms can be vague. Low-grade fever, night sweats, weight loss and mild back pain.

“Early X-rays may even appear normal,” Dr Bwika notes. “In areas where access to MRI scans is limited, diagnosis is often delayed.” In Michael’s case, delay was shaped by conflict and displacement.

Timing 

As violence intensified in South Sudan, Michael and his father fled to Kenya in search of care. They arrived in Kakuma refugee camp, one of the largest refugee settlements in Africa.

For two years, his condition worsened. “I was in pain. I could not walk. We did not know what was happening inside my body,” he says. “We were just hoping for help.” Eventually, he secured a referral to Kijabe Hospital. There, doctors diagnosed tuberculosis of the spine and performed surgery. The operation saved his life. It did not restore his mobility.

“I survived,” he says. “That was a miracle but I did not walk again.”

Dr Bwika explains why timing matters. “If caught early, spinal TB can be fully treated with antibiotics for six to 18 months,” he says. “Most people recover well with little lasting damage. Late diagnosis can lead to severe spinal destruction, nerve compression and permanent disability.”

Refugees and children face higher risks. “Overcrowding, poor nutrition and limited access to healthcare increase both infection risk and delays in treatment,” Dr Bwika says. “Children also have weaker immune systems and can develop severe disease more quickly.”

Kenya remains one of the high TB burden countries globally. The WHO estimates that Kenya records about 124,000 new TB cases each year. The national incidence is estimated at over 200 cases per 100,000 population. Extrapulmonary TB, including spinal TB, forms a significant minority of these cases. Behind each statistic is a life reshaped.

Michael’s story did not end in the hospital. It began again in a wheelchair. Kenya’s 2019 census by the Kenya National Bureau of Statistics (KNBS) reported that about 2.2 per cent of the population lives with some form of disability. That translates to more than 900,000 people.

Mobility difficulty is among the most common forms. Census data indicate that hundreds of thousands of Kenyans report difficulty walking or climbing steps. A significant proportion experience severe limitations that affect daily independence.

Globally, the WHO estimates that around 75 million people require a wheelchair. In low- and middle-income countries, up to 80 per cent of those who need wheelchairs do not have access to an appropriate one.

In Kenya, access gaps remain wide. According to the National Council for Persons with Disabilities (NCPWDs), many persons with disabilities lack assistive devices due to cost, limited supply chains and inadequate assessment services.

Wheelchairs, crutches and orthotic supports are provided through a mix of government programmes, county health services, faith-based organisations and non-governmental groups. Provision often depends on donor funding and outreach camps rather than systematic distribution.

The result is that many users receive ill-fitting or generic devices that fail to meet clinical standards.

Survival

For Michael, the wheelchair was not a symbol of defeat. It was survival. “I realised that a wheelchair is not just equipment,” he says. “It becomes part of your body.” That insight would shape his life’s work.

Dominic Hamisi, a consultant orthopaedic physiotherapist, sees the consequences of poor fitting every day.

“A wheelchair must be properly scaled to the patient,” he explains. “If a patient weighs 120 kilogrammes and you give them a chair that cannot support that weight, accidents can happen.” Beyond safety, posture is critical.

“We have natural curves in the spine,” Hamisi says. “If a patient sits in the wrong posture for long periods, it can worsen their condition. Sitting like a C curve instead of maintaining the natural S curve can lead to pain, muscle stiffness and delayed healing.”

Long-term wheelchair use without guidance can bring further complications. “Human beings are meant to move,” he says. “If someone sits all day without exercise or training, the spine can become stiff. They may gain weight. They risk cardiovascular problems or deep vein thrombosis. Even lung capacity can be reduced if breathing muscles are not engaged.”

Proper fitting reduces pressure sores, fatigue and chronic pain. It also restores dignity. “People think wheelchair users cannot take care of themselves,” Hamisi says. “That is a misconception. With training and proper equipment, they can live a comfortable life like anyone else.”

Children require special attention. “If a child develops disability early, fitting affects growth and development,” he says. “The wheelchair must support participation in school and play. It must adapt as the child grows.”

Early rehabilitation is also vital. “If patients delay seeking care, they may develop contractures. That is when muscles become so stiff that joints cannot move fully. In severe cases, joints can fuse. Early physiotherapy prevents these complications.”

After surgery, Michael faced not only paralysis, but despair. “I felt like my life had ended,” he admits. “In our society, disability is often seen as inability.”

Hope came in unexpected form. A missionary couple working at the hospital later adopted him, ensuring he received education and long-term care. Years later, he pursued higher studies and began reflecting on his journey. “I asked myself why I survived,” he says. “Many did not.”

He returned to East Africa with a new purpose. He founded Living with Hope, now known in some regions as Hope Mobility, an outreach platform focused on providing custom-fitted wheelchairs and counselling to people with disabilities.

To date, his organisation reports distributing more than 100,000 custom-fitted wheelchairs across Kenya and other African countries. The model emphasises assessment, fitting and user training rather than one size fits all donation.

“When you sit in the right wheelchair, your posture improves. Your pain reduces. You can go to school. You can work,” Michael says. “It changes everything.”

Restoring movement

His work aligns with global guidelines from the WHO, which stress that wheelchairs must be individually prescribed, fitted and accompanied by training and follow-up.

In Kenya, assistive devices are supplied through multiple pathways. Government hospitals may issue devices through disability funds. The NCPWDs runs registration and limited support programmes. Faith-based hospitals and international charities conduct periodic mobility camps. Social enterprises assemble or import components for local distribution. Demand, however, still outstrips supply.

Michael believes dignity must sit at the centre of provision. “We are not giving charity,” he says. “We are restoring movement. We are restoring participation.”

Tuberculosis remains preventable and treatable. Disability from spinal TB is often avoidable with early diagnosis and sustained treatment. Dr Bwika emphasises prevention and awareness.

“BCG vaccination for children, early testing for persistent cough, prompt treatment and better living conditions are key,” he says. “We must also improve screening for those with early symptoms, even if the cough has only been present for a few days.”

The stakes are high. Globally, TB continues to claim more than a million lives each year. In Kenya, tens of thousands are diagnosed annually. For those who fall through the cracks, rehabilitation becomes the bridge between survival and living.

Michael’s life now stands at that intersection. “I refused to be the face of war,” he says. “I chose to be the face of hope.”

In villages and urban settlements, children once confined indoors now wheel themselves to school. Adults, once carried on backs, now navigate markets independently. Each chair fitted to a body carries more than metal and rubber. It carries a second chance.

Michael remembers the boy who lay in pain, uncertain of the future. “I could not walk,” he says. “But I found purpose.”

By helping others move, he has shifted the conversation itself. From illness to inclusion. From survival to service.