The moment Ghanim Al Shnen lifted the water bottle to his lips, he knew the hard work of the past 12 months had been worth it.

Although the hand lifting that bottle was an amalgamation of plastic, metal and wiring, it was his mind controlling the movements.

For the first time since his accident, the 37-year-old could see a path to independence.

In November last year Al Shnen lost both his arms — one below the elbow, one above. He is now about halfway through a complicated process that will see him fitted with two mind-controlled robotic arms.

When Al Shnen was brought to Sydney's Concord Repatriation General Hospital, it was a miracle he was alive. He had suffered a massive electric shock on a worksite when a metal bar he was holding made contact with overhead wires.

The electricity surged through both arms and across his chest before blasting out the back of his right shoulder, leaving an enormous wound. He lay on the ground unconscious with sparks flying all around.

"It was daytime but on the sky it looks like fireworks," he was later told.

His injuries were horrific.

"What happens with an electrical burn is that the bone heats up and burns the body almost from the inside out," explains Dr Justine O'Hara, who treated Al Shnen at Concord Hospital.

"His hands were basically cooked in the position of holding a pole. If the muscle is cooked and the nerves are cooked and the bone is cooked, nothing is ever going to work again."

He begged the doctors to save his arms but there was nothing they could do.

It is hard to imagine how difficult it would be to suddenly lose both your arms.

"It's an intimate thing," explains Dr O'Hara. "You can't feed yourself. You can't wipe your own bottom. You are reliant on other human beings."

Al Shnen suffered horrific injuries and rescuers initially presumed he was dead. ( Supplied )

It's a situation many people would struggle to cope with, but Al Shnen surprised everyone.

"You have two choices," he explains. "Give up or accept this and continue the life. Yes, I lost my arms. But I'm still alive."

Through connections in the Iraqi community, Al Shnen made contact with Professor Munjed Al Muderis, a world-renowned orthopaedic surgeon who specialises in preparing amputees for the attachment of robotic limbs through a process called osseointegration.

It has become a special connection for both of them.

'Ghanim has a special place in my heart'

At first glance, the two men could not seem more different, despite a shared Iraqi heritage.

Al Muderis is an only child, born into an influential Baghdad family. His surgical expertise is in demand worldwide and he was recently named NSW Australian of the Year.

Al Shnen is one of nine children from an ordinary family in southern Iraq. At the time of his accident he was on a bridging visa, working as a labourer on sites around Sydney.

But there are uncanny similarities in the journeys that led them to where they are today.

Both fled Iraq in fear of their lives — Professor Al Muderis because he refused to cut off the ears of deserters from Saddam Hussein's army; Al Shnen because he refused to help the militia in post-Saddam Iraq by altering a statement he had taken while working as a policeman.

Both made their way to Australia by boat from Indonesia and both spent time in detention. And both took the opportunity while in detention to educate themselves — Al Muderis by poring over an anatomy textbook; Al Shnen by teaching himself English from a dictionary.

"Ghanim has a special place in my heart," Professor Al Muderis says.

"I can relate to Ghanim from my personal story and I think a person that goes through these kinds of difficulties comes out of it stronger."

In late January, Professor Al Muderis moved Al Shnen to Macquarie University Hospital to prepare for his osseointegration surgery.

Professor Al Muderis shared heritage with Al Shnen meant he could easily communicate the complicated surgery. ( Australian Story )

What is osseointegration?

Osseointegration involves the implantation of titanium rods into the remaining bones of a limb, onto which a prosthetic limb can be firmly attached. Professor Al Muderis and his team lead the world in this procedure, which is viewed with suspicion by some in the medical profession.

"At the beginning I was criticised heavily," Professor Al Muderis says. "They thought this is a completely crazy idea because a piece of metal sticking out of the skin is definitely going to cause infection."

"There are lots of things to learn," Dr O'Hara says. "And, sure, there are cases where it can become complicated. But if you ask the patients, they are enormous advocates for this in terms of their function and their mobility."

Professor Al Muderis says infection rates are now comparable with conventional treatments and he believes osseointegration will soon become the standard procedure for amputees.

The procedure is generally performed on patients who have lost legs.

Al Shnen's case, which involves both arms, is believed to be unique. His right arm, which was amputated above the elbow, also required the complicated reattachment of nerves and muscles in order for him to eventually operate a robotic arm.

"It is a highly complex procedure," Professor Al Muderis says. "Two teams work on each arm separately and it will take possibly 10 hours."

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Seven years without seeing his family

As Al Shnen lay in hospital contemplating the operation, he had never felt more alone.

