25th Mar 2017 5:54:04 AM

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Jacques Abrahams
Main Pic









Jacques is currently staying in Los Angeles with former South African doctor Hilton Kaplan. He has benefited from leg-shortening surgery at the Shriner Institute to make the fitting of new prosthetic legs more feasible.

He is also getting personal tuition in mathematics and has caught up enormously.



Jaques 24 June 2006





He lives in the USA now but has returned for a short visit to South Africa with his adoptive Dad, Dr Hilton Kaplan.

Jacques' Cool Hairstyle!



  





Jacques' 15th Birthday!







Jacques Abrahams is fourteen years old. He was born on 25th March 1990. After he was burned and initially hospitalised, he was placed in the Sarah Fox “convalescent home” and thereafter he lived in a Catholic institution, the St Joseph’s Home for Chronic Invalid Children in Montana, Bellville (Cape Town), South Africa for most of the first 12 years of his life. When he eventually returned to his family home, his mother frequently demonstrated that she felt unable to cope with the needs of a disabled child. Children of Fire supported the family financially while social services pondered over Jacques’ need for a disability grant – but this was eventually secured. Once home on the farm, Jacques started to attend the local school and did well. He is now in Grade 7, the final year of Primary School. The farm manager John was also extremely kind and supportive.

However his mother continues to express an unwillingness to raise her disabled child, although she is happy to keep the other two children. Jacques would certainly not want to return to institutional life. For all its imperfections, the boy likes a small family home in the countryside.

  

His mother’s attitude is not unusual anywhere in the world, but particularly not in a country where there are few or no support systems for anyone under emotional strain. Many parents or guardians of burned children have asked Children of Fire to take the children and put them with other children “like them”. Some of this is touched on in the Burns Psychology Guide.

The light on the horizon is a former South African doctor who has emigrated to the USA but maintained an interest in Jacques. He might be able to arrange for Jacques to travel to California on a special needs visa in the latter half of 2004 and to receive further surgery, prosthesis and education there. Jacques might even become an ambassador for Children of Fire and the needs of all South Africa’s burned children, on the world-famous Oprah show.

  

  

The bureaucracy around injured children visiting different countries is never easy, but Dorah has already travelled that path. Because Jacques is physically far more capable than her, he might even be able to attend a boarding school or become part of a long-term foster family. Jacques attended the Children of Fire burns camp in September/October 2003 and also stayed with the charity in Auckland Park, Johannesburg. He seems a couple of years too young for his age but is highly gregarious, fun-loving and generally outgoing. He was equally relaxed with injured and uninjured children and very adept at using his little wheelchair-come-tricycle that was made by Shonaquip in Cape Town.

Jacques is funny and friendly. He seems not to bear grudges for all the hardships in his life, but wants to live life to the full. When he first travelled in an aeroplane, he wondered what it would be like to travel through the “intestines” of clouds. Maybe the unusual vocabulary simply came from translating Afrikaans into English, but he has a unique way of looking at the world that is a pleasure to others around him. His spoken English is still not his strong point and he managed to “convert” a lot of the Umashesha volunteers and even the other burned children around to speaking Afrikaans in October 2003. They simply wanted to please him.

Beyond wanting a happy normal family life and satisfying schooling, Jacques wants to walk. Children of Fire (and its predecessor the Dorah Mokoena Charitable Trust) purchased two pairs of legs for him and paid for the various adjustments. His current legs were fitted at the end of 2002. Our Cape Town representative Anna drove Jacques to and from the farm and the hospital to try to improve their fit and workability. The charity met the costs of the travel entailed as well as various items needed for his schooling.

Jacques still has the legs and in mid 2004 they still fit him, but while his physical leg remnants are relatively wasted, the rest of his body is growing as fast as a teenager should.

Jacques would prefer a prosthetic right leg that bends as it would make it much easier to walk with. He can walk and stand, but he cannot sit comfortably with the leg attached, as the back of it hurts his thigh. Also the right leg sticks out and there is a risk of people tripping over it and the associated embarrassment. The right prosthetic leg is also too heavy. When Jacques walks with it, he complains that the weight breaks the skin and then sores have to heal before it can be worn again. Whether regular physiotherapy to build muscle in the leg would improve this, is not known as physiotherapists are not regularly available to impoverished children living on remote South African farms.

The left leg is less heavy but still his skin breaks within 15 minutes of walking. In common with most child amputees, the bone grows quicker than the skin and regularly protrudes on the right stump. It has been suggested that Jacques should have a right leg amputation above the knee so that he could then have a bending prosthesis fitted. Like most children that Children of Fire has assisted, he does not want any more bone cutting. And like Irene Peta, Jacques achieves a fair bit of crawling mobility in the small family home, because he has that knee joint. But Jacques wants real mobility. To move freely in society like anyone else.

Jacques can use his right hand stump with great dexterity and can play computer games competitively with other children. But when he is an adult he would like a realistic looking false hand that functions. He is aware that these can cost more than a hundred thousand rands, that there are only two manufacturers in the world and that the batteries to maintain them (let alone the technicians) are not even readily available in South Africa. But it is a dream that Children of Fire would like to fulfil for Jacques and scores of Africa’s other burned child amputees. The early years One of the conditions of the St Joseph’s Home was that the children should not be orphans and should have relatives to stay with during holidays. We arranged bus transport so that Jacques could keep in touch with his family. The charity has visited and assisted various burned children living in the home and was also involved in the care of a little boy called Bonga Mandla, who was moved there (despite his relatives maintaining no contact with him at all) following our intervention. Bonga was earlier, inappropriately, placed at the Sarah Fox Convalescent Home - also in Cape Town and in November 2001 placed with a loving foster family through the charity's assistance. Jacques's parents Lodewijk & Susan Abrahams lived on the Farm La Valle Daljosaphat, in the Wellington area. His father is facing imprisonment for alleged abuse of a minor.

