It is a parent’s worst nightmare – when your young child is badly injured or is suffering from a debilitating condition, and you do not know if or to what extent they will recover. However, there is a place dedicated to the rehabilitation of children, where they can receive the specialised care they need to start moving forward in their young lives.
One such child is little Olerato Legong, who at the age of just one year and seven months was involved in a serious car accident. According to Prof Andre Mochan, a neurologist practising at the paediatric unit of Netcare Rehabilitation Hospital in Johannesburg, the collision left her with several skull fractures and a severe traumatic brain injury, with bruising and bleeding in parts of her brain.
An earth-shattering event
“While surgical intervention at Netcare Garden City Hospital successfully healed Olerato’s skull fractures, the little girl had to spend a month in the hospital’s intensive care unit [ICU] before being transferred to Netcare Rehabilitation Hospital for rehabilitation therapy to help address the effects of the brain trauma. When she arrived she was conscious and attempting to sit but her entire left side was very weak and she presented with visual difficulties. “At that point she was poorly responsive and unable to interact,” recalls Prof Mochan.
Prior to the accident, Olerato had reached all her developmental milestones and was a happy and active toddler, walking and talking as any healthy child of her age would. The sudden impact of the accident on her life was devastating for her family.
“Our lives changed just like that, from one day to the next. It shook my whole world,” says Thabang Legong, Olerato’s mother. Despite the ordeal, Olerato showed enormous resilience. With the support of her mother and the specialised multi-disciplinary team in the paediatric unit at Netcare Rehabilitation Hospital, she made significant progress.
A highly specialised type of care
Dr Anri Carstens, a general practitioner with a particular interest in children with special needs, notes that the journey of a child in rehabilitation requires a very specialised approach. “Many people think of children as being small adults, but they really do need very particular care. So much so that there is a special kind of dedicated paediatric team of clinicians required for a children's unit in a rehabilitation centre. Their physiology is different to that of adults, they have varying communication capabilities, their nursing requirements are very specific and their family involvement needs to be far greater than in the case of an adult.”
“It is also important for children and their families to have assistance with transitioning from rehabilitation back to daily life. For many this includes finding a suitable outpatient facility for follow-up sessions in their area, possibly special needs schooling and continued care at home. This alone can be an overwhelming experience after an already difficult time, and we find that families gain great value from having a professional team such as the one at our hospital to help them join the dots and support them through this adjustment process,” she notes.
This certainly seems to have been true for Olerato, whose mother Thabang was fully involved and dedicated herself to the needs of her child, according to Charne Cox, a physiotherapist on Olerato’s dedicated paediatric team. “Thabang really became part of the team in treating Olerato while she was here with us. Even though she had to travel all the way from Pretoria to be here, the time we were able to spend working so closely together made a huge difference to ensuring continuity of care after Olerato’s discharge,” says Cox.
|Olerato Legong at 20 months old, recovering through play with physiotherapist Charne Cox (left) and occupational therapist Jamie-Lee Janks (right) in the paediatric unit at Netcare Rehabilitation Hospital
|Olerato Legong at 20 months old with physiotherapist Charne Cox in the paediatric unit at Netcare Rehabilitation Hospital
Olerato was able to benefit from a full range of on-site treatments during her time at the paediatric rehabilitation unit, including physiotherapy, speech therapy and occupational therapy, incorporating therapy on land as well as hydrotherapy. While she was admitted, she was also assessed by a paediatric optometrist and an audiologist, both of whom are regular referral sources for the unit.
Children admitted to Netcare Rehabilitation Hospital’s paediatric unit have access to a dedicated, multi-disciplinary paediatric team comprising doctors, paediatric nurses, a physiotherapist, an occupational therapist, a speech therapist, a social worker, a psychologist, case manager as well as an on-site state of the art orthotics and prosthetics service, should they need it.
