Pippie’s survival nothing short of a miracle

By Time of article published Jun 19, 2012

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Sheree Bega

Dr Miles Bartlett didn’t give Isabella Pippie Kruger much of a chance. She was only two years old and the freak fire had devoured almost all of her skin.

Her hysterical mother, Anice, was shocked. Her baby could not be dying. She was a chatterbox and had been talking for almost the entire 400km ambulance race to Netcare’s Garden City Hospital from the family’s farm in Lephalale, Limpopo.

“She was worried about her dad’s hands that had been burnt and she wanted to see the fireworks because we had told her it was New Year’s Eve,” remembers Kruger.

The family’s GP wept as he begged several hospitals to treat the little girl. Everyone turned them away – except Dr Bartlett.

“Pippie got burned at 6.30pm and we only got here (Garden City) at 2.30am,” says Kruger. “When we got to the private hospital in Ellisras, they told us to please leave, that (there) was nothing they could do for Pippie. Dr Bartlett, who I think had by then been working for 36 hours straight, told us to just give him two hours, that he was going to get some sleep.”

“Ja, she wrecked my Christmas,” chuckles Dr Bartlett, a paediatrician and intensive care specialist.

“I’d been treating a child who had been shot by her father when Pippi arrived.”

There was a zero chance that Pippie would pull through. “But you know, I’ve done ICU for 30 years and have had kids with 99 percent predicted death rates. Statistics are just statistics.

“If you’ve got a 1 percent chance of survival, are you not going to be active with this child because he’s only got a one in a 100 chance of pulling through? He might be the one.”

Colleagues describe Dr Bartlett as a doctor who works himself to the bone to give critically injured children like Pippie, who sustained third degree burns on 80 percent of her body, a fighting chance at Garden City, Joburg’s only paediatric ICU.

“You pull out all the stops. If you don’t, you’ll lose anyway. The sisters always laugh at me because I won’t give up. I go on until I know I’m beaten. I have faith because I’ve seen miracles.”

Miracles like Pippie. More than five months after the accident which left her with burns on her chest, arms, face, thighs, head and parts of her back, the toddler crossed the frontier of cutting-edge medicine this week by becoming the first South African to have plastic-like sheets of her own skin, grown for her in a US lab in Boston, delicately grafted onto her wounded body.

That this happened at all is largely thanks to the 27-year-old Anice, who has both of her children’s names tattooed on her wrist, and refused to take no for an answer.

For Dr Ridwan Mia, the plastic surgeon who led Pippie’s groundbreaking surgery and who has been at her side from the start, the cloned skin is a marvel – but so is Pippie, who turned three last week.

“For a two-year-old of this size to survive 80 percent full-thickness burns, that for us is the miracle already,” he says.

She was the textbook case for a severe burns victim. She went into cardiac arrest five times, suffered pneumonia and her kidneys failed. She has endured 45 operations.

“It’s like you’re hit by a car, only to stand up and then to be hit by a truck and to survive and then to be run down by a train,” says Mande Toubkin, the head of trauma and transplants at Netcare, of Pippie’s ordeal.

In the days after the tragedy, Pippie swelled three times her size. “We actually called her the Michelin baby,” remembers Mia. “We had some doctors tell us we were wasting our time, that we were treating a piece of meat… But she’s an absolute fighter.”

Mia spent the past week worried about the logistics of flying the cloned skin from the US. But he was excited. “This was a great procedure. It’s the best thing anyone could ever ask for – to have your own skin grown elsewhere and put back on you.”

It hurts Kruger now to see her daughter bandaged so tightly she can’t move, on drips and a ventilator again. She is in an induced coma and has to be kept completely still to not disrupt the fragile skin – thinner than hair – from attaching and being kept alive.

“Seeing her like that is like seeing her the first time she got admitted,” says tears welling in her eyes. “I can’t wait for Monday when they take all the yukkies off.”

She remembers how Dr Mia told her and her husband Erwin that Pippie needed skin grafts.

Kruger was adamant that the doctors would not touch the perfect skin that remained, untouched by the flames. “I told Dr Mia to please give me a week or two, that I would find a miracle somewhere.”

She punched “burn wounds, stem cells, wound healing” into Google – and found her miracle, the Genzyme lab in Boston, which clones human skin. Several weeks later, its specialised biopsy kit arrived.

“When it got here and there were no special effects we were like, “Oh, is that it?” It was just this bowl that came with tubes in it.”

They packed the tiny 2cm by 6cm ovals of Pippie’s skin that had been harvested from her groin and nappy area and sent it back. “A little less than a month later, we had 41 pieces of perfect skin… it was awesome,” she says.

Kruger is keeping her brown hair streaked with pink – it’s her daughter’s favourite colour and a celebration of when she started breathing on her own. “When I walked into the room that day with this shocking pink hair, Pippie’s eyes lit up, so I decided to keep it pink.”

Her daughter’s mass of blonde curls, too, are growing back. “Where there wouldn’t have grown hair, it’s growing. It’s just a sign of the miracle not stopping. People think when you talk about a miracle, it’s like Lazarus in the Bible. But now it’s six months and everyone is seeing it.”

Pippie can only say “mama, papa and eina” and will have to learn to talk again. “Because she can’t talk, we won’t tell her what happened (the accident) yet.”

She was a happy child, and her mother remembers her stealing Aromat and being yellow from head to toe.

In a way, Kruger has come out of her own shell. “I’m finding out how many people I inspire. I mean I was the biggest Goth loser in school and God chose me for this wonderful thing.”

In the past six months, Kruger has been home for just three days. She now has a flat in nearby Melville, 3km from Pippie’s rehabilitation centre, and will continue to see Erwin and her family on weekends. The hospital staff are like family now.

Her mom has been caring for baby Arno who turns one next week. “It hurts to not spend time with my son, but at least he won’t remember this.”

Erwin, a professional hunter, blames himself for lighting the braai on New Year’s Eve when the bottle of fire lighter gel exploded. Pippie was just metres away and was swallowed by the flames.

“His arm has healed but his heart is still very sore.

“She’s his princess. He blames himself but it was just an accident. So many people ask me if I blame him. How on earth could I ever?”

Pippie has a long road ahead. There will be extensive rehabilitation and more surgery.

“She’s a young girl and has to bond with other children,” adds Dr Mia. “The only way you do that is by giving her as normal appearance as possible. It’s that support that will heal her.”

Dr Bartlett is still amazed by how children like Pippie bounce back from the brink. “That’s the biggest gift for us – when we can return a child to their family.”

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