The moon hung so huge in the icy June sky that it seemed all out of
proportion with the stars. Fat and full, a deep mature-cheddar-yellow and so
low in the sky, it was as if I would be able to touch it once I reached the
crest of the hill.
I was driving six hours to Durban on the second stage of Children of
Fires raison dêtre: After Dorah.
The quest is to find an effective way to help other children injured like
Dorah Mokoena those already hurt and those who, inevitably, will be hurt
in the future.
To be proactive and tackle education of the least educated in
fire-and-injury-prevention, in first aid and childcare, in understanding the
need for swift medical treatment if a child is burned and knowing how and where
to get it.
Longer-term aims are to help parents and the children themselves, to
understand the medical process of fixing limbs and faces, and how they have a
right to aim for the best available treatment. How they can fundraise for sums
that state health care cannot meet and where the best possible and affordable
treatment can be found.
Children of Fire is aware how few dedicated burns or childrens medical
facilities there are in South Africa. There is only one dedicated
childrens hospital in Africa south of Cairo and that Red Cross
Childrens Hospital in Cape Town needs 36 million rands just to function,
now.
Even if children get the optimum treatment when they are injured, those from
rural areas in particular are lost to medical follow-up, because there is no
way of keeping in touch with the families, let alone provision for transport
costs or a field worker who will take the time to explain the need for
follow-up to the families.
The task is enormous and the full extent of the problem is not known.
It is important to find out which existing Non-Government Organisations
(NGOs) are undertaking any sort of education programmes in squatter camps
and it would be useful to know how effective they are
if at all.
Industrial theatre, television and video can provide a short-term increase
in awareness; radio too reaches into the poorest households. Often poor
families have a television operating from a car battery even if there are no
other "mod cons" around. But print media where at least one person in
the household can actually read has to be the best choice because people can
look at it more than once. They can discuss the pictures and information in
their own time.
The journey to Durban was to meet a British dietician Luise Marino who is
working for a pittance as a normal South Africa state healthcare employee,
trying to improve the diet of Durbanites and deal with a whole host of related
socio-economic and political issues across KwaZulu Natal.
She decides how to nurture the manifold malnourished children but she also
deals with aspects such as giving people with extensive burns the best possible
food to help them rebuild skin quickly.
Luise is personally involved in the welfare of a little girl who lost much
of her face and hands when a petrol bomb was thrown through the house window in
the township where the then two year old was staying.
Casey, as she is known, got the best treatment available and very quickly.
Now she is a precocious, friendly, almost-five year old.
Caseys proper name is Kimberleys Charlene Mattheys. She lives with her
diminutive 14-year-old sister Cenovia and her 40-year-old mother Ethel. The
father Jan Johannes Mattheys, also 40, lives somewhere in Cape Town and
provides no financial or emotional support for his former family at all.
So I drove to Durban aware only of a tiny proportion of the problems that I
would find there.
Maybe the only benefit of a long drive - once the children had fallen asleep
in the back is the time to reflect. But the trip from the cold highveld
plateau on which Johannesburg lies, right down to the warm seaside city of
Durban is tough in one stretch. One travels from two thousand metres above sea
level right down to the sea. The road companions are heavily laden lorries
setting off for the port. The route has stacks of serpentine downward bends
etched only in amber, green, red or white cats eyes. The lorries travel
too fast and accidents are not unusual.
It was still daylight as I crossed the boring dusty plains of the Free State
with occasional stark monoliths of rock introducing the edge of the
Drakensberg. But night falls quickly in this southern hemisphere winter and
dusk was too short to remember. I prayed that the car would not let me down as
I found a couple of hundred kilometres with no garage at all and tried not to
imagine what it would be like if we broke down. Women and children are quite
seriously at risk if they are stranded at the roadside at night in South
Africa.
The car worked well. It is underpowered as a difficult-to-replace heat
control switch is missed out by a piece a makeshift copper wiring. But it has
four wheels and goes. Thats all I really needed.
My well-meaning navigator seemed unable to tell right from left but
eventually we arrived at our destination: Wentworth Hospital. Tedious security
men delayed our entry but soon we were ensconced in Luises tiny flatlet.
Luise is a remarkably tall red head of part-Italian extraction but who speaks
only English.
We had supper of a tasty curry but I was really too sleepy to savour it
well; collected some cushions from a communal sitting room and made makeshift
beds on the floor. I slept between 7 year old Tristan and 8 year old Thobeka
while my other companion, 23 year old American volunteer Amy had her own berth.
We rose around 6.30 the next morning, fed the little ones Fruit Loops and
set off to meet a leading plastic surgeon in the area.
The hospital where we went to meet Dr Madaree was stunning. I was mentally
revising all my thoughts of KwaZulu-Natal provincial health care when I
realised that it was private. Ah well.
I thought, some love it, some hate it. I dont mind generating good
publicity for him if he helps the children that I want to help.