“We are a very close-knit team and communicate about our patients in great detail in our weekly team meetings,” says Anna Potgieter, speech therapist at the unit. “This allows us all to be on the same page when it comes to each child’s needs, treatments and progress. Our specially trained nurses will pick up the smallest detail while caring for their young patients and relay that information to us, so there is a bird’s eye view of progress at all times.”
One step at a time
Potgieter recalls that Olerato visibly improved almost daily. “While in the beginning she was only managing very small amounts of food and not initiating any communication at all, she quickly progressed, imitating us and actively wanting to engage, so we could be quite creative in our therapy with her.”
Cox too recalls Olerato’s steady progress, her personality starting to shine through after just a few days, enjoying playing in all of her therapy sessions, getting to know everyone caring for her and blowing kisses when moving from one part of the unit to another.
Olerato was discharged approximately two months after her arrival at the unit, with marked progress, much to the joy of her family. Now, two years later she is a healthy three-year-old, happily attending crèche, learning new things every day and making friends. “She is still recovering, but the progress is huge – far quicker than I thought it would be. It’s better and better all the time,” says Thabang.
Dr Carstens notes that the paediatric unit at Netcare Rehabilitation Hospital is the only licensed paediatric rehabilitation unit with a dedicated paediatric team in the Johannesburg area. With a total of eight beds, it is small enough to provide highly personalised, one-on-one care. “Being situated in Auckland Park, our close proximity to Netcare Garden City Hospital means there is just a short distance to go if further specialised care or scans are required,” says Dr Carstens.
“Whether it is several months or just a few days, time spent in rehabilitation is invaluable. For referring specialists, paediatric rehabilitation is an important stepping-stone for their patients, providing the opportunity to truly bridge the gap in ways that would otherwise not be possible. For this team and I, it is our greatest calling and a privilege to work with these young patients, for whom we will continue to care as long as there is a need,” concludes Dr Carstens.
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For more information on this media release, contact MNA at the contact details listed below.
Issued by: MNA on behalf of Netcare Rehabilitation Hospital
Contact: Martina Nicholson, Meggan Saville, Estene Lotriet-Vorster or Clemmy Forsthofer
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More about the paediatric unit at Netcare Rehabilitation Hospital
• The specialised paediatric rehabilitation unit was established in 2008
• The ward has eight beds
• Children from newborns to those who are 16 years of age (depending on maturity level) are accepted at the unit
• Noteworthy specialised equipment in the unit includes:
◦ A heated pool for hydrotherapy used for the re-education of muscles and joints and creates a natural buoyancy for ease of movement.
◦ A paediatric tilt table-used in a wide range of assessment and therapy techniques such as the facilitation of weight-bearing and standing, prevention of muscle contractures, improving lower limb strength and increasing state of arousal.
◦ A paediatric standing frame, primarily used for hip development and improvement in the stability of the hip. It is used to maintain a straight and symmetrical posture and also to prevent contractures of the hip.
◦ A sensory room to facilitate focused attention and concentration, reactiveness to sensory stimulation, heightened awareness and alertness.
◦ Electrical stimulation to strengthen weak muscles affected by injury or illness. It can be used in resting or in active movement or during play.
◦ Sleepform, to allow therapists to continue addressing postural management issues even during the night.
◦ Squiggles Seating System, supporting the growing pelvis, torso, head and legs while giving children the greatest possible freedom of movement.
◦ Hammocks and suspension swings, which are powerful sensory modulation tools.
Conditions treated in the unit include:
• Acquired brain injury
• Spinal cord injuries
• Burns injuries
• Amputations and polytrauma
• Developmental delays
• Congenital abnormalities of the brain and spinal cord
• Metabolic conditions affecting the nervous system
• Paediatric neuromuscular disorders including muscular dystrophy and congenital myopathies
• Childhood stroke
• Neurological complications of paediatric diseases
• Postsurgical complications
• Prolonged hospitalization
• Complications related to Cerebral Palsy