daniel chigunwe
Rumbidzayi Zinyuke
Health Buzz
Nearly two years ago, a field visit to some remote parts of the Cyclone Idai ravaged Chimanimani gave me a chance to meet 15-year-old Nyasha Chiripasi.
No words were shared between us, only smiles, yet she made a lasting impact on me.
Nyasha had cerebral palsy, so she could not speak, walk, sit on her own or make any voluntary movement.
She had contractures on the major joints of her upper and lower limbs and her motor skills were not developed at all. So she had absolutely no control over any of her body parts.
She solely relied on her mother for all her needs. All of which were communicated through grunts and groans.
Nyasha is a surviving outcome of one of the delays in seeking obstetric care that is prevalent in the settings her family comes from.
Because her parents could not afford treatment for her early on, she suffered in silence for more than 15 years.
Save for a radiant smile in response whenever she heard her name, she did not have much going for her.
Nyasha is not alone in her predicament, millions of children across the world go through the same.
Cerebral palsy is a debilitating form of disability.
It is the most common physically disabling paediatric condition globally and its prevalence in Zimbabwe is estimated to be at 1.55 per 1000 live births in rural areas and 3.3 per 1000 births in urban areas.
Cerebral palsy is a group of disorders that affect movement and muscle tone or posture and is characterised by multiple impairments and functional limitations.
It is caused by damage to the motor control centres of the developing brain and can occur during childbirth, or after birth up to the age of three. Signs and symptoms appear during infancy or preschool years. In general, cerebral palsy causes impaired movement associated with exaggerated reflexes, floppiness or increased rigidity of muscles in the limbs and trunk, unusual posture, involuntary movements, unsteady walking, or some combination of these.
People with cerebral palsy can have problems swallowing and commonly have eye muscle imbalance, in which the eyes don’t focus on the same object.
They also might have reduced range of motion at various joints of their bodies due to muscle stiffness.
And they experience abnormal touch or pain sensations, bladder and bowel problems, including constipation and urinary incontinence.
Mental health conditions are also common for people who suffer from the condition including emotional disorders and behavioural problems.
In essence, the condition affects people differently.
Where some people with cerebral palsy can walk, others need assistance; some have intellectual disabilities, but others do not. Epilepsy, blindness or deafness might also be present in some but not in others.
In most cases, the exact cause of cerebral palsy is unknown.
Experts say while unusual brain development or injury to the developing brain can cause cerebral palsy, other possible causes include head injuries as a result of a car accident, fall, or child abuse.
It can also be caused by intracranial haemorrhage or bleeding into the brain, brain infections such as encephalitis and meningitis, infections acquired in the womb such as German measles (rubella) and herpes simplex, a lack of oxygen to the brain during labour and delivery, gene mutations that result in atypical brain development, or severe jaundice in the infant.
There are certain factors that put babies at an increased risk for cerebral palsy including premature birth, low birth weight, breech birth, the mother’s exposure to toxic substances that damage the foetus and being a twin or triplet.
Although the majority of conditions that cause cerebral palsy cannot always be prevented, it is important for women who are pregnant or planning on becoming pregnant, to take certain preventive measures to minimise complications.
They have to get vaccinated against conditions that can cause fetal brain damage such as rubella. It is also crucial to receive adequate prenatal care. Attending regular antenatal appointments during pregnancy can help prevent premature birth, low birth weight, and infections.
Unfortunately, cerebral palsy is a lifelong disorder and there is no cure, but treatments can help improve function.
The goal of treatment is to improve limitations and prevent complications.
Mostly, treatment may include assistive aids such as eyeglasses, hearing aids, walking aids, wheelchairs and body braces. They may also get medications such as muscle relaxants, which are commonly used to treat the symptoms of spasticity. Relaxing the muscles helps reduce pain from muscle spasms.
The other option would be orthopedic surgery which may be used to relieve pain and improve mobility. It may also be needed to release tight muscles or correct bone irregularities caused by spasticity.
Other types of treatment for cerebral palsy include speech therapy, occupational therapy, physical therapy, recreational therapy as well as counseling or psychotherapy.
Although experts are exploring stem cell therapy as a potential treatment for cerebral palsy, research is still in the early stages. It may be most effective at helping improve motor symptoms, according to a 2020 literature review.
For all conditions, early diagnosis and treatment are important in the management of cerebral palsy.
The Centres for Disease Control and Prevention says it is important to begin a treatment program as early as possible.
“After a CP diagnosis is made, a team of health professionals works with the child and family to develop a plan to help the child reach his or her full potential,” the organisation says.
However, for children like Nyasha, who live in low income countries, chances of this happening are low owing to the poverty they are usually born to.
Research has shown that the prevalence of cerebral palsy is higher in developing countries than it is in Europe, Australia or the United States.
Data also showed that cerebral palsy is more frequent in boys and in patients with low socioeconomic status and more frequent in patients living in rural areas, compared to those in urban areas. This was attributed to the fact that people who live in rural areas are less likely to access medical services.
It then becomes more important for every citizen to have access to healthcare services to ensure optimal development and care of these children.
Because disability associated with cerebral palsy imposes significant demands on health, education, and social services, it is vital for authorities to obtain updated data on the risk factors associated with the condition in order to allocate appropriate health resources.
So preventing cerebral palsy, diagnosing it and offering treatment for it as soon as possible remains key.
After all, the Second Republic is on a drive to ensure that no one and no place is left behind in terms of accessing health care.
This could make a difference for many vulnerable families in the country who have had no chance at defeating such conditions.
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