Madarees specialty is not particularly burns but he has worked with a
lot of burn victims. He talked of Fluffy who was severely damaged but whom
everyone describes as beautiful now. She apparently has false hair stitched to
her scalp that prettily frames her face. She and a boy called, I think, George
Ogle, both attended a special school in the area called St Raphaels. It is the
same school that Casey attends and seems recommended by all who know of it.
Luise said that Madaree had managed to reattach the legs of a boy that were
severed by a combine harvester and that he is recognised as a superb surgeon.
He expressed shock that anyone would think to remove Dorahs eyes; and
then started to say how he would work with her if she were his patient.
Hes keen on placing "cushions" or bags beneath the skin that
are inflated with air or saline and stretch areas of useful skin. Particularly
where a patient has lost a lot of hair-growing skin on the scalp. He says by
stretching a good area, one can move the surplus skin forward (once it has been
created) and so make the hairline more natural again. Madaree thinks this would
be a good idea for Dorah.
I certainly think it is worth mentioning to her current doctors who want to
improve skin quality on her forehead, as it is certainly an option to place a
bag under the skin at the back of her scalp.
Madaree also thinks it is important to work on the possible right hand for
Dorah soon because of tightening ligaments with time.
Madaree even told me that one of my UK contacts James Partridge is coming
out to South Africa to give a motivational talk at a major burns conference
next April.
Luise suggested that I should speak at it from a laymans point of view
maybe on the morality of medicine.
Madaree has agreed to draw up a summary of his view of problems in his area
and of possible solutions. He has also agreed to collate details of past and
future patients who form useful case histories to put Children of Fires
point across or who may need our help in future.
He admitted that many patients that he helped with a great deal of surgery
were lost to essential follow-up, because they returned to remote areas and
there was no means (and particularly no staff) to find and remind them. He
believed that some patients would have died because of this.
We then went to meet Casey, the petrol bomb survivor.
Being used to Dorahs appearance, Casey is a beauty queen. But to
others, they would notice her nose is tiny because it doesnt have the
fatty lump at the end that most of us have; her eyelids look sore and her mouth
is skew. Her teeth are normal and meet nicely at the front.
She has no hands but has a useful mitten-like left arm, where a short thumb
allows Casey to hold a pencil and write, or to turn pages of a book.
On her right stump the knuckles of a hand are visible beneath the skin and
reconstruction for some dexterity will be attempted later.
The skin on the "hand" areas is of a very odd snakeskin-like
texture.
When Casey takes off her hat, the front half of her head is bald and made of
fragile thin whitish skin with scabs in places because it breaks so easily.
The hair at the back of her head grows normally and is tied with bright
yellow ribbons. And her ears look fine though Luise says part of the earlobe is
missing.
But Casey was older than Dorah when she was burned. So she had learned and
developed more. Now she is one of the brightest in her class and has a
personality to match.
She happily sits on the laps of strangers and is quite conversational.
We met her with Marissa a senior caterer at the hospital who helps a
number of children in her personal capacity. And she helped Caseys mother
to get a job and a large room for the family of three, so that Casey had a more
secure future.
We went to Wentworth Hospital to meet her mother. A tiny woman with a very
pretty face and a sharp sense of humour. I thought of Dorah and Margaret and
wondered if the mothers always seemed beautiful in comparison with their
children but realised in both cases that the two mothers simply happen
to be good looking and that they form a reflection of how their children might
have been.
Then off to a ward where 11 year old Lungile Shange from Driefontein Tongaat
had a rectangular little headpad beneath the skin on her forehead. The
objective? To stretch the skin and allow movement of hair-producing areas to
the totally bald triangle one side of her skull, where hair and skin had been
scraped off in a car accident. It was her birthday but no one in the ward
seemed aware of the fact.
And then to Clairwood, a few kilometres away.
Thokazani Hlatshwayo has an irrepressible spirit. A dashing ten year old
secure in self worth and his own charms, he is heavily bandaged on both arms.
His right thigh is bound, not because of burns but because surgeons have
borrowed the skin from there to try to rebuild his damaged hands and arms. But
how was the boy from Bergville burned? By dropping his single one rand coin
into the fire by mistake and thinking that he had to save his paltry wealth at
once, in case it melted. Thokazani could not explain this to me in English; but
a bilingual mother of another burns victim translated my persistent questions
and his answers.
Thokazani is a handsome boy who will
overcome whatever long term damage he has suffered. For now he simply
doesnt know the extent of it, but hops around, the life and soul of the
ward.
Quiet Lungile Ncobo is also ten years old. She speaks English well and
explains that she was pumping paraffin out of its container and that there was
a lit candle nearby. "It just exploded onto me" she says. From her
pubescent breasts down to her waist, Lungiles brown skin is instead
several shades of sore red and pink, scabby where it is too thin. And yet she
smiles. At least today her grandmother is coming to fetch her home to Mayvill.
I ask Lungile what "treatment" she was
given before going to hospital. She says the family broke eggs over her
stomach. I assume that this is ineffective but check with a nurse before
condemning it and she reassures me that this is an old wives tale
and simply a waste of food that others certainly need.
