Back in March I wrote about two of my art students, Sbonelo and Londe, victims of abuse from their primary caregivers. Today, I am writing about another student, a victim of gross neglect.
Amahle is 4 years old. She started showing up at Sunday art classes a few months ago. All of my students are filthy. They arrive in tattered clothes that don’t fit them and they look and smell like they haven’t bathed in weeks. Among my filthy children, Amahle is the worst. A cloud of dirt swirls around her wherever she goes, like Pig Pen from Peanuts. There is also something wrong with her eyes. When I look at her, she looks back with her left eye; her right is off wandering somewhere else.
I have seen Amahle wearing pants with a gaping hole where the backside should be. I have seen her with a belly swollen to the size of a soccer ball. And I see her rotten front teeth every time she smiles. Pig Pen was cute, but he was a cartoon. Amahle is a real child. And her horrible hygiene and poor health is a direct reflection of her life at home – neglected.
Last week, Amahle arrived at class with a heavily bandaged left hand. I approached her, crouched down to eye level, and asked if her hand hurt. She smiled, her sweet rotten tooth smile and nodded. She cannot understand me.
This Sunday, Amahle showed up without the bandage. She arrived only to collect dinner after class. I was speaking with Sthe on her front veranda when I heard gasps from the food drive volunteers. I looked over to see Amahle grasping a styrofoam take-away container with an unbandaged left hand.
Her hand had been badly burned and was infected. The sight of it made my stomach turn. I am not a physician, but I am not blind. I know trouble when I see it. I looked to Sthe, wide-eyed and shaking. She told me that Amahle, “left her bandage at home.”
The volunteers were packing up and heading toward the front gate. Sthe was looking toward her front door. Five adults saw Amahle’s hand. Five adults let her walk away. The bandage was at home.
I knew better. There was no bandage. And simply covering the horror that was Amahle’s left hand would not save her from blood poisoning or amputation. My first instinct was to put Amahle in my car and go straight to the hospital. Instead, I asked Sthe to watch Amahle and called Krista for help.
I described what I saw. Krista asked me to send a photograph along with some information about Amahle, including how the burn was incurred (hot porridge). She advised me to go with Sthe to speak with Amahle’s mother while she wrote a referral letter.
Sthe sent Amahle home while we discussed how best to approach the family. I made sure Sthe understood that I would not leave without Amahle and her mother.
With Krista’s referral letter in hand, Sthe and I drove down the road and stopped at Amahle’s gate. It was a grey, wet day. The ground was saturated from days of rain. The muddy pathway leading up to the house was littered with plastic Albany bread bags and empty soda bottles. Soggy cardboard boxes, brimming with trash and broken toys lined the side of the house. A doll’s head lay face down in the muddy path.
Amahle’s mother, Musa called for us to come inside. She was lying back on a couch with Amahle watching television. Amahle’s granny was sitting on a couch opposite them. Between them, a hot plate was perched atop a plastic bucket – chest height for Amahle – both burners on, red hot, heating the small room.
Amahle smiled and waved at me. She seemed excited that I was in her home. Sthe spoke with Musa, explaining who I was and why I was in her house. When she finished, I told Musa that Amahle needed to see a doctor right away. She nodded. I explained that my car was outside their front gate, and I would drive them to the hospital and bring them home when they were finished.
Musa was still reclining on the couch, covered in a blanket, the TV chattering uselessly in the background. Nothing about her indicated the slightest sense of urgency, or even interest. Musa looked at Amahle, then back at me and asked, “When must we go?” Yesterday. I looked her dead in the eyes and said, “Now.”
Musa sighed, clearly disappointed with my response. But she peeled herself from the couch and dressed Amahle to go out. Sthe made sure she had her ID book and Amahle’s health information. Then we made our way back down the muddy path to my car. I thanked Sthe, dropped her off, and continued on to Edendale with Amahle and her mother.
