One cold night in February this year, 12-year-old Maria Nanyanzi woke up in the middle of the night, screaming and wailing insurmountably. Her left thigh was burning like a boiling kettle with of porridge. At about 3am, another part on her thigh burst. Pus oozed down her knee like magma from an erupting volcano. She fainted.
Nanyanzi sits holding onto her mother Esther Nakyanzi, as she narrates her 11-year ordeal.
For years, Nanyanzi had lived with the horrifying experience of being surrounded by houseflies attracted by the odor emanating from her wounded leg.
At first, Nakyanzi was disuaded from taking the child to hospital by her neighbours and mother-in-law who claimed Nanyanzi had been bewitched by some malicious people.
“I took her to my church for prayers but this changed very little,” she says almost regrettably, “Because her grandmother always insisted that my child had been bewitched.”
In fact, the following morning, Nakyanzi says her mother-in-law had woken up in the wee hours to go and ‘consult the gods’. The gods recommended some herbs which were applied on the leg but the situation had worsened instead.
Understanding the problem
After several visits to Mulago hospital; an option they had resorted to after failing all traditional methods, the doctors failed to diagonise the ailment. They administered painkillers as the immediate remedial support.
“That did not help at all,” Nakyanzi says.
Nakyanzi says she almost believed the superstitious insinuations that her child could have been bewitched. She resorted to praying for her in church. The leg got better, the wound disappeared and the pain reduced.
“Thanks to the antibiotics and pain killers from hospital and God’s healing power from the prayers,” she says.
Rose Namuddu, Nanyanzi’s grandsays she also wanted to try and find a cure since she saw her pain on a daily basis.
“I did everything in my means to cure for the ailment or at least ease my granddaughter’s pain. That is why I applied the herbs but they did not help,” she says.
This seemingly incurable illness played on the already held superstition that Nanyanzi was never meant to live.
“My baby has had to fight to live from the moment she was born. First of all she was born without genitals until doctors performed a surgery to get her one. Three months later (at nine months old) it was discovered that she had a syphilis infection. Three years later, Nanyanzi started getting pain in her femur bone,” Nakyanzi shares.
“After delivering from a hospital in Kampala, my husband then suggested that we go back to his home village in Kalisizo, Masaka District where I would be well attended to by his mother,” she says adding, “It was during that time that the pain in the bone started but we didn’t know the source nor the remedy.”
In 2011 the pain became unbearable prompting the parents to intensify the search for a possible relief for their child. After ruling out the suspicions of a possible witchcraft, Mulago hospital subjected Nanyanzi to a litany of tests which would later confirm a rotten femur bone, a condition medically known as osteomyelitis.
Dr William Masereka, of Corsu Hospital in Wakiso District who attended to Nanyanzi says this is a condition common among children below 10 years and the elderly above 70 years.
Dr Masereka says the condition can be controlled if discovered in its early stages. If the condition goes to the third stage, he says the only way out is a surgery.
For this particular case, the doctor says it could have been caused by an injection which brought a Staphylococcus aurous bacterial infection to the femur bone hence the rotting.
“Among the infants, the bacteria combine with the staph bacteria causing the condition,” he says, adding: “In the elderly people, some diseases such as diabetes can put one at the highest risk of getting osteomyelitis,” he says.
Heavy financial implications
As the condition became persistent, Nakyanzi’s relationship with her husband started becoming strained because they both accused each other of negligence. The couple then separated leaving Nakyanzi stuck with her daughter and the daunting task of footing the hospital bills single handedly.
She found a job at a restaurant around town where she could save some money for medication. She was supposed to use Shs13,000 to buy three tablets every day before the review which took place after every two weeks. By the end of 30 days, she would spend Shs390,000 that was thrice her monthly Shs120,000 pay.
“My husband gave me support for the first 14 days of the first month. I was overwhelmed with the amount per day,” she says.
Doctors say this whole condition could take anywhere between Shs20m to Shs30m for the whole process to be completed in most of the international hospitals because it is such a complicated ailment.