Lungile has to return to Kind Edwards Hospital for further treatment.
I hope she does.
Kethiwe Hlongwane is four. Like Thokazani she too is from Bergville near the
Drakensberg mountains. Her face, lips, arm and scalp are freckled and blotched
in white. No one can readily tell me the details of how she was injured but
Kethiwes insistence on wearing her own orange and white daisy covered
dress rather than pastel blue hospital pyjamas shows a strong spirit in one
so young.
Sinovuyo Phalazweni turns four in July. Her skirt caught fire as running
round an open fire, playing. Sinovuyo was left in the care of a nine year old
while her mother Novumile was working the fields for the farmer.
Now though her mother is with her. Sinovuyo wants
to be hugged and held but almost any embrace from her mother hurts her. She was
burned on the chest, stomach and thighs
She can hardly bear to stand and
does so bandy legged and in pain. She is from Lusikisiki, Goqwana location
some four hours away.
The ward, in an old typhoid and other fever hospital, is painted white and
has some pictures on the walls but no toys at all. There is a jungle gym
outside and some of the children are fit enough to use it, but one feels that
the nurses are more inclined to keep them inside. I give the children books
because I did not have enough toys with me to give one to each of them.
Because most children come from far away, many have no visitors. No family
to see them through the painful operations and the lonely nights.
I talked to the nurses and tried to encourage them a little. I showed them
photos of Dorah. The children except those most recently burned were mostly in
good spirits. But some round faced toddlers just sat sad and lonely and
searching for a familiar face. It seemed as if the pain of feeling abandoned
(even if it was simply that their parents lived far away) or actually
being abandoned - was far greater than the pain of scarred legs and bandaged
heads.
Luise helped feed the little ones bread in milk. It seemed an uninspiring
diet to an outsider but she said that nutritionally it was ok (though not
brilliant).
We left and set off in search of Fluffy. Past many squatter camps and the
overloaded Cato Manor area. While taking an extensive tour of a low to medium
income suburb, Fluffy was not to be found. We did, however, seem to meet half
of Marissas family
..
Then off to the coast for coffee, waves, shark warnings and conversation.
The elegant street lamps were strung with notices no dogs, no
bicycles, no swimming, ..the city of nos.
We took Marissa home and I bought a couple of enormous pizzas to share.
Tristan and I eat out so rarely I was shocked at the price but they
tasted good!
And then we started to talk some ideas through. What was needed and what to
do.
I wanted details of the school Casey attends as it sounds unusually good.
And details of other children who have been fixed up well
to inspire
those who are injured about the hope after treatment and to inspire others to
contribute funds.
And I felt like asking for the name and number of the large white nurse who
steals valium and other drugs from the hospital en route to the patients
- and sways around outside the hospital and in the childrens ward in a
drunken manner. Or the name of one of only two social workers at Wentworth who
does so little (apart from her home handicrafts) that doctors are unaware that
there are two social workers on the payroll.
Or the name of the alcoholic housekeeper who instead of being sacked was
promoted.
to executive housekeeper!
But I decide that I need all the contact details for burns facilities and
names of useful individuals there; NGO/literacy in squatter camp information;
details of proactive work with/by fire brigades; details of municipality plans
to take water to squatter settlements; details of medical facilities used by
burns victims and the size of the "catchment area"; details of the
burns conference next year; Mr Madarees email address; and any proactive
ideas on prevention that Luise and Marissa can come up with,
On Sunday we talked more and then tried to arrange a meeting with a
translating contact who also lives in Durban but could never get beyond
her home help who demonstrated her inability to understand English by simply
putting the phone down again and again.
So I took the children to the beach and for a coastal cable car ride
so that they had a little rest and relaxation on an emotional trip.
They ran in and out of the waves for an hour or more before we made contact
with Patience Buthelezi, the translator, teacher and collector of Zulu rhymes,
and went to see her briefly at her home.
I showed her and her husband a series of Dorah photos .. and tried to enlist
her rather reserved husband into assistance with getting Children of Fire
discussed on Radio Zulu (for who he works).
And then the long schlep back to Joburg.
The bends were easier to negotiate in daylight. And then we drove into the
most stunning sunset of scarlet, turquoise, salmon and charcoal with strips of
buttercup-almost-gold yellow.
The panorama of mountains and sky stretched almost 360 degrees as we drove,
seemingly, ever up towards and into the firmament. Quickly it was night. Pitch
black and then red clouds glowed from behind the silhouette of the mountains.
We were driving into a massive veld fire that ringed the rocks and pinnacles
all around. The lines of scarlet flame like red thorns encircling us; the smell
of smoke heavy in the air.
This was the biggest known fire to hit Harrismith. An amazing spectacle;
like a scene from Dantes great poem sprung to reality in the hills of
KwaZulu Natal.
And so we drove through, safely. To plan the next stages of Children of
Fire.
Bronwen Jones, Johannesburg, RSA, June 1998.