A Cry for Help

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Francis Sardauna writes on the need for the Katsina State government and philanthropists to assist 11-year-old Hamza Salisu to undergo his fourth surgery. Salisu is suffering from imperforate anus, a birth defect of improperly developed anus and needs N800,000 for the surgery

An imperforate anus is a birth defect that happens while a baby is still growing in the womb. This defect means that baby has an improperly developed anus, and therefore can’t pass stool normally from the rectum out of their body.

The condition, according to medical experts, develops in the womb during the fifth to seventh weeks of pregnancy. The cause is unknown. Many times, babies with such condition also have other defects of the rectum.

Sadly, this is the condition of Hamza Salisu, the fifth child of Salisu Dahiru, an indigene of Matazu Local Government Area of Katsina State. Hamza’s condition requires immediate treatment.

The 11-year-old Hamza was born on June 6, 2009 at Kwabdaya community within Matazu metropolis without posterior opening of the digestive tract often referred to as anus but his mother, Bilkisu Salisu, could not identify the problem till after three hours.

When the parents of Hamza later discovered that he was born without anus, they rushed him to General Hospital Matazu to ascertain the situation but the doctors in the hospital referred them to Turai Yar’adua Hospital in Katsina, the state capital.

At Turai Yar’adua hospital, the young Hamza underwent three different surgeries to enable him have an anus but all the operations conducted could not yield any positive result as the patient is still defecating and urinating through a rectum stationed outside his stomach.

The alarming phase of Hamza’s health began after his second surgery at 11 months. He was in and out of the emergency room or hospital nine times for issues like dehydration, vomiting and low temperatures, as well as an infection of the surgical site after the surgery.

Hamza, a primary 2 pupil with Bako Matazu Primary School, is currently facing stigmatisation from his schoolmates as a result of his frequent urination and defecation through the rectum which often force the teachers to send him home because of what they termed endless smells.

Despite the discrimination, Hamza continued to pursue his elementary education until recently that his health condition apparently turned to unbearable stage. Consequently, he is in urgent need of over N800,000 to undergo a fourth surgery and other necessary medications.

Speaking in an interview with THISDAY in Matazu, Hamza appealed to the state government and philanthropists to come to his aid by assisting his parents with finances that will enable them to return him to the hospital for further examination and treatment.

Hamza who wept uncontrollably during the interview, said: “My mates are in secondary school now but I am still in primary 2 because of my situation. Anytime I go to school, my classmates and teachers will be saying I am smelling and sometimes they send me away from the class.

“I don’t know why my mother gave birth to me with this bad condition. I don’t have anus so I am urinating and defecating through this rectum outside here. I want to be like other children of my age. Government should assist me if not I am dying; my situation is worsening everyday”.

Narrating Hamza’s ordeal, his mother (Bilkisu) said: “When I held my sweet newborn moments after his birth, he was already swaddled. It was only three hours later, after a nurse offered to change his first diaper, that I received the shock of my life.

“My child had no anal opening. Instead, his pale behind was completely smooth. There was no hole. There were no cheeks. With this gory condition, Hamza continue to cry with frequent vomiting throughout that night and his stomach swollen up.

“My life-partner and I took him to Turai Yar’adua Hospital in Katsina where he had two surgeries to enable him to have bowel movements out of a newly created anal opening. But three months after, the newly created anal opening blocked”.

She stressed that: “By the time he reached 9 months old, he woke screaming up to 11 times per night. I got up each time and cared for him. There were many days I would sob from exhaustion”.

The 35-year-old Bilkisu, who could not control her emotions, added that: “So we returned him to the hospital for the third surgery where they removed his rectum and stationed outside his stomach. And for the past 11 years that is where my son is defecating and urinating without control”.

Bilkisu, a mother of nine children, reiterated that monitoring Hamza’s fluid intake so his bladder wouldn’t grow to be too full and managing his care while traveling miles for his doctor appointments and next surgery is a serious challenge that is militating against the growth and development of the family.

“Our child’s condition came with many daily challenges. One of the biggest ones that we puzzled over was how he would scream and cry throughout the night even though during the day he was largely a very happy. But at night he seemed to be in frequent pain.

“Then, a really alarming phase in his health began after his second surgery at 11 months. Soon he was in and out of the emergency room nine times for issues like dehydration, vomiting and low temperatures and many health related issues occasioned by the surgical operation”, Bilkisu said while crying.

She explained that they sold all their properties, including farmlands to raised N1,000,000 to cater for Hamza’s health condition but the situation seems to be deteriorating everyday, adding that the family is in need of another N800,000 to enable Hamza undergo the fourth surgery at Turai Yar’adua hospital.

According to her, “We have sold all our properties, including my bed and some of my clothes for Hamza’s treatment. As we speak, myself, Hamza and his siblings are sleeping on mats and we hardly eat three square meals because the farmland that his father normally farm on to feed us has also been sold”.

On his part, Hamza’s father, Salisu Dahiru, said he sold three of his farmlands and part of his residence for the treatment of his son, lamenting that he no longer has food to eat with the family.

According to Dahiru, “I sold all my farmlands and part of my residence for Hamza’s treatment. In fact, I spent over N1,000,000 for the three surgeries that Hamza has undergone including drugs and injections.

“And the doctors said Hamza will undergo another surgery to return the rectum which is outside his stomach to its normal position. The fourth surgery will also enable them to another opening for him to be defecating and urinating.

“I have no where to seek help again, government should please assist my son before he die. I know Governor Masari is a listening governor, he should come to our rescue because we have exhausted what we had. We are all sleeping on mats and rags”.

Explaining Hamza’s condition, a paediatric surgeon, Dr. Aliyu Sati, said when a baby’s urinary system and the ano-rectal passage fails to separate, it can result in a condition whereby the baby is born without an anus.

Sati, who termed Hamza’s condition Ano-rectal Malformation (ARM), said the condition refers to an abnormality in the formation of the rectum or anus of a newborn.

He said: “Babies are often present with no opening to their bottom end at birth. The urinary system and the ano-rectal passage is separated and functions independently. Failure of this separation process before the child is born results in ARM in babies.

“Hence, the poo and wee pipes remain abnormally connected in these kids. The most common abnormality in a girl child with ARM is when the rectum opens into the entrance of the vagina, with no other opening on the bottom.

“In a male child, the commonest form is when the rectum opens into the urethra (urinary tube connecting the bladder to the tip of the penis), close to the prostate gland and again with no other discernible opening on the bottom”.

He noted that the connection between the rectum and the structures he enumerated are often small, and hence, the baby will not be able to open his or her bowels, which will subsequently be obstructed.

When asked on what should be done, Sati said it is imperative that a paediatric surgeon create a stoