"I can now walk!"

The miraculous story of Karabelo Fanka

By Theonevus Tinashe Chinyanga, PIH Lesotho

	Karabelo was bedridden upon arriving at the Bobete Health Center in Lesotho.

At 5 years old, Karabelo weighed about as much as a normal nine-month-old baby. At 3’8’’ tall, the boy weighed less than 18 pounds. His body was composed of skin attached directly to bone, no muscles. His skin had been cut and pierced by various traditional healers. He was bedridden and could not talk.

Karabelo’s mother, Makhahliso, is a widow. She worked as a house maid in the small township about 30miles away, leaving Karabelo and his little brother under the care of their elderly paternal grandparents (who would have been living in a nursing home, were they in the first world). Karabelo’s grandpa had spent most of his life working in the mines in neighboring South Africa and soon fell ill with excessive coughing, weight loss and drenching night sweats. Several consultations with traditional healers ensued and all pointed to the need of making a feast to appease the ancestors since they were angry that he had spent most of his life away from them in South Africa. He eventually died in early 2007, while they were still preparing for the ceremony.

In October 2007, Karabelo fell ill, with the same symptoms as his grandpa. Traditional healers were quick to point out that the ancestors were punishing him for the sins and arrogance of his late grandpa who did not make a feast to appease them. The feast had to include slaughtering a cow. The family had no animals, and this crucial requirement for the ceremony would cost about $350. Makhahliso’s monthly salary amounted to about $20. To raise money for a cow, she would have work for one and half years without spending a cent on anything for the rest of her family, not even for food.

Last January, a community health worker in Makhahliso’s village convinced her to bring her sick, unconscious son to the Bobete Health Center, a clinic operated by PIH’s partner organization in Lesotho, despite disapproval from her family and the traditional healers. At the clinic, it did not take a rocket scientist to diagnosis the child with malnutrition.  We also inferred that Karabelo’s grandpa had died from tuberculosis, and thus Karabelo had probably contracted the disease from him as well.

But treatment for the boy was much more complicated than making the diagnosis. We started carefully rehydrating him, and had to put a tube from his nose through to the stomach so that we can push in life saving tuberculosis tablets and. We also found that the boy had fluid around his heart, which is fatal if not drained. Removing this fluid is normally performed with complicated equipment in the U.S. PIHL’s Dr. Jen Furin was forced to do it using only a syringe and needle.

Days turned into weeks, and weeks into months, Karabelo remained unconscious. Every member of the team at Bobete was worked hard to ensure his survival. He was resuscitated countless times a day. Towards the end of the second month, he finally began to improve. He no longer needed the feeding tube, but still was not able to talk, sit or move his limbs. The sensible medical explanation was that he had suffered massive brain damage from tuberculosis which would make him dependent on others for everything; he would be a paraplegic child for life. It seemed all we had done was to delay death by creating another big problem for the mother. Would it have been better for him to die?

	Karabelo exploring a possible career option at a recent visit to the Bobete Health Center

Like Karabelo, many children in rural Lesotho live in extreme poverty. However, thanks to PIH’s long list of sponsors and partners who bring the requisite equipment, supplies, food, and medications, we have the tools we need to treat them—sometimes with delayed, but nonetheless astonishing results.

This September, I was busy in the consultation room when l heard a light knock on the door. When l opened the door, it was Karabelo! He was standing there by himself leaning on a stick and he said to me, “Look Dr Tinashe, I can now walk!”  He wanted me to know that the team’s effort was not in vain. Physical therapy devised by the clinic staff and carried out by his mother had helped him regain his mobility. He weighed almost 40 pounds, thanks to a partnership with the World Food Program, which supplied him with food rations to complement his medical treatment for TB.

Karabelo has conquered two diseases responsible for death of many children in Sub Saharan Africa: malnutrition and tuberculosis. His survival and progress continues to defy basic medical principles and reasoning. Today, his caregivers spend most of their time chasing him, as he often attempts to come back to the clinic just to visit. Makhahliso has since joined our clinic as a general hand, earning a decent salary. Their lives will never be the same again. In my life as a medical doctor, I have seen many near-death situations but Karabelo’s survival will linger in my mind for as long as l live.

[posted November 2008]