Tuesday 5 June 2012

Komla

In February, I got to be a part of the plastic surgery screening day, when our plastic surgeon Dr. Venter met and assessed all of his potential patients.  There were many people that came through, and many that made an impression.  One of the ones that stuck out most to me was a small boy with a stick.  Eight years old, he held a sturdy stick, about 4cm in diameter, and at least as tall as his shoulder.  One hand grasped the top of the smooth stick, the other held it as low as he could reach.  His right leg was normal and straight and was what he walked on.  The left leg was bent at an extreme angle and he leaned it up against the stick to guide it as he walked. 
The stick was comfortable to him.  You could see it as he walked and manuevered with it.  This was his normal.  It became apparent just how normal this was for him after we made the decision that he would have surgery.  Because at that point, we gave him crutches and tried to teach him how to use them.  We told him no more stick.  And he cried.  We were taking away the one thing that he could use to get around.  He didn't understand yet that the crutches would make things easier.  He didn't understand what we wanted to do for him.
The boy I'm talking about is Komla, and his story starts about 4 years ago.  At around the age of four something happened.  It wasn't a fire, it was an infection.  As is often the case with our patients, the story is vague.  No one is certain what caused the infection.  Possibly a cut, a bite, it's hard to say.  Whatever it was did a lot of damage behind his knee.  Whatever it was never got treated properly.  And so just like with a burn, as it healed, the scar tissue took over and pulled the skin tight until it could cover the open area.  This tight skin left him with a leg pulled up so high that it was impossible to walk on. 
And just like any child, Komla was resourceful and found a way to get around upright.  His stick.  Which is exactly how he showed up to the mass screening day with his mother, clutching his stick.


(Can you see him, the small child in blue in these two pictures?)
After the mass screening, he came again to the plastics screening day, where I got to meet him.  For an idea of how he started out, here are a couple of screening pictures:
Uncertain about these white people who took away his stick and made him do all kinds of weird (therapy) things, Komla arrived to the ward in February.  He was off to a bit of a rough start, and had a lot of pain right after surgery. 

And then came the difficult task of learning to use crutches while keeping his newly-straightened leg from touching the ground.  Lets just say it took a lot of encouragement.  And time.  Komla had a lot of time.  Things went well at the beginning, but unfortunately he had some problems healing, and spent a majority of the last 3 months in hospital, trying to get things as well healed as we could. 
The more time this precocious eight year old spent amongst the nurses, the more we started to fall in love with him.  And the wilder and less disciplined he started to become!!!
 As his behaviour got worse, we started having to be firm with discipline.  He started getting more and more boundaries and time-outs in his bed.  Even so, he spent a lot of time playing with the nurses and being carried around, or being taken for walks up and down the hallway to exercise his leg.

His main language is Ewe, with a little french that he learned in school, but not enough for a conversation or for explaining things etc.  In his time here, he learned bits and pieces of english.  Our favorite phrase to teach him was "I love you" which sounds cute coming from any kid.  But he also would mimic random phrases he heard a lot, such as trying to answer the phone.  His english is actually not bad at this point, and he generally gets his point across!   He had so many IV starts, that the nurses had to turn it into a game.   He got to the point where he could put on a tourniquet, slap your inner arm almost hard enough to bruise, shove a (plastic)cannula at the approximate right area, and cover with gauze, saying 'all done.'

He also enjoys stealing our name badges and pretending to be us!!!

As the hospital closes up, his father has been taught his dressing changes.  Things are very, very close to healed, and his father has done well, we have given them supplies and pray it will continue to heal.
The morning Komla was leaving, I came down to the ward for one last visit with him.  He barely wanted to look at me when I came down.  Sullen and sad, he was avoiding all the nurses, just sitting quietly in a chair, knowing this was all about to end.  After a few attempts, I convinced him to come to me, and lifted him up for a hug.  As soon as he was in my arms, he was directing me where to go.  So we walked down the hall, him with his legs wrapped around me like a small child, head nestled under my chin, content to be carried for a while.  We stopped to look in other wards, wave at other patients, shake hands with and hug other nurses.  And then we came back to the ward and goofed around a bit.  One final hug and I passed him off to someone else.  I didn't return for the time he left.  I didn't want to fight for his attention amongst everyone else who wanted to say goodbye.  I wanted my last time with him to end on a good note. 
My friends though, they got the chance to go with him to his village, see his reunion with his siblings and mother.  Meet his brand new baby sister born a couple of weeks ago.
And now, all we can do is trust.  Trust his father will take good care of his wounds  until they heal.  Trust that he will use his brace until things are fully healed.  Trust that God's plan is better than ours, and this small boy's future is in His capable hands.

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