Play is the
ingredient that gives infancy its flavour. We chuckled, giggled, rolled in the
sand, jumped off mounds, chased our peers and climbed trees. In turn, wounds,
scars and bruises were sculpted on our skins.
But did you know that
a bad injury could result into something more tragic, like a bone infection?
Seven-year-old
Jonathan Wasswa, a resident of Nkumba has lived through the pain of a bone
infection, medically called osteomyelitis.
 |
| Jonah (L) plays with a friend |
HIS STORY
Wasswa was at his
best on the morning of December 26, 2012.
Standing on a low
stool, he chorused, ‘mbuuke mbuuke?’ (should I jump, should I jump?)
His friends responded, ‘buuka!’ (jump)
and he did. The jump left him with a broken bone and swollen limb. The pain
stung every part of his body making the little child wail.
His mother, Maria
Specioza Nalwanga consulted a herbalist who wrapped Wasswa’s injured leg with
herbs, as pain relief agents and treatment. The herbs lasted one week but did
no good. His leg turned yellow and the swelling got bigger.
On February 14, he
was taken to Mulago hospital for an X-Ray which revealed an internal bone
fracture. His leg was put on traction, a set of
mechanisms to straighten broken bones or relieve pressure on the spine and
skeletal system, and the leg was encased in a cast.
 |
| Jonah and his mother after his incident of an injured leg |
“Before
[the cast could be removed], his leg oozed large volumes of pus, so much so
that it seeped through the two mattresses on his bed, and on to the floor,”
Nalwanga recalled, adding that he was taken back to Mulago.
It
was discovered that he had a wound on the inner side of the left knee. By then,
he had lost appetite and was immobile. On April 9, 2013, he was referred to CoRSU
(Comprehensive Rehabilitation Services in Uganda) in Kisubi for surgery to rid him of the dead bone
due to osteomyelitis.
ABOUT OSTEOMYELITIS
Osteomyelitis is a bone infection often caused by bacteria
called staphylococcus aureus. In children, it
usually affects the long bones of the arms and legs.
“Patients usually present with pain, swelling, pus discharge
in the affected area and sometimes, one may be unable to use the affected
limb,” explained Dr Paul Muwa, an orthopedic specialist at CoRSU. Additionally,
patients might have fever and chills and feel nauseated.
Osteomyelitis
is more common in children because their bones are more vulnerable as they are
not fully grown.
Malnourished children and those from poor socio-economic backgrounds are more
prone to the condition.
If
not treated quickly, it leads to the chronic stage with severe bone destruction
that may necessitate amputation.
Adults
are also predisposed to bone infection because of increased incidence of
diabetes and poor dentition and frequent surgical procedures such as open heart
surgery and dental extractions.
At
CoRSU, bone infection is the orthopedic condition with the highest number of
surgical procedures. Out of 3,018 procedures last year, 747 were due to
osteomyelitis.
DIAGNOSIS AND
TREATMENT
Records indicate that it is sometimes difficult to diagnose
osteomyelitis in infants and young children because they don't always show pain
or specific symptoms in the area of the infection.
When Wasswa was admitted at CoRSU, he was examined and had a
bone X-Ray.
“The X-Ray revealed that one bone overlapped the other and
that the head of the femur (thigh bone) had been eaten by bacteria,” Moses
Kiwanuka, CoRSU’s head of community-based rehabilitation said.
Immediately, Wasswa was put on antibiotic treatment through
an intravenous drip (IV) to stop the bacteria in its tracks. In some instances,
like it was in Wasswa’s, Kiwanuka said osteomyelitis can become severe and a
hole may develop in the bone.
Pus and a collection of bacteria may have formed in the hole
and this calls for a surgical procedure to drain the pus to allow the bone to
heal completely.
Once the condition improves, a patient is discharged but
continues with oral antibiotics for several weeks.
Dr Muwa, however,
noted that recovery depends on the state of a patient’s condition i.e. how much
of the bone is involved.
PREVENTION AND HOME CARE
 |
| A vibrant Jonah relaxes in the lawn |
Kiwanuka said the
easiest way to prevent osteomyelitis is to practice good hygiene.
“One needs to keep
wounds clean and this can be done through traditional sterilization using
cotton wool and warm salty water and cover it with sterile gauze or a clean
cloth to avoid its exposure to infection,” he urged.
For those that have
undergone surgical procedure, regular exercise such as walking helps in
restoring the mobility of the affected body part. Kiwanuka also calls for
improved nutrition, a balanced diet, to boost the body’s immunity.
Before the infection, Wasswa mainly fed on
rice, groundnut sauce and matooke. Today, his diet has widened to include eggs,
small fish (mukene) and posho. The
lively and warm Wasswa now spends his days helping ‘mummy’ in the garden.
The possibility of
him returning to school and graduating into a medical doctor is as ripe as it
was two years ago.
