Physio Fletch by monkey6

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Physio Fletch

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									Physio Fletch
Alison Fletcher CMS Mission Partner Kiwoko Hospital PO Box 149 Luweero UGANDA Email: No. 6 Dear friends, Eflance is a little, smiling girl of nearly 5 years of age. She runs around outside, playing cheerfully with a ball, yelling to whoever is nearby to throw her the ball. Inside, she chats happily while drawing a picture or threading buttons on a string. constitutes a serious injury, and there are many dangers associated with burns, mainly risks of dehydration as so much fluid is lost through the burn, and infection as the body’s natural barrier, the skin, is damaged. Severe burns are common here. Eflance managed to tip paraffin over herself and light a match. (Paraffin is often used to light stoves so it is around the house, usually not stored separately or securely.) Another child had fallen into a boiling pot of beans, badly burning his arm. Two other boys had been lying in their house when it caught alight – a lamp having been left burning too fiercely when their mum went out to work. Sadly those two small boys died; their injuries were too severe. Some people are burned when the mattress they are sleeping on catches fire, as the stove is inside the house and therefore a hazard. Eflance’s early treatment from the doctors consisted of fluid replacement and prevention of infection. The nurses have seen her every day in order to apply fresh, clean dressings. Eflance’s cries are audible from the neighbouring ward when the wounds are cleaned and dressed. We began seeing Eflance almost immediately after she was admitted – as any wound heals, scar tissue forms and contracts. With a large surface-area March 2004

Eflance running around

It is hard to believe that just four months ago she was lying flat on her back, in incredible pain, after sustaining burns to 40% of her body surface area. This

wound, such as a burn, which may extend across one or even several joints, there is a very real possibility of permanent disability. It seems cruel and heartless to make a small child move their arms and legs when it hurts them, but it is vital. There isn’t the same range of pain relief here as in the UK, so it is likely that we did cause real pain in those early days.

after so long in bed all her muscles would be weaker, as well as stiff. Taking steps were painful initially, but the more she moves about, the easier it becomes. However, she has been incredibly brave, and gets on with the task. It was a boost for me to be told she didn’t want Emmanuel to treat her one day, she wanted me, as many Ugandan children cry at the sight of a muzungu coming to treat them! Her wounds have healed very well, with minimal infection, which is a bit of a miracle in itself. Her scars will eventually turn the same colour as the rest of her, but at present some continue to be a harsh bright pink. The remaining problems are her hips and her right hand which was badly affected. Her thumb sticks out too far, and she can’t bend it across her palm. You may not think this would make much difference, but you try gripping a cloth, holding a cup, or trying to write without using your thumb – its tricky! Our attempts to improve the thumb have not been entirely successful; however, when I look at her, I think that even if she leaves with stiff hips and a sticking-out thumb, this is a vast improvement to what the outcome could have been, had physiotherapy not been started early.

This was one of the first occasions Eflance got out of bed.

Our physiotherapy treatment has been focussed on maintaining good movement in her limbs, and trying to get her to move around – difficult when arms, trunk and legs are covered in wounds and dressings. After two months, we started lifting her out of bed and using a little walking frame, as

My working day probably isn’t as exciting as you think, as I don’t see that many patients at the moment. I do rather a lot of admin now, as Emmanuel is capable of seeing most of our patients alone. I miss being with patients all day, so it’s a treat to go onto the wards for a little while. I’ve really enjoyed seeing Eflance over the past few months; a smile is rare but it makes the day so much better when she gives one!

Please pray for: Eflance, as she prepares to go home, and for her mum who has been with her the whole time Give thanks for the nursing team on the children’s ward who have cared for Eflance Community health education teams, that such serious injuries will be prevented by their work

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