When he fled Iraq in 2012, he left his wife and three children behind, unwilling to subject them to the dangerous journey.

He imagined he would settle in Australia and eventually send for them but applying for a protection visa proved far more difficult than he imagined.

His application was initially rejected and at the time of his accident, more than six years after arriving in this country, the appeal process was ongoing.

Meanwhile, his family had been accepted as refugees in Finland.

Not having seen his family for seven years was taking a psychological toll and his treating team were worried.

Then to his surprise and delight, his family was given a visitors' visa.

It only allowed them to stay for three months at a time, but it meant they could be there to support him through the surgery and his initial recovery.

While Al Shnen's future in Australia is uncertain, his family has refugee status in Finland. Their dream is to live together in Australia permanently. ( Supplied )

Days after his family arrived, Al Shnen underwent surgery. Electrical burns cause terrible damage to nerves so Professor Al Muderis and his team were unsure what they would find but they were able to insert rods in both arms and successfully regroup the muscles and nerves in his right arm.

Now everything was up to Al Shnen, whose extraordinary adaptability and resilience had already impressed the team.

Within weeks he was coming up with ingenious ways to perform simple tasks. He taped a spoon to the attachment on his left arm so he could eat and designed a pen holder for his right arm so he could operate his phone.

"His ability to adapt has been phenomenal," Dr O'Hara says. "I think he is going to be the poster boy for upper-limb osseointegration, but it's his motivation. He never stops — if you ask him to do something 10 times a day, he'll do it a hundred."

A team of medical specialists, led by Professor Munjed Al Muderis, spent 10 hours operating on Al Shnen. ( Australian Story: Greg Hassall )

After several months of rehabilitation, Al Shnen was ready to start using a robotic arm.

The left arm, which was amputated below the elbow, is the simpler of the two as there was more surviving muscle to work with.

When Al Shnen thinks of opening his hand, the surviving muscles that used to perform that action contract in a certain way.

Electrodes and software in the robotic arm recognise those signals and assign them the task of opening the robotic arm. To Al Shnen, it simply feels like he is opening his hand.

The right arm, which he will start to use next year, is far more complicated. Because the amputation is above the elbow, the robotic arm is unable to utilise muscles that would have performed tasks such as moving a thumb. This was why the complex rerouting of nerves and muscles was required during surgery.

"It's a completely different procedure and maybe 100 times more complex, but it's the same philosophy — he thinks about moving his thumb and the thumb will move," Professor Al Muderis explains.

It will, however, take a lot longer to learn.

Sophisticated robotics a gamechanger

For now, Ghanim Al Shnen is just happy to be able to perform simple tasks such as drinking, eating and brushing his teeth — tasks most of us take for granted.

In the future he should be able to do many of the things he used to do, such as dress himself, manage his personal care, even drive a car and write.

There are limitations. The arms require regular charging and they are not waterproof, so he will always need help bathing.

The fingers don't grip as well as a normal hand. and the arms can't make simultaneous movements, such as turning the wrist and opening the hand at the same time.

But there are things he may be able to do in the future that those of us with normal arms could only dream of.

"The robotic arm is very sophisticated," Professor Al Muderis says. He foresees a time when the arms will contain such things as cameras and implements you might find on a Swiss army knife, operated by voice or mind control.

"You think about a spoon and a spoon comes out," he explains. "This will happen."

Al Shnen plays soccer in his backyard with his son during his family's visit to Australia. ( Australian Story: Greg Hassall )

Doctors say 'Ghanim should stay in Australia'

For Al Shnen, the medical breakthroughs have been overshadowed by the uncertainty surrounding his visa application.

His medical team want him to remain in Sydney for the foreseeable future while they work on his arms and monitor his progress. They and the wider medical community have much to learn from the way he adapts to his robotic limbs.

His refugee status, however, is unclear. Recently, he made an application for ministerial intervention in his case, which remains before the Minister for Immigration, David Coleman.

The expertise of Professor Al Muderis' team changed Ghanim Al Shnen's life after his workplace accident. ( Supplied )

For those helping him through his recovery it is inconceivable that he be removed from Australia, given how drastically his circumstances have changed since he arrived.

"I don't understand how any human being would determine that a person like Ghanim would survive in an environment like Iraq at the moment," Professor Al Muderis says.

Even joining his family in Finland, if Finland agreed to take him as a refugee, would not be viable, given how far he would be from his treating team.

Ever the optimist, Al Shnen continues to hope the Minister will intervene and eventually he will be united with his family.

"I never lost my hope," he says. "If I lost my hope I'm not here right now."

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