Jacques has a sister and a brother. Jacques lost his lower legs and most of one hand in a fire as an infant. He also has other body and facial scarring and he might have mild foetal alcohol syndrome. This problem besets many Western Cape children, not least because of the archaic “dop” system where farmworkers formerly received part of their salary in alcohol. With most badly burned children in South Africa, they are far behind the usual academic milestones, partly because of their original impoverished circumstances. They are also often from families “at risk” where schooling is not a priority and, once the child is injured, becomes even less of a priority.
Children placed in long term convalescent “homes” often get no education at all – often for more than a year; sometimes for a lifetime. [see Class Action].
The charity was asked via the Red Cross Children’s Hospital, to fund new prosthetic legs for Jacques, some years ago. As we had not at that stage managed to meet him, we asked local volunteers, surgeons and social workers to provide medical and social information on the child, as well as photographs. This took an extremely long time to happen.
We were concerned, following experience with Irene Peta (also on this website), about the problem of bone growing through amputations. This happened with Irene and made her false legs unwearable because of pain.
The procedure followed to alleviate this problem with a growing child seems to be quite barbaric. The hospitals periodically open up the stump and saw off the bone. The child then cannot wear their prosthesis for some months as the skin heals. We believe that there has to be a better option and hope to keep the debate open among orthopaedic surgeons.
Jacques was fitted with prosthesis that he wore on and off during 1999, but he stopped using the false legs because of the pain on his amputations, with intermittent breaking of skin on the stumps. (No one has explained what happened to the previous prosthesis and whether they could be adjusted to help another child – there are no “limb banks” in South Africa.) We agreed to a figure in the region of R15000 for new prosthesis after Professor Don Hudson provided information on the surgical intervention that needed to take place first. A Cape Town Rotary group offered to help with about ten per cent of the cost.

In June 2001 Jacques has a skin break on the tip of the right stump so leg fitting could not take place til December 2001. A suggestion was made in a report from the children's home, that the right stump might need shortening to increase the thickness of the skin flap around the bone. They stated however that 'A concern is that he gets sellulitis in the right lower leg which can complicate an operation such as this.' Jacques attended the St Joseph’s R.C. Primary School and was in Grade 5 in 2002. Other South African children of a similar age are usually in Grade 6 or 7, but paediatric burns patients often seem to be behind in their school performance because of lack of timely intervention by the authorities. Jacques was described by social workers as 'a very active boy placed on Ritalin for his over-activeness.' The charity voiced its concern about children in care being placed on Ritalin as the practice is alarmingly common in South Africa. The children's home said that Jacques, while 'struggling with academic performance, is a very sociable boy who enjoys the company of his friends and is also comfortable in adult company.'
Heinz Rode (Charles FM Saint Professor of Surgery) said at end Feb 2001: 'Jacques is seen regularly in our clinic and his future and long term management has been handed over to Professor Don Hudson. He has contracted a prosthetist in Cape Town who would provide a prosthesis for Jacques at the cost of about R17,000. Certain surgical procedures still have to be done to his legs. He suffered a major burn (60 per cent) as a neonate - a newborn baby - and has residual deformities of his face, his right hand and both feet and legs. He is severely crippled and is unable to walk although he has prosthesis, which he refuses to wear.'

End March 2001: The charity's Cape Town representative wrote: 'The social worker just had a meeting with Nazrina from Friends of the Red Cross Hospital. St Joseph's people say that Jacques' problem is not just lack of money but the bone that protrudes through the skin. So they want him to be assessed again by one of the doctors. Prof Hudson said he would be happy to see him. However, this being a bureaucracy, it can't just happen. So St Joseph's will send a report to Nazrina, who must then take it to Prof Hudson who in turn must request to see Jacques and only then will they start doing anything.'

Mid June 2001: Prof Don Hudson said that he still wants Jacques to have the legs and believes that Jacques deserves the best. For this reason he went to a specific prosthetics specialist, who is supposed to be the best. However, the problem of the protruding bone remains and he says that in Jacques' case the only option is sawing off the bone because the skin around the stump is so badly burnt. However, the prosthetics specialist said that in his view it would be possible to construct something that would nevertheless enable Jacque to walk. But before giving the go-ahead and giving us a medical opinion, Prof Hudson wants to hear the opinion of the orthopaedic surgeon in the Red Cross Hospital who will be the one sawing off Jacques' leg. We expect this by late June.
And so it continued over the months and years. It was immensely difficult to help Jacques while he was in a children’s home but far more difficult still, once he was in a rural area and far from professional support services. Nothing could be done without high calibre, committed volunteers and there are very few such people around. Early December 2001 Jacques gets fitted with new 'legs', close on a year after the request for help as we had to be sure of that the veracity of all the information provided and not everyone had the same sense of urgency. Jacques Abrahams has got new 'legs' bought for him by the Dorah Mokoena Charitable Trust, the forerunner of Children of Fire International. The new 'legs' made for him by prosthetist MZ Adams in early December 2001, helped to give Jacques some of the mobility that he yearns for.


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