Exit Wounds

There is a man who, appearing violent, was shot, reportedly in defense.  The AK47 7.62 mm bullet that struck his arm entered near the elbow, travelled down the arm and exited just above his wrist.  Both bones of the lower arm were destroyed, and there is basically nothing but a few tendons and some skin attaching his hand to what is left of his arm.  He needs an amputation of his hand and lower arm.  When we initially evaluated him, he would only consent to debriding, or cleaning the area.  However, over the next couple of days, he has developed gangrene of this hand.  Again we discussed further surgery, but this time his family refused for him to go to surgery.  They recommended a traditional healer, and he left the hospital.  Today, I heard that he was back, and wants to go ahead with further surgery.  I'm not really sure how much we can save at this point.
The family dynamics of consent in this region are very interesting.  The family must all agree, and women are not allowed to consent for themselves, but must have their husbands give consent for them. We have learned that we cannot rush this process.  We just wait, sometimes knowing that the situation is becoming more and more grave.  It can cost a life.  But there are violent reprisals if we were to circumvent this process.  So we wait, and watch, and wait.  And hope for the best.