Jacques Latest Legs
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Jacques Abrahams has got new "legs" bought for him for some R5500 by the Dorah Mokoena Charitable Trust, the forerunner of Children of Fire International. The new "legs" made for him by prosthetist MZ Adams in early December 2001, will hopefully give Jacques the mobility that he yearns for.
Jacques Abrahams was born on 25th March 1990. He lives in a Catholic institution, the St Joseph’s Home for Chronic Invalid Children in Montana, Bellville (Cape Town), South Africa. One of the conditions of the home is that the children should not be orphans and should have relatives to stay with during holidays. The charity has visited various burned children living in the home and is also involved in the care of a little boy called Bonga Mandla, who was moved there (despite his relatives maintaining no contact with him at all) following our intervention. Bonga was earlier, inappropriately, placed at the Sarah Fox Convalescent Home - also in Cape Town and very recently (November 2001) has at last been happily placed with a good foster family - again through the charity's assistance.
Jacques's parents Lodewijk & Susan Abrahams live on the Farm La Valle Daljosaphat, in the Wellington area. Jacques lost his lower legs and most of one hand in a fire as an infant. He also has other body and facial scarring. The charity was asked via the Red Cross Hospital, to fund new prosthetic legs for Jacques, some time ago. However on our previous visits to Cape Town we had not managed to meet him and so we asked local volunteers, surgeons and social workers to provide medical and social information on the child, as well as photographs. This took an extremely long time to happen.
We were concerned, following experience with Irene Peta (also on this website), about the problem of bone growing through amputations. This happened with Irene and made her false legs unwearable because of pain.
The procedure followed to alleviate this problem with a growing child seems to be quite barbaric. The hospitals periodically open up the stump and saw off the bone. The child then cannot wear their prosthesis for some months as the skin heals. We believe that there has to be a better option and hope to get full advice on this topic from orthopaedic surgeons, but have not been successful to date.
Jacques was fitted with prosthesis that he wore on and off during 1999, but he stopped using the false legs because of the pain on his amputations, with intermittent breaking of skin on the stumps. (No one has explained what happened to the previous prosthesis and whether they could be adjusted to help another child.) We have provisionally agreed a figure in the region of R15000 for new prosthesis after Professor Don Hudson provides information on the intended surgical intervention that needs to take place first. About R1500 would have been contributed towards the cost by a Cape Town Rotary group if detailed medical options were decided by end June. In June 2001 Jacques has a skin break on the tip of the right stump so leg fitting in any case could not take place til December 2001.
A suggestion was made in a report from the children's home, that the right stump might need shortening to increase the thickness of the skin flap around the bone. They stated however that "A concern is that he gets sellulitis in the right lower leg which can complicate an operation such as this."
Jacques attends the St Joseph’s R.C. Primary School and will be in Grade 5 in 2002. Other South African children of a similar age are usually in Grade 6 or 7, but paediatric burns patients often seem to be behind in their school performance because of lack of timely intervention by the authorities. Jacques is described by social workers as "a very active boy placed on Ritallin for his over-activeness." The charity has voiced its concern about children in care being placed on Ritalin as the practice is alarmingly common in South Africa now. The children's home say that Jacques, while "struggling with academic performance, is a very sociable boy who enjoys the company of his friends and is also comfortable in adult company."
Heinz Rode (Charles FM Saint Professor of Surgery) said at end Feb 2001: "Jacques is seen regularly in our clinic and his future and long term management has been handed over to Professor Don Hudson. He has contracted a prosthetisist in Cape Town who would provide a prosthesis for Jacques at the cost of R15-17 000-00. Certain surgical procedures still have to be done to his legs. He suffered a major burn (60 per cent) as a neonate - a newborn baby - and has residual deformities of his face, his right hand and both feet and legs. He is severely crippled and is unable to walk although he has prosthesis, which he refuses to wear."
End March 2001: The charity's Cape Town representative wrote: "The social worker just had a meeting with Nazrina from Friends of the Red Cross Hospital. St Joseph's people say that Jacques' problem is not just lack of money but the bone that protrudes through the skin. So they want him to be assessed again by one of the doctors. Prof Hudson said he would be happy to see him. However, this being a bureaucracy, it can't just happen. So St Joseph's will send a report to Nazrina, who must then take it to Prof Hudson who in turn must request to see Jacques and only then will they start doing anything."
Mid June 2001: Prof Don Hudson said that he still wants Jacques to have the legs and believes that Jacques deserves the best. For this reason he went to a specific prosthetics specialist, who is supposed to be the best. However, the problem of the protruding bone remains and he says that in Jacques' case the only option is sawing off the bone because the skin around the stump is so badly burnt. However, the prosthetics specialist said that in his view it would be possible to construct something that would nevertheless enable Jacque to walk. But before giving the go-ahead and giving us a medical opinion, Prof Hudson wants to hear the opinion of the orthopaedic surgeon in the Red Cross Hospital who will be the one sawing off Jacques' leg. We expect this by late June.
So the charity will stil help Jacques. We had to ask for detailed information as our main base is in Johannesburg and we needed to be sure of the veracity of that information. More than six months have elapsed since we were first approached to help him but we believe that our questions may have helped those involved in his day to day care to assess his wider needs more carefully, as well as the sheer logistics of getting him legs.
Our Cape Town representative is hopeful that a foster family might be found to give Jacques the loving one-to-one attention that he really needs. She is working on it.
Early December 2001
Jacques gets fitted with new "legs".
We had to ask for detailed information as our main base is in Johannesburg and we needed to be sure of the veracity of that information. Close on a year has elapsed since we were first approached to help him but we believe that our questions may have helped those involved in his day to day care to assess his wider needs more carefully, as well as the sheer logistics of getting him legs. Our Cape Town representative says what Jacques needs most now, is loving one-to-one attention from a surrogate aunt, uncle or whole family. Such volunteers are hard to find.