3-year-old with kidney problem needs life-saving operation
If three-year-old Atang Mmusi does not get help soon, he will die.
This is the bleak reality facing the toddler and his increasingly desperate mum, Kakale Mmusi.
For the last two years of his young life, Atang has been tormented by kidney problems (he has a condition known as nephrotic syndrome), which have caused his belly to swell to three times its normal size.
It is an affliction that means the youngster spends most of his days in immense pain.
With her son’s life in limbo, 33-year-old Kakale’s frustrations are compounded by the knowledge that a medical operation in South Africa could save him.
However, as Kakale ruefully explains, the Botswana government is unable to foot the medical expenses.
“Atang has been referred to a South African hospital for a kidney biopsy. Unfortunately South African hospitals are refusing to take patients from Botswana (government sponsored) because our government owes them a lot of money,” revealed the single mum, who says she contacted Morningside Hospital in Johannesburg on the recommendation of Princess Marina Hospital only to be told a single operation would cost R40, 000 (P30, 104).
“The R40, 000 does not cover other medical expenses, food and accommodation and I have no idea how long we will need to stay there. I am pleading with people out there to help save my son’s precious life,” continued the unemployed Kakale, her voice breaking with emotion as she contemplates what will happen if her son does not get the operation.
Atang was born a healthy, happy child on 17th August 2015.
He began showing signs of ill-health the following November, when his face suddenly became swollen and his stomach began to bulge.
It proved to be the first of many trips in and out of Princess Marina, where different diagnosis and treatments were given.
“Initially he was given antibiotics and we were sent back home, but after two days we were back in hospital with a worsening problem; swollen face and big stomach.
“At some point doctors thought he had an appendix problem and operated on him. However, after the operation they said all his organs were okay but that they found too much fluid in his stomach which was causing the stomach to swell,” revealed Kakale, who says Atang has been dependent on steroids ever since, something which has stunted his growth.
Three months after the operation, Atang’s symptoms returned, this time accompanied by a severe cough.
“The doctors said he had pneumonia. More tests were made after a few months and they said he was asthmatic and we were given the asthma spray and discharged from hospital. He was also given medication which would help drain fluid from his body.”
By July 2017, Atang’s condition had drastically deteriorated.
His stomach had ballooned and he could no longer sit down on his own.
“We went back to hospital for the fluid to be drained. In August, 2017, more tests were made and that is when a diagnosis that showed he has kidney problem was made. According to the doctors, his kidneys are unable to hold proteins and as such he loses it with his urine. It also causes acute fluid overload in his stomach.
“He was then referred to a South African hospital but could not immediately be taken there as the hospital said there was no money to pay for the medical bill,” narrated Kakale, who adds that Atang’s stomach is often so painful she is unable to bathe him as it hurts him too much.
His blood pressure is persistently high, 136/93 against the 90/70 of a normal child.
“He cries a lot and he sleeps on his back. Just this week we were discharged from hospital following another long admission. We were admitted for three weeks when his whole body,including private parts were swollen,” she continues bitterly, her eyes moist with tears.
“I am really worried and scared for my son and in desperate need for help. The government has no money and my last hope is people out there,” ends a visibly-distressed Kakale.
Atang’s medical report, which was issued by Princess Marina on 29, October, 2018, confirms that the little boy is resistant to the steroid medication.
“Atang is a 3-year-old male child, RVD negative with a suspected Steroid resistant nephrotic syndrome. The child has had multiple admissions in Princess Marina hospital with wheezing episodes which were responsive to short course steroids. He was seen by pediatric surgeons in January 2018 with abdominal distension with signs suggestive of an acute abdomen and subsequently underwent exploratory laparotomy. The laparotomy only reveals lymph nodes suspected to be reactive hyperplasia. Following that the patient continued to visit the hospital with various complaints.
“The extensive investigations the diagnosis of nephrotic syndrome was made in August 2018. Patient was started on long course steroids with prednisone 2mg/kg daily. He is currently on the 6th week of steroids with no clinical improvement.”
What is childhood nephrotic syndrome?
Childhood nephrotic syndrome is also called nephrosis. Nephrotic syndrome happens when tiny structures in the kidneys called glomeruli stop working properly and let too much protein enter the kidneys.
What causes it?
In most cases, the cause is not known, but a number of conditions can damage the glomeruli and cause nephrotic syndrome.
In children, the most common cause is due to minimal change disease.
The cause of minimal change disease isn’t known, but it can be related to infections, tumors, allergic reactions, and overuse of over-the-counter medications like ibuprofen and acetaminophen.
Most children outgrow minimal change disease by the time they are in their teens.
In certain cases, an allergic reaction to food or the use of certain legal and illegal drugs, or obesity can lead to nephrotic syndrome.
Other conditions can damage the glomeruli, including other kidney conditions, immune system problems, infections, or diseases like cancer and diabetes.
Who gets it?
Usually, young children between the ages of 1 ½ and 5, although children of all ages and even adults can get it.
It happens twice as often in boys than in girls.
How can I tell if my child has it?
You may see swelling around your child’s eyes in the morning. Often, that’s the first sign.
As time passes, the swelling may last all day, and you may see swelling in your child’s ankles, feet or belly.
Also, your child may:
• be more tired
• be more irritable
• have a decreased appetite
• look pale.
Your child may have trouble putting on shoes or buttoning clothes because of swelling
Source: National Kidney Foundation