A bundle of agony

A bundle of agony

MOKHOTLONG – The joys of motherhood are turning into agony for ’Maboitumelo Moeketsi. Moeketsi was ecstatic four months ago when a midwife told her she had delivered a baby boy, whom she named Boitumelo, which means “he who makes us proud”. But it all turned into a nightmare just a few days after birth after her child suffered a condition that doctors are battling to identify.

Boitumelo developed a tuber-like small pimple on the fontanel, which the mother took for granted thinking it was just a minor skin blemish that would heal with time.
But the fontanel bulged as days went by and is becoming unmanageable
Unemployed and living in the rural area of Mokhotlong Ha-Mphafa deep in the northern mountainous region of Lesotho over 30 kilometres away from the district town, ’Maboitumelo delayed taking the baby to the clinic.

The baby’s head has continued to swell. “The pimple grew daily until it was equal to a soccer ball,” Moeketsi says.

Medical staff at Mokhotlong district hospital were unable to help, and the baby was hurriedly transferred to Queen ’Mamohato Memorial Hospital but nothing seems to be changing.
When thepost interviewed ’Maboitumelo last week, the baby’s head had grown so big that he had to be carried by two people.
One carried the body while another supported the head.
“After noticing the pimple was growing, I borrowed money from neighbours to take the baby to Mokhotlong Hospital where he was referred to Tšepong (Queen ’Mamohato Memorial Hospital),” Moeketsi says.

“From Tšepong he was taken to Bloemfontein where they told me they couldn’t help me and told me the child had to be taken to Pretoria for surgery.”
Some at the Queen ’Mamohato Memorial Hospital believe Boitumelo is suffering from hydrocephalus, a condition that occurs when fluid builds up in the skull and causes the brain to swell.
Hydrocephalus is a condition, not a disease, which can develop for a variety of reasons and is present at birth, according to the website hydroassoc.org

It is caused by a complex interaction of genetic and environmental factors during fetal development, according to the website.
However, doctors at a South African hospital are yet to determine if it is hydrocephalus that young Boitumelo is suffering from.
If it is confirmed as hydrocephalus, then it is a terrifying condition that Boitumelo has to manage.

Healthline.com, an online magazine, says brain damage can occur as a result of the fluid build-up and this can lead to developmental, physical, and intellectual impairments.
Early signs of hydrocephalus in infants include a bulging fontanel, which is the soft spot on the surface of the skull, a rapid increase in head circumference, and eyes that are fixed downward.
The mother’s problem is not that her baby has been taken too far away but the amount required for his surgery – a whopping half-a-million Maloti.
A poor woman depending on subsistence farming in her rural Ha-Mphafa village, ’Maboitumelo does not have even M1 000 in her savings.
Now she needs to raise M500 000 for her son’s surgery?

The government decided to chip in but bureaucracy is taking its toll.
“I don’t know where to get that amount of money. I am pinning my hopes on the government to help me. As I am waiting, the baby’s head has not stopped growing in size,” the sad mother says during a telephone interview with thepost, her voice trembling with emotion.

It is not clear as of now what surgical procedure is going to be followed but if the boy is suffering from hydrocephalus, some online medical magazines suggest two procedures.
Healthline.com talks of shunt insertion. The shunt is a drainage system made of a long tube with a valve.

The valve helps cerebrospinal fluid (CSF) flow at a normal rate and in the right direction.
The doctor inserts one end of the tube in the patient’s brain and the other end into his chest or abdominal cavity.
Excess fluid then drains from the brain and out the other end of the tube, where it can be more easily absorbed.
A shunt implant is typically permanent and has to be monitored regularly.

Another one is called Ventriculostomy, which can be performed as an alternative to having a shunt inserted.
This involves making a hole at the bottom of a ventricle or in between ventricles.
This allows CSF to leave the brain.

The good news in Boitumelo’s case is that, according to Hydrocephalus Association website, children often have a full life span if hydrocephalus is detected early and treated.
“Infants who undergo surgical treatment to reduce the excess fluid in the brain and survive to age one will not have a shortened life expectancy due to hydrocephalus. Adults who develop hydrocephalus typically have a shortened life span,” the website reads.
That is, if indeed Boitumelo’s condition is hydrocephalus.

Lesotho’s Ministry of Health Director General, Dr ’Nyane Letsie, suggests it could be another new phenomenon which they still have to determine.
Observing the tumour, it looks like a burned lump. It is shiny, hard and bigger than his head.

Dr Letsie says this condition is the first of its kind in the country as in some cases a child can have a bigger or smaller body.
“This phenomenon is new and we would like to find out what it’s called and how it can be healed or prevented,” Dr Letsie says.

She says the ministry is doing all it can to help the family but “there is a long procedure to be followed” to get the needed funds.
In the meantime the tumour is growing daily making it hard to dress and undress the baby.

Senate Sekotlo

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