Disability, hope and disappointment in Bangladesh

Last month a 20 year old girl called Rabeya came to our hospital as she had been incontinent of urine and unable to use her legs for one year.  She had a scoliosis (curve) in her spine since birth, which had progressively worsened with time.

One year ago the curve became so severe that it caused a spinal cord injury resulting in her incontinence and inability to walk. In the UK, this would not have happened as she would have had this surgically corrected earlier in her life and had assistance with improving her posture.

Despite the sudden onset of these symptoms, it had taken her family a whole year to bring her to the hospital and they only came thanks to a grant from the government of the equivalent of £10 to assist with transport. She was almost sent home, but thankfully a doctor from the UK referred her to physiotherapy to see if we could help in any way.

Due to her incontinence, Rabeya was continually wet and spent most of her day lying in bed.  To use her bowels, she crawled on her hands and knees outside her house and managed to support herself somehow by pulling up on a tree. The family adamantly refused her admission to the hospital and just wanted to go home. It was only towards the end of the day that I managed to take her to the rehab centre to show her a wheelchair.  

It became clear that one of the main factors for them refusing to stay was due to lack of money. So we referred them to the poor fund and they were given significant support so they only had to pay a small amount. Finally, after much deliberation, they decided Rabeya could stay for three days. Even then, her family argued over who had responsibility for staying to care for her. 

Rabeya was then catheterised with the agreement that she would return to hospital every month to have her catheter changed. No-one was convinced that they would return which would then lead to infection, so the next day following ward round, it was decided to teach her mother to catheterise her intermittently at home four times a day.  

Meanwhile, our physiotherapy team assessed Rabeya and realised that she had a small amount of function in her legs. We provided her with a walking frame so that she could stand up even though she wasn’t able to walk and she was delighted with this. When she came over to the rehab centre again in the afternoon I was looking forward to showing her the potential of her independence if she had a wheelchair. I was really disappointed however as she looked really upset —  she had been wet all day because the intermittent catheterisation hadn’t worked effectively and as a consequence, she didn’t even want to try the wheelchair.

I went home that day feeling really miserable as it seemed like such a hopeless situation. Her problem should never have occurred in the first place and she was just treated as though she had so little value by her family.  We had a prayer meeting after work and I asked the group to pray for her. 

The next morning I came onto the ward and found out that she had been dry all night long and had gone to the toilet that morning using a wheelchair!  I was totally astounded and when I asked how long she had been dry, she said since later on in the previous afternoon which was around the time we prayed for her. I don’t think I was expecting that kind of a miracle when I prayed but was so grateful to God for it!  She was like a different person as she was bright and happy and wanted to use the walking frame and wheelchair; it was amazing.

So she went home after three days, dry and with a walking frame which she can use to transfer into a chair.  We are making her a wheelchair in the assistive device workshop at the hospital and she is due to return to collect it this weekend, when we will take a picture of Rabeya in her wheelchair, with her new-found independence. 

 27/06/2012