How relief was found
She says after sometime, her then husband stopped supporting them financially and yet her daughter had become sickly so she decided to go to Kampala and make money, which would eventually support her and her child.
Nakyanzi says she gave it another shot and went back to Mulago hospital, where doctors suspecting cancer took some samples of her flesh and blood for examination.
“Since our first visit in Masaka Hospital, they had indicated that the problem could be cancer, I did not panic when Mulago suspected the same. They went ahead with the tests,” she says adding, “It was not the case. Mulago said she did not have cancer. Instead of being a relief I was more frustrated.”
Despite the frustration and the pain the child was going through, the mother did not tire to look for possible solutions.
She started asking other people for help and support in whatever form they could manage. In 2018, one of her sisters called and told her that she had heard of Bulamu Health Care International; an organisation that gives medical care to people at no cost, regardless of the condition. Despite the skepticism that she had after failing on many occasion, she gave it try. The other hurdle she had to jump was finding them since they are a mobile medical organisation.
“I picked my duaghter who was still staying with her grandmother at that time and started moving to look for them. By this time, the leg had become crippled,” she narrated.
When they contacted the organisation, they were told they had taken their routine health camp to Kamuli District where they arrived on the last day.
Joseph Bisaso the operations manager of Bulamu Healthcare International, says Nanyanzi’s case was an emergency that needed to be handled as soon as possible.
“When we receive cases during our camps, we give the initial tests and pain killers as we link up with our partner hospitals depending on the condition one is suffering from. Upon discovering that Nanyanzi had been in this state for years, we called our hospital and arranged for immediate surgery,” Bisaso says.
Bisaso says Nanyanzi is one of the many patients that have received medical care since the camps offer many rural Ugandans the best access to quality primary healthcare.
According to their website, Bulamu treated 1,820 patients at the first camp in 2016 and watched that number grow to nearly 12,000 at the next camp in April of 2018.
Bulamu International has conducted more than 15 successful medical camps where they have helped give free medical services to over 100, 000 people who would have otherwise failed to afford them.
Nanyanzi is one of the more than 8, 000 patients that they have worked on using their doctors who partner with them on on that particular camp.
Mr Bisaso also says they spend about a month looking for and engaging with different stakeholders and district health officers who come up with the main diseases that is prevalent in the district and then finally set up dates for medical camps.
“We do optical, dental, surgery and lab services, ultra sound and x-rays. We have 50 doctors who are well trained from different hospitals. And we get the 150 workers from different host health centres,” Mr Bisaso says.
What is osteomyelitis
In children, osteomyelitis most commonly occurs at the ends of the long bones of the arms and legs, affecting the hips, knees, shoulders, and wrists. In adults, it is more common in the bones of the spine.
In children, osteomyelitis most often occurs more quickly. Osteomyelitis in children is most likely caused by bacteria that travel through the bloodstream (bacteremia) and spread to the bone. Hematogenous osteomyelitis is the medical term for the spread of bacteria through the blood to infect the bone.
Children often develop pain or tenderness over the affected bone, and they may have difficulty or inability to use the affected limb or to bear weight or walk due to severe pain. They may also have fever, chills, and redness at the site of the infected area.
In adults, the symptoms and signs often develop more gradually and include fever, chills, irritability, swelling or redness over the infected bone, drainage of pus, stiffness, and nausea. In people with diabetes, peripheral neuropathy, or peripheral vascular disease, there may be no pain or fever. The only sign may be an area of skin breakdown that is worsening or not healing. In osteomyelitis of the spine (vertebral osteomyelitis) or the spinal discs (discitis), the only symptom may be back pain.
“The best way to prevent osteomyelitis is to keep things clean. If you or your child has a cut, especially a deep cut, wash it completely. Flush out any open wound under running water for five minutes, and then bandage it in sterile bandages.”
Dr Masereka also explains that this kind of ailment needs to be reported before it reaches its third stage which he says may lead into amputating the limb.
“Whenever you suspecting pain or discomfort in a child, always reach out to a medical worker and explain. This would help prevent many diseases in your child,” he says.