February 9^th, 2021 was a sad day for me in the consulting room. A mother sat before me with her 9-month-old son. She complained that her son could not sit at 9 months; his neck could not support his head when he was held in the sitting position. In addition to these, I noticed that he did not smile back when I smiled at him.

He also did not reach out for any of the colorful objects I showed him, neither could he follow my movements with his eyes. He was a little stiff. He had cerebral palsy with global developmental delay and that meant the journey was going to be a long one for both mother and son.

As I listened to the mother’s story, I was extremely saddened by the fact that the condition could have been prevented at many levels.

Her story:

The pregnancy was unplanned, and so she was not taking folic acid before the pregnancy. Folic acid is very important in the development of the brain of a foetus/baby. The ideal thing is for every woman in her reproductive age to take it so that if pregnancy happens, there would be enough stores in the mother for the baby to develop. My patient’s mother started taking the folic acid rather late. 

She also lived in a house with cats and was therefore exposed to cat faeces. Cat faeces can have an organism called “Toxoplasma gondii”, which can cause toxoplasmosis. A pregnant woman with toxoplasmosis can transmit the infection to the foetus and the development of the foetal brain can be affected negatively The baby also did not cry immediately after birth. He had to be on admission for 2 weeks during which he suffered seizures (convulsion), which can be a complication of the severe birth asphyxia or possibly meningitis.

The head of the baby was noticed to be enlarging abnormally and so a head CT scan was requested. Sadly, it was not done on time. It was in  the early days of Covid 19 and a lot of people were afraid to visit the hospitals. The head scan was done many months later and it showed excessive collection of fluid in the brain with very little brain tissue/matter left.

If the scan had been done earlier, a shunt/tube could have been placed to drain the excess the fluid and he still could have been left with some brain tissue for some optimum development. Now with very little brain tissue left, I wondered what his quality of life would be and the burden both parents and son had to bear.

That is one of many stories health workers encounter. A lot of people still suffer from conditions that can be easily prevented. 

Folic acid is a must take for any woman who can get pregnant. At worst, it should be taken as soon as one realises  that she is pregnant .

Pregnant women should not get close to cat faeces as much as possible and must ensure hand hygiene at all times.

When labour is getting prolonged, interventions must be made to get baby out as soon as possible to prevent birth asphyxia which can also cause cerebral palsy. That means, women in labour must be monitored very well to pick up early signs of distress in the foetus.

Investigations must also be done early so that interventions can be made on time.

The health-seeking behaviour of our populace must also change. Sometimes,  children are sent to so many places and different remedies tried before they are brought to the hospital. And usually, by the time they come, some complications would have set in.

Our health workers must also continually improve upon their attitude towards patients in order to make the hospitals welcoming to them. 

A baby with jaundice particularly in the first week of life must be sent to the hospital for assessment. Severe jaundice in the first week can cause kernicterus, a condition which can result in cerebral palsy. 

An innocent child has to suffer from a condition that could have been prevented so easily. 

I pray that with the help available,  we will be able to bring some improvements  to his quality of life.

God bless our homeland Ghana