We are taking one of the girls from Saint Angela to hospital to review her prosthetic leg which is used to extend her shortened leg so she can walk. It’s now too small for her and broken. I have seen a variety of such devices in Lesotho, which when considering the lack of resources available, vary from ingenious to torturous. The social worker calls us and says there is another girl with a similar problem and can we see her as well.
This girl is 17 years old but has only just started at high school. Unlike primary school, high school is not free in Lesotho and parents must either pay school fees or seek help from the department of social development. After all these years this girl has finally got support from social development and a chance to go to high school by being a resident at Saint Angela. We find she has gone to church with the school and as we cross the football field towards the church Ntseliseng points out a group of students returning and a small slight girl trying to keep up with them, “That must be her”.
The girl has a massive built-up shoe, which although putting her in touch with ground she is struggling to drag along. It must weigh well over a kilo and on top of the build-up there is a small shoe, in which her tiny foot sits. The shoe looks so heavy and awkward she might as well be dragging a ball and chain along with her.
We ask her to come back to the workshop so we can find out more about her story and do an assessment. Ntseliseng translates, she says the girl was born normally but when she was around two she was crossing a river, balancing on a wrecked car, using as it as a stepping stone, and lost her balance, falling into the car. It was when she was dragged out that she sustained her injuries.
I ask her to take the shoe off and there is a noxious smell of rancid flesh. Her lower leg is so withered I can easily encircle it with my thumb and finger. The foot is paralysed, the toes tightly curled under wasted sole of foot where the base of the metatarsals bear hardened callouses and sores. The tiny shoe she is forcing her foot into is much too small and every step she takes must be agony. She is ashamed of her foot and likes to keep it covered up.
The fingers of her right hand are deformed, while the muscles of the left shoulder complex are wasted, weak and the skin discoloured. I’m unsure of what her diagnosis is but the story of her falling into a car in the river does not ring true. It is also apparent that her prothesis is doing more harm that good.
The next day we take her and the other girl to see the orthotist at Q2. He is over an hour late for the appointment, so it gives me plenty of time to trawl through her Bukana. These are small little medical booklets people are given by hospitals when they are born. Fortunately written in English they contain varying amounts of useful medical information. I can see she’s had a number of past appointments with doctors who note a deformed leg which needs a prothesis.
Then I decipher a scribble which notes “polio leg” and that’s it! I’m sure this doctor’s observation is correct, and everything falls into place. A virus that may cause paralysis, especially of one leg, mainly affecting children under five. Its not something I’ve particularly come across before with vaccinations programs being quite successful in eradicating it, but there have been outbreaks in African countries in the past. It possible that the girl’s strange story of falling into a river has been the families way of trying to explain how a normal girl could be struck down by an unseen virus.
Further follow up phone calls from the hospital find out that whoever made this terrible shoe is making another one for her, being paid for by social development. Maybe it will be a better fit than this one, but for the moment I don’t think she can carry on with the dreadful device and the pain and damage its causing to her foot. I decide to try her on crutches and immediately the excruciating pain in her foot stops. She can walk quite well using the crutches by swinging through on her good leg. It will give her damaged foot a chance to heal but is not totally ideal as her weakened shoulders ache with the effort. Hopefully in a few weeks’ time her muscles will strengthen and adapt.
The more immediate problem is her shame over her small, withered foot, which she wants to keep covered. We go shopping and she chooses a soft black ankle boot to cover it. Further conversations with Ntseliseng over the next couple of days reveal the girls mother is dead. She lives with granny who finds her a burden and was only too happy to send her off to Saint Angela, but basically with virtually nothing, barely any clothes and no toiletries, she’s had to borrow other children’s.
I feel so angry and upset by the mountain that these children with disabilities must climb to get to school. Hardly any of them get the opportunity and the few that do arrive have endure more hardships and humiliations. Another shopping trip is due. She needs a school rucksack to carry her books, soap, towel, and Dettol to clean and dry her foot, toilet bag, Vaseline, flannel, toothbrush and toothpaste. School socks, pens, pencils, rubber, sharpener etc and of course a secret bag of sweets stashed away for emergencies.
The whole lot, including the shoes, only comes to £35, its such a small amount but will make such a difference to her. I use part of a donation that a kind friend sent me to help another child a few weeks ago. He was expelled for not being able to use a spoon to feed himself and I was trying to find somewhere else for him to stay and someone to care for him. It’s a long story and makes me too angry to repeat it. Anyway, the outcome was I didn’t need the donation in the end so I use some of it to help the girl.
She comes to the workshop, and we show her how to wash and care for her foot and give her the rucksack filled with goodies to make her difficult life a little easier. She is wearing tracksuit bottoms and a T shirt and looks so young and innocent now she is no longer dragging the heavy painful shoe around with her. She thanks me and wants to say more but language and emotions stop her. She doesn’t need to say anything because I can see it in her eyes. The weight of her disability and the ball and chain curtailing her freedom has lifted just a little and hopefully will help her start her secondary school opportunity with a lighter step.
