A six-month old child with conformity disorder needs the help of everyone
By Ndama Abubakar
Unlike several other children, Abdullahi, just 6 months old, began his earthly life on a bleak note, being born with a life-threatening disorder called spina bifida. When he was born, the mother, Aisha Musa, noticed a brownish patch just above the waistline, with a dimple. The patch of skin looked scorched. Each time the boy cried, and he cried all too frequently, either from pain or hunger pangs, the small depression in the waistline will quiver and deepen still further. As he grew up, the dimpled area steadily developed into a small mound of flesh the size of a tennis ball. Then all by itself, the swelling ruptured, spilling out some fluid substance that the mother said looked like water. Strangely, there is a connection between the fluid discharge and the topography of the boy’s head. As the fluid drains off, the middle of Abdullahi’s shaven scalp gradually collapses into a hollow, concave shape. With the fluid discharge complete, the scalp returned to its previous shape, but the mother also noticed that day-by-day her son’s head was also bulging. She took the boy to Gwagwalada Specialist Hospital, which after examining the ruptured mound of flesh referred the case to the National Hospital, Abuja. The National Hospital has recommended immediate surgical intervention, which will cost N500 thousand, money that seemed to the indigent mother as fictive as a tale from the Arabian Night. But without this money, Abdullahi’s existence is grim and uncertain.
Spina bifida abnormality
Spina bifida simply means a split or hole in the backbone (i.e. spine). The abnormality has some varieties, including the mildest type called Spina bifida occulta, but Dr. Usman Baba Agaie, now a director with Niger State Ministry of Health, who first described Abdullahi’s condition, said the boy presented manifestations of the severe type. It occurs during the first trimester of pregnancy, probably at the end of the first month of conception, when the two ends of the developing spinal column fail to join, resulting in a gap or hole. When this happens, the spinal cord or the tissues responsible for covering and protecting the neural material may push outward through the spinal aperture, developing into a small ball of flesh. When this bulge ruptures, it leaks out what Dr Baba called cerebrospinal fluid, that is, hydrocephalus. Hydrocephalus is a fluid substance that accumulates in the head as a complication of spina bifida, the reason why Abdullahi’s head is abnormally large and distended, and his scalp soft. The frequent seepage of hydrocephalus from the waistline opening is, thank God for small mercies, is the reason why Abdullahi is yet alive. Without this, the continuous accumulation of the fluid in the brain may reach a breaking point, ultimately leading to fatality.
In spite of the frequent leaks, there are severe risks, unless the boy got immediate surgical intervention, which Dr Baba described as ‘shunting operation’, to create an alternative way for cerebrospinal drainage. The open spinal column is also liable to infections from meningitis, which will impair the boy’s mental and locomotive capacities. Other complications include loss of bowel or bladder control.
Poverty and spina bifida
Abdullahi Musa is born to a peasant family from Kaduna State, resident in Lambata, in Niger State. The fifth child from her mother’s line, he is also the twelfth in the family. The father is married to two women. The father is currently away in Katsina State to eke out a living from small farming opportunities.
Although several factors have been implicated in the congenital biological disorder called spina bifida, Dr Baba sees a strong correlation with poverty and ignorance. Dr Baba opines that many poor people shun prenatal care and many for reasons that they are unaware of its significance or cannot afford it. Yet early detection is possible during the first trimester of antenatal care and can be diagnosed. “The poverty relation comes in this way”, explains Dr Baba. “In a situation where there is no antenatal healthcare to check the condition of the child, this could result to children with this congenital defect. If during antenatal visits, a sample of amniotic fluid is taken or ultrasound done, then this very condition would have been detected and diagnosed. But if the parents cannot afford these services, this condition may arise”.
It is not exactly known what causes this developmental abnormality. Dr Baba suggests a genetic, probably chromosomal defect. He said in many cases, the condition is heritable, meaning that children born from mothers with similar defects or from a family with known or forgotten history or spina bifida were likely to give birth to children with similar abnormality, but in a large number of cases, the incident is sporadic.
Members of the public who want to help little Abdullahi should contact Dr Usman Baba Agaie, a director with Niger Ministry of Health (Tel: 08036172439).
Ndama Abubakar is a Minna-based journalist. Email: firstname.lastname@example.org