A 23-year-old mother of three is lying in agony at Queen Elizabeth Central Hospital in Blantyre after developing septic pressure sores on the buttocks following a Caesarean operation at Mzuzu Central Hospital in November last year.
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The patient, Gertrude Nkhonjera from Rumphi, was told at Mzuzu and Queen Elizabeth central hospitals that her condition requires referral to outside hospitals like in Tanzania, South Africa or Zambia, according to her medical file.
Nkhonjera’s nursing care record shows that she is frequently going to the theatre for debridement and vacuum dressing. She has deep wounds on the buttocks that expose the bones. The surgery she undergoes involves removing tissue from the wounds.
“For debridement tomorrow [12/4/12] please remove all neurotic tissue on debridement,” reads a recommendation from one of the doctors as depicted on hospital records at QECH.
Sometimes, operation fails to take place because of unavailability of blood that is required to be transfused into her body.
Hospital records show that Nkhonjera has altered mobility related to paraplegic of lower extremities as evidenced by her failing to walk. She also has altered body comfort and body temperature related to wound infection and has risk for anaemia and constipation related to immobility.
Notes on the provisional clinical diagnosis on April 11 2012 reads: “Deep pressure sores bilateral buttocks. Bony erosion (a piece of bone was removed when dressing).”
One of her guardians Edith Mhango said on Tuesday the family cannot afford to take the patient outside the country. She said Nkhonjera’s condition started after undergoing Caesar at Mzuzu Central Hospital.
“We appeal to people who can help us to take her to other hospitals outside the country,” pleaded Mhango. She said the family believes that the Caesar at Mzuzu Hospital was not done well.
Medical admission note from Mzuzu Central Hospital dated January 5 2012 confirms: “Had C/S [Caesar] on 20/11/11 here since then cannot walk, cannot feel any touch to toes or feet both.”
In an interview on May 1 Nkhonjera narrated how she found herself in the present condition. She said she developed septic pressure sores after Caesar at Mzuzu Central Hospital and was later referred to QECH.
A report from QECH contained in the file says after Caesar, Nkhonjera took three days to awake only to find that her lower extremities were no more active. The report says Nkhonjera stayed in the hospital for two weeks and was discharged after being told that there was nothing the hospital could do about the condition.
“On discharge, she was told that Mzuzu Central Hospital could do nothing on numbness of lower extremities. She was advised to seek medical treatment from one of the following countries Tanzania, Zambia or South Africa.
“They did not visit one of the above countries for medical treatment since they lacked full information on how to book and where to get that prescribed medical treatment. She has been bedridden since early December because she could hardly walk.”
The report further says Nkhonjera developed pressure sores on the buttocks early February this year and when she visited the hospital again, she was advised to dress the wounds at home using salty water. When she went bank to the hospital, she was referred to QECH.
“Here at QECH Miss Gertrude Nkhonjera was admitted with the diagnosis of pressure sores secondary to neurotic tissue damage on both buttocks,” reads the report.
Ministry of Health spokesperson Henry Chimbali had not responded to our questionnaire on the patient’s condition as we went to bed.
