I’m not sure how I have got to the age of 55 without
meeting a priest, so when Justice’s mother was keen to introduce me to the
local Father, early in the week, I decided to take the opportunity. The
possibility of divine intercession, in trying circumstances, can never be
passed by.
I was expecting to be introduced to a black Father, but
instead find a white Italian, South African who enjoys brass bands. I decide to
play him the beginning of John Coltrane’s Spiritual on my soprano sax. He looks
puzzled and I wonder how anyone can not have heard of the 60’s Jazz icon John
Coltrane. I decide a quick switch to Amazing Grace is necessary and when I
finish offer to look at the fathers aching neck. I show him some exercises to
do, which he says he adhere to, but thinks he will still need the medicinal whiskey
to keep the pain in check.
My soprano playing goes down better with the pre-school
children who have no inhibitions about getting on down with James Brown and
Jaco Pastorius. I feel I have slightly redeemed myself in their eyes, having
baffled them on Tuesday with the story of the three little pigs. This totally mystified
them, even with the aid of finger puppets. The pre-school is just across the
corridor from the physiotherapy room so I see quite a lot of their activities
and have already had two children brought to me with extremely bowed legs. It
is unclear whether they have Rickets or Blount’s disease (I have never seen
either before) and I try to make a sensible plan of action with the aid of the
internet.
I come across a lot of medical conditions in Lesotho that I
have never seen before and am currently following up Lorato from the adjoining
primary school (see blogs 5 and 10) who has TB of the hip. When I last saw
Lorato, in April 2016, she was in a great deal of pain. She had been in a
wheelchair for 6 months, unable to walk, had massive abscesses on her buttock
and leg and the left hip had contracted to 45 degrees. I suspected
osteomyelitis and she finally got the X-ray, I had been demanding, just before
I left Lesotho. This confirmed osteomyelitis due to TB of the bones. Lesotho
has the highest rates of TB in the world, due to poverty and HIV. TB of the
bones is much less common than in the lungs, and unusual in young children.
Since her diagnosis Lorato has been on antibiotics and has
improved to a much better level than I had hoped. She is now on crutches and
back at school. When I examine her, the left hip is still contracted and her
pelvis rotated to compensate for the shortened muscles in her back. She has a
cord tied round her waist which Christine (the volunteer social worker) tells
me is a charm against witchcraft. Lorato’s parents have no concept of TB and
believe her condition is “deliberate” (a curse). The conflict between Western
medicine and traditional Witch doctors add to the many problems of healthcare
in Lesotho.
Lorato herself, has been turning up regularly to do
physiotherapy with her little gang of friends from the school. She’s a spunky
kid and tolerates me stretching and grinding her hip, with a grimace. She has
much more fun stretching herself on the physiotherapy ball, and has already become
an expert in this skill. Justice arranged for a doctor, with a special interest
in TB, to come and see her this week. I talk to Dr Johnson about the
possibility of Lorato seeing an orthopaedic specialist and having an operation
to reshape the femoral head. This would improve the movement of the hip so she
can grow in a more normal posture as she approaches puberty. Dr Johnson
promises to pursue this and how much such a procedure would cost.
He is just about to leave when Kats crawls through the
door. The ever-smiling Kats who sometimes comes to physiotherapy several times
a day with his great friend Rets, who never stops laughing despite his trousers
continually falling down his spindly, stiff legs. They both love to play
floor football and Kats has asked whether he can go to Bloemfontein to fix his
legs. Bloemfontein is in South Africa and the nearest big hospital where the
kids can go to have major procedures.
I get Dr Johnson to take a picture of Kats flexed knees in
view of asking a specialist about the possibility of Botox injections to relax
the hamstrings. Even if such a procedure is possible I don’t know how long it
would last as Kats has Cerebral Palsy and his brain will keep sending the same
messages which tighten his leg muscles. The procedure would cost thousands of
Maluti and it is unlikely that the Lesotho government would pay for the
operation, or the ongoing follow ups he would need.
Kats goes and cheerfully smiles and waves to me in his
wheelchair as he passes by the window, unaware that he has further added to the
banging headache that has plagued me this week. Trying to make the right
decisions for the children’s health care in areas which I have little experience
in, with no specialist guidance, is proving stressful. Added to these concerns are
two meetings I have arranged to try and effect longer term changes at Saint
Angela’s, which could improve the future well being of all the children.
Before these meetings, I have more minor decisions to
consider on grab rails in the children’s toilets. The wonderful men and women of
Ireland, who have fixed a basket-ball net to the physio room wall, put a grid
for noughts and crosses on the repaired floor, made a large contribution to the
water bill debt, built the pre-school a playground and put a disabled shower into the dormitory block, have grab bars left over from
their endeavors and ask me if they can be used in the toilets. In the UK, such
decisions are taken by an occupational therapist and I decide the best thing to
do is to get the kids to demonstrate how they get on and off the toilet. With a
variety of disabilities, they approach this task in different ways, including
two boys who pull themselves forward onto the seat by pulling on the toilet
cistern. How the cistern hasn’t fallen off the wall I don’t know and the result
is grab rail on the back wall as well as ones on the side.
Action Ireland has been a revelation to me this week. I was
unaware of all the work they do, besides the kid’s entertainment with the Irish
students they bring over each year. I meet with the director of the Charity and
explore the possibility that Saint Angela’s might benefit from some more
sustained input and support from them over the next five years. I meet with
Sister and the board of Saint Angela’s and tell them that opportunity knocks,
not only with Action Ireland, but in engaging the volunteer social worker as
the employed social worker and physiotherapy assistant. I have been very
impressed by her and feel she offers a chance to engage someone with the
necessary skills and aptitudes in both areas.
I hope I’ve said the right things and presented a
compelling case for Saint Angela’s to consider taking advantage of these
opportunities. The pressure has felt huge as I try and pick my way through the
surrounding politics. Ultimately you can take a horse to water … Perhaps when the
priest has recovered from the shock of John Coltrane he will offer up a prayer
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