Luzuko is a 3 year old boy from Samora Machel informal settlement in Mitchell’s Plain. Returning from church, he was walking hand-in-hand with his mother on 8 September 2013 and after she let his hand go for a second on the sidewalk, he was knocked by an oncoming taxi. Rescue services took him to the Red Cross War Memorial Children’s Hospital, where they established that he sustained a severe traumatic brain injury with extradural haemorrhage, brainstem contusion and a fractured maxilla. He also suffered impairment of function of cranial nerves. He was intubated and an intracranial pressure (ICP) drain was inserted to release the pressure on his brain. Eight days later, a PEG tube was inserted for feeding and two days later while still under the watchful eyes of ICU critical care specialists, Luzuko had a tracheostomy procedure to insert a breathing device in his throat and spent a further four days in ICU. Luzuko was transferred from ICU for ward-care and then to Groote Schuur Hospital for another one month period.
Luzuko was admitted to St Joseph’s for Chronically Ill Children for a few weeks of block therapy and therapeutic intervention. On examination, he was unable to sit independently or engage in feeding and play due to his poor head and trunk control. He was confined to a buggy, with full dependence on his carer for all grooming activities, feeding, drinking and toileting (nappy). On the bed he was unable to change position when lying on his stomach or back. Verbal communication was a struggle for him, affecting communication between him and his carers. Luzuko’s mood was labile and he was very attached to his mother. He became frustrated and teary when his mother was not around.
With therapy from St Joseph’s, Luzuko showed potential to learn and regain more of his functional abilities. At the end of the block therapy he was able to use a basic communication board to indicate his needs. He started finger feeding and was able to sit upright in his buggy. As recovery post-traumatic brain injury takes up to two years and his traumatic brain injury was recent, it was felt that he would benefit from medium term rehabilitation and he was transferred to the facility’s six month rehabilitation programme.
It is now three months since his admission to St Joseph’s and Luzuko’s mother has returned home to attend to her seven other children. His family is involved and caring during his rehabilitation, which is encouraged by the programme offered. Luzuko goes home over holidays and weekends and has become more confident, independent and loves to watch the other children in the ward. He can verbalise two to three word sentences, has a good sense of humour, is able to feed himself and sits independently. Before his accident, Luzuko had very little educational stimulation and is now colour-matching and can do basic shapes and pegs. He has been moved out of his buggy into a wheelchair and is starting to propel himself. All of these progressions were enabled by the intensive rehabilitation received at St Joseph’s for Chronically Ill Children.