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Cape Town - At about 2am, 12 hours after a cadaver skin transplant, a heavily bandaged five-year-old girl propped herself up on her arms, turned to Dr Roux Martinez, who had been waiting by her side, and said: “Doctor, f** off huis toe. Ek wil slaap! (Doctor, f*** off. I want to sleep!)”
Martinez smiled because that’s when she knew Michelle Motibi would survive.
Four months later, on August 21, Michelle is taken out of her bed for a physiotherapy session. Her small hands are bandaged to a walking frame and she begins her long walk down the ward corridor to the rehabilitation room.
Tears well up in her eyes. She doesn’t want to walk. Physiotherapist Rukaiya Mowzer tells Michelle that the formidable Professor Heinz Rode, an internationally renowned burns care specialist with more than 40 years’ experience, is in the ward.
“He’ll be so proud to see you walk,” Mowzer says.
Michelle begins walking. “Oupa! Oupa! Kyk hoe stap ek,” she shouts in her raspy voice.
As Michelle makes her way down the corridor, nurses clap and make a big fuss over the accomplishments of the child, who not so long ago was left for dead, or in the clinical speak of the medical world, “her condition was assessed as not compatible with life”.
Michelle was burnt in a shack fire in Wallacedene on April 27. A candle fell over, causing the blaze. She suffered burns to 86 percent of her body, as well as inhalation burns, which required intubation and ventilation.
Martinez explained that due to the massive swelling from her burn injuries, Michelle developed abdominal compartment syndrome and needed to have her abdomen opened to decompress and allow her kidneys to function properly.
At this stage skin grafting was started, but she developed severe sepsis.
Palliative care was given.
“We pulled out, left her to die, basically,” says Martinez. “She was given fluid, food and pain care.” No one expected her to live. However, as Martinez puts it: “Michelle decided that we were not done yet.”
After five days, Michelle remained bright-eyed and aggressive, he said. Intervention was continued.
She spent 21 days in the intensive care unit at Red Cross Children’s Hospital, undergoing 20 operations and 11 bouts of life-threatening septicaemia.
According to Martinez, what kept Michelle alive was the gift of donor skin from no fewer than six donors.
“It was a bit of fate, we just managed to get skin whenever we needed it for her.”
The skin is “harvested” whenever it is available, but needs to be changed about once a week.
“Not even the most expensive dressings can give us what donor skin does.”
Michelle hopes to be heading home soon, but the road to recovery is still a long and painful one.
She attends physiotherapy sessions twice a day in the burns unit while in hospital and will attend physiotherapy and occupational therapy as an outpatient after she is discharged.
Mowzer says it’s quite difficult to get Michelle to do her physio exercises, so she has to trick her into doing it: “It needs to be a game for her.”
As soon as Michelle gets into the rehabilitation room it becomes play time. She starts off throwing a ball with Mowzer to promote movement in her arms, but that soon changes as she starts to bounce the ball off her head and into Mowzer’s hands.
“Wat is daar binne? (What’s inside there?)” Michelle asks, pointing her small burnt hand at a cupboard.
Despite protests from the physio staff, Michelle unpacks the cupboard. She finds building blocks, table tennis paddles, and her personal favourite – a mop. She makes her way around the room, mopping the floor. She manages to move around the room quite quickly despite being a little unstable on her legs.
Walking back to her room, with no walking frame, she moves faster and faster. She clutches a little handbag she found in the cupboard.
Student physiotherapist Brett Phillips tells Michelle to slow down.
“Ek wil nie stap nie, ek wil hardloop,(I dont’ want to walk, I want to run)” Michelle shoots back in her little voice.
Martinez has never seen anything like this before: “Michelle has a most unbelievable feisty spirit and has taken every challenge on as if it’s her last and only battle.
“Her skin grafting was completed last month and she is already walking and dressed all in pink. She is our own Pippie and a star in her own right.
“We have all grown incredibly attached to her and we’re going to miss her when she goes home.”