We arrived at Edendale Hospital around 6:30pm. During the day, queues spill out of the admissions building and various clinics, but by 4pm, the hospital is virtually empty. It only took 5 minutes to get a new patient file for Amahle. This would have taken half the morning if we arrived at 7am. We were referred to Emergency, where we waited in the triage queue. Our fellow emergency patients ranged from young men passed out on gurneys (drunk) to old gogos in wheelchairs with broken ankles. At one point, a young man, his right arm glistening with blood from the elbow down, casually made his way down the corridor, leaving a trail of dark red drops behind him. I guessed it hadn’t occurred to him or his friends that a wound like that should be wrapped up.
That evening, Amahle was the darling of Emergency. Despite her badly infected hand, she was in better spirits than the rest of us. Amahle made every (conscious) person in Emergency smile at least once. Several doctors took note. “Why hasn’t this little girl been seen yet?” Nice work, Amahle. Keep up the cuteness. We were called in to see a doctor a few minutes later.
I helped Musa describe her daughter’s injury to the doctor, a young Indian man. He directed most of his observations and instructions for treatment toward me, for better or worse. Amahle was to have her wound cleaned and dressed, start antibiotics, and return on Wednesday to see a burn specialist.
We returned to the corridor and waited a while longer. Eventually, a nurse waved us into the Emergency treatment area. I let Musa and Amahle go on their own this time. After a few minutes, I heard Amahle screaming. Oh God. I stuck my head in the door. Musa called me over for help. She was trying to remove Amahle’s jacket and sweater. Amahle wasn’t screaming because this was hurting her hand – it hadn’t been touched. She was screaming in protest. She knew what was coming.
The cheerful little girl that had entertained all of triage had disappeared. Amahle screamed and sobbed as the nurse cleaned and dressed her hand. I kept telling Amahle, “You’re okay,” as I rubbed her dirty little foot. She stared back at me through sad, tearful eyes and nodded. She cannot understand me.
The nurse finished and spoke with Musa in Zulu. They seemed to be discussing Amahle’s medication. A passing doctor looked at Amahle’s file and told me that Musa needed to return the next day to pick up medicine – the prescribed antibiotics were not available in the evenings. That is to say, the largest public hospital in the district does not stock antibiotics in Emergency. Fantastic. Taxi fare for a trip back to the hospital would cost Musa (and Amahle) a meal. I told Musa not worry. I would go to the pharmacy in the morning and bring the medicine to her home.
I dropped Amahle and her mother at their gate at 10:30pm – not bad.
I returned the next morning with antibiotics and pain medication, as promised. Musa was not home. I showed Amahle’s aunt (or cousin, or sister) how to dose the medicine and feed it to Amahle, and explained that she was to do that 3 times each day until the medicine was finished. Sthe was with me. She made sure the girl understood and asked her to remind Musa of Amahle’s follow-up appointment on Wednesday.
Throughout this short visit, Amahle’s granny watched from the corner, babbling in Zulu, nursing a 1-liter bottle of Black Label beer. When I turned to leave, she grabbed my leg and barked something in Afrikaans, spitting beer all over my face. I looked back toward Amahle and her aunt. All I could think to say was “Take care of her.” And I left.
7am, Wednesday morning, I sent Sthe a text message to let her know I was on my way to pick up Amahle and her mother. (Musa does not own a phone.) Sthe responded, “They already left. Check the hospital.” This was surprising. Either Musa misunderstood my offer to give them a ride, or she had taken initiative and decided to get Amahle to the hospital as early as possible. In either case, it was a good sign.
I spent the better part of the morning on a wild goose chase through Edendale Hospital, looking for Amahle. I had to make sure she was there. Makhosi Shoba, an iTEACH traditional healer, offered to help. He seemed as determined to find her as I was. We checked the admissions queues, the Special Clinic, the Family Clinic, Occupational Therapy, the pharmacy, the wards – we couldn’t find them anywhere. And no one had a record of Amahle in the register. I was beginning to worry that they had not come to the hospital after all.
