Malala Yousufzai, shot Pakistani schoolgirl defied the Taliban, can stand, communicate

LONDON (CNN) -- Pakistani schoolgirl Malala Yousufzai stood with the aid of nurses Friday for the first time since her shooting and is "communicating very freely," according to the director of the UK hospital where she is undergoing treatment.

Malala can't talk because she has a tracheotomy tube inserted to protect her airway, which was swollen after her gunshot injury, but she is writing coherent sentences, said Dave Rosser, director of University Hospitals Birmingham.

"We have no reason to believe she won't be able to talk when the tube is out, which may be in the next few days," he said.

She "is not out of the woods yet" but is doing very well, he added.

The latest progress report -- more detailed than previous updates -- suggests that the girl shot after she defied the Taliban by insisting on the right of girls to go to school could make a good recovery.

There "is certainly physical damage to the brain" from the bullet that entered Malala's head, Rosser said, but she appears to be functioning well intellectually and has the motor control to stand, with help from nurses.

"Whether there's any subtle intellectual or memory deficits down the line, it's too early to say," he said.

Queen Elizabeth Hospital released the first photographs of Malala since she was admitted on Sunday after being flown from Pakistan. She looks bruised and wan but clearly conscious.

Rosser said Malala, who is aware of her surroundings and appears to have some memory of what happened, had agreed that the hospital could tell the public more about her medical condition.

"She is keen that people share the details. She is also keen that I thank people for their support and their interest, because she's obviously aware of the amount of interest this is generating around the world," he said.

One of the first things she asked nurses Tuesday afternoon, as she gradually regained consciousness, was what country she was in, he said.

"There is every sign that she understands why she's here," he said. "It's a very difficult position for her, because she's gone from being on her school bus, and the next thing she will be consciously aware of is being in a strange hospital in a different country. So she seems to have understood why she is no longer in Pakistan and what is happening to her."

Malala has spoken to hospital staff in Urdu and seems to understand English, he said.

Many well-wishers have sent messages of support for the teen, and the hospital has set up a bank account for donations.

In terms of Malala's care, the key concern for doctors at present is to treat signs of infection probably related to the path the bullet took through her body, Rosser said.

The bullet entered above the back of her left eye, traveled down through her jaw and into her left shoulder, lodging in the tissue above her shoulder blade, he said. Her skull and jaw were damaged by its passage.

MRI scans also show that the bullet grazed the side of her brain, he said, although in such cases, most of the damage tends to be caused by shock waves from the shot.

The hospital is trying to arrange for the 15-year-old to listen to her father on the phone, although she cannot speak because of the tracheotomy tube, he added.

Malala is likely to spend another couple of weeks recovering before the team of specialists considers reconstructive surgery on her skull, using either a piece of bone that was initially removed or a titanium plate, Rosser said. She may also need surgery on her jaw joint.

"It certainly would be over-optimistic to say there won't be any further problems, but it is possible she will make a smooth recovery," he said, adding that she probably faces weeks in the hospital even if all goes well.

Doctors and nurses are trying very hard to limit communication to her medical needs rather than risk setting back her recovery by discussing the trauma of the attack, he said.

The shooting in the northwestern district of Swat last week, which left Malala battling to recover from her injuries, generated a wave of shock and anger in Pakistan and around the world.

The Taliban quickly claimed responsibility for the act, but they didn't appear to have anticipated the level of revulsion and condemnation that it would provoke.

Thousands of people joined in rallies across Pakistan in support of the wounded teen, and calls have grown for a strong response from the government.

Authorities are investigating the attack and say they have made a number of arrests.
 
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