Shoba decided to go back to Special Clinic. That’s where they should have been for Amahle’s follow-up appointment. Sure enough, they were there. And Amahle wasn’t filthy, for a change. She was wearing a dress and flowery sandals, and had a bright yellow sun hat on her head. The only thing missing was an Easter basket.
I continued to check in on their progress the rest of the morning. The burn specialist removed all of the infected tissue from Amahle’s hand and sent her to physiotherapy. Shoba and I left them there with lunch and 10 rand for taxi fare.
I was reluctant to leave. I wanted to wait until Amahle was finished at the hospital and see her safely to her front door. Krista had to convince me to let them go. Musa had remembered the follow-up appointment and gotten Amahle to the hospital without my help. She even asked Sthe for my phone number so she call (from a payphone) after Amahle’s appointment to update me on her progress. Musa, it seemed, had committed to taking better care of her daughter, at least for now. I plan to visit them on Sunday after art class.
Amahle’s condition is not at all unusual. Children here are notoriously neglected and often abused. Burns from hot porridge, wood fires, and hot plates being used as home heaters are all too common. Last week, a 4 year-old child from Imbali died from burns incurred from boiling water. Electrocution is another common cause of child mortality. Poor families who cannot afford to pay for electricity strip raw wires from power lines and connect them to their homes. Any child unfortunate enough to grab one of these wires will likely die from it.
Amahle was lucky. But she is one of too many.
I shared this story with my iTEACH coworkers at our staff meeting on Monday. As a result, the training team has decided to build a curriculum on child safety and parenting, to be delivered to families in the surrounding communities. There is no one in the world I trust more to make a difference than the iTEACH team. With their help, I know we can save many more Amahles.
Below is the photo of Amahle's had I sent to Krista. If you're squeamish, best not to scroll down.
Amahle is 4 years old. She started showing up at Sunday art classes a few months ago. All of my students are filthy. They arrive in tattered clothes that don’t fit them and they look and smell like they haven’t bathed in weeks. Among my filthy children, Amahle is the worst. A cloud of dirt swirls around her wherever she goes, like Pig Pen from Peanuts. There is also something wrong with her eyes. When I look at her, she looks back with her left eye; her right is off wandering somewhere else.
I have seen Amahle wearing pants with a gaping hole where the backside should be. I have seen her with a belly swollen to the size of a soccer ball. And I see her rotten front teeth every time she smiles. Pig Pen was cute, but he was a cartoon. Amahle is a real child. And her horrible hygiene and poor health is a direct reflection of her life at home – neglected.
 |
| Amahle and her elephant mask |
Last week, Amahle arrived at class with a heavily bandaged left hand. I approached her, crouched down to eye level, and asked if her hand hurt. She smiled, her sweet rotten tooth smile and nodded. She cannot understand me.
This Sunday, Amahle showed up without the bandage. She arrived only to collect dinner after class. I was speaking with Sthe on her front veranda when I heard gasps from the food drive volunteers. I looked over to see Amahle grasping a styrofoam take-away container with an unbandaged left hand.
Her hand had been badly burned and was infected. The sight of it made my stomach turn. I am not a physician, but I am not blind. I know trouble when I see it. I looked to Sthe, wide-eyed and shaking. She told me that Amahle, “left her bandage at home.”
The volunteers were packing up and heading toward the front gate. Sthe was looking toward her front door. Five adults saw Amahle’s hand. Five adults let her walk away. The bandage was at home.
I knew better. There was no bandage. And simply covering the horror that was Amahle’s left hand would not save her from blood poisoning or amputation. My first instinct was to put Amahle in my car and go straight to the hospital. Instead, I asked Sthe to watch Amahle and called Krista for help.
I described what I saw. Krista asked me to send a photograph along with some information about Amahle, including how the burn was incurred (hot porridge). She advised me to go with Sthe to speak with Amahle’s mother while she wrote a referral letter.
Sthe sent Amahle home while we discussed how best to approach the family. I made sure Sthe understood that I would not leave without Amahle and her mother.
With Krista’s referral letter in hand, Sthe and I drove down the road and stopped at Amahle’s gate. It was a grey, wet day. The ground was saturated from days of rain. The muddy pathway leading up to the house was littered with plastic Albany bread bags and empty soda bottles. Soggy cardboard boxes, brimming with trash and broken toys lined the side of the house. A doll’s head lay face down in the muddy path.
Amahle’s mother, Musa called for us to come inside. She was lying back on a couch with Amahle watching television. Amahle’s granny was sitting on a couch opposite them. Between them, a hot plate was perched atop a plastic bucket – chest height for Amahle – both burners on, red hot, heating the small room.
Amahle smiled and waved at me. She seemed excited that I was in her home. Sthe spoke with Musa, explaining who I was and why I was in her house. When she finished, I told Musa that Amahle needed to see a doctor right away. She nodded. I explained that my car was outside their front gate, and I would drive them to the hospital and bring them home when they were finished.
Musa was still reclining on the couch, covered in a blanket, the TV chattering uselessly in the background. Nothing about her indicated the slightest sense of urgency, or even interest. Musa looked at Amahle, then back at me and asked, “When must we go?” Yesterday. I looked her dead in the eyes and said, “Now.”
Musa sighed, clearly disappointed with my response. But she peeled herself from the couch and dressed Amahle to go out. Sthe made sure she had her ID book and Amahle’s health information. Then we made our way back down the muddy path to my car. I thanked Sthe, dropped her off, and continued on to Edendale with Amahle and her mother.
We arrived at Edendale Hospital around 6:30pm. During the day, queues spill out of the admissions building and various clinics, but by 4pm, the hospital is virtually empty. It only took 5 minutes to get a new patient file for Amahle. This would have taken half the morning if we arrived at 7am. We were referred to Emergency, where we waited in the triage queue. Our fellow emergency patients ranged from young men passed out on gurneys (drunk) to old gogos in wheelchairs with broken ankles. At one point, a young man, his right arm glistening with blood from the elbow down, casually made his way down the corridor, leaving a trail of dark red drops behind him. I guessed it hadn’t occurred to him or his friends that a wound like that should be wrapped up.
 |
| Art in Emergency triage |
That evening, Amahle was the darling of Emergency. Despite her badly infected hand, she was in better spirits than the rest of us. Amahle made every (conscious) person in Emergency smile at least once. Several doctors took note. “Why hasn’t this little girl been seen yet?” Nice work, Amahle. Keep up the cuteness. We were called in to see a doctor a few minutes later.
I helped Musa describe her daughter’s injury to the doctor, a young Indian man. He directed most of his observations and instructions for treatment toward me, for better or worse. Amahle was to have her wound cleaned and dressed, start antibiotics, and return on Wednesday to see a burn specialist.
We returned to the corridor and waited a while longer. Eventually, a nurse waved us into the Emergency treatment area. I let Musa and Amahle go on their own this time. After a few minutes, I heard Amahle screaming. Oh God. I stuck my head in the door. Musa called me over for help. She was trying to remove Amahle’s jacket and sweater. Amahle wasn’t screaming because this was hurting her hand – it hadn’t been touched. She was screaming in protest. She knew what was coming.
 |
| Before cleaning and dressing |
The cheerful little girl that had entertained all of triage had disappeared. Amahle screamed and sobbed as the nurse cleaned and dressed her hand. I kept telling Amahle, “You’re okay,” as I rubbed her dirty little foot. She stared back at me through sad, tearful eyes and nodded. She cannot understand me.
The nurse finished and spoke with Musa in Zulu. They seemed to be discussing Amahle’s medication. A passing doctor looked at Amahle’s file and told me that Musa needed to return the next day to pick up medicine – the prescribed antibiotics were not available in the evenings. That is to say, the largest public hospital in the district does not stock antibiotics in Emergency. Fantastic. Taxi fare for a trip back to the hospital would cost Musa (and Amahle) a meal. I told Musa not worry. I would go to the pharmacy in the morning and bring the medicine to her home.
I dropped Amahle and her mother at their gate at 10:30pm – not bad.
I returned the next morning with antibiotics and pain medication, as promised. Musa was not home. I showed Amahle’s aunt (or cousin, or sister) how to dose the medicine and feed it to Amahle, and explained that she was to do that 3 times each day until the medicine was finished. Sthe was with me. She made sure the girl understood and asked her to remind Musa of Amahle’s follow-up appointment on Wednesday.
 |
| Medicine with instructions in Zulu |
Throughout this short visit, Amahle’s granny watched from the corner, babbling in Zulu, nursing a 1-liter bottle of Black Label beer. When I turned to leave, she grabbed my leg and barked something in Afrikaans, spitting beer all over my face. I looked back toward Amahle and her aunt. All I could think to say was “Take care of her.” And I left.
7am, Wednesday morning, I sent Sthe a text message to let her know I was on my way to pick up Amahle and her mother. (Musa does not own a phone.) Sthe responded, “They already left. Check the hospital.” This was surprising. Either Musa misunderstood my offer to give them a ride, or she had taken initiative and decided to get Amahle to the hospital as early as possible. In either case, it was a good sign.
I spent the better part of the morning on a wild goose chase through Edendale Hospital, looking for Amahle. I had to make sure she was there. Makhosi Shoba, an iTEACH traditional healer, offered to help. He seemed as determined to find her as I was. We checked the admissions queues, the Special Clinic, the Family Clinic, Occupational Therapy, the pharmacy, the wards – we couldn’t find them anywhere. And no one had a record of Amahle in the register. I was beginning to worry that they had not come to the hospital after all.
Shoba decided to go back to Special Clinic. That’s where they should have been for Amahle’s follow-up appointment. Sure enough, they were there. And Amahle wasn’t filthy, for a change. She was wearing a dress and flowery sandals, and had a bright yellow sun hat on her head. The only thing missing was an Easter basket.
I continued to check in on their progress the rest of the morning. The burn specialist removed all of the infected tissue from Amahle’s hand and sent her to physiotherapy. Shoba and I left them there with lunch and 10 rand for taxi fare.
I was reluctant to leave. I wanted to wait until Amahle was finished at the hospital and see her safely to her front door. Krista had to convince me to let them go. Musa had remembered the follow-up appointment and gotten Amahle to the hospital without my help. She even asked Sthe for my phone number so she call (from a payphone) after Amahle’s appointment to update me on her progress. Musa, it seemed, had committed to taking better care of her daughter, at least for now. I plan to visit them on Sunday after art class.
Amahle’s condition is not at all unusual. Children here are notoriously neglected and often abused. Burns from hot porridge, wood fires, and hot plates being used as home heaters are all too common. Last week, a 4 year-old child from Imbali died from burns incurred from boiling water. Electrocution is another common cause of child mortality. Poor families who cannot afford to pay for electricity strip raw wires from power lines and connect them to their homes. Any child unfortunate enough to grab one of these wires will likely die from it.
Amahle was lucky. But she is one of too many.
I shared this story with my iTEACH coworkers at our staff meeting on Monday. As a result, the training team has decided to build a curriculum on child safety and parenting, to be delivered to families in the surrounding communities. There is no one in the world I trust more to make a difference than the iTEACH team. With their help, I know we can save many more Amahles.
Below is the photo of Amahle's had I sent to Krista. If you're squeamish, best not to scroll down.
 |
| Amahle's hand, badly infected below the thumb |
No comments:
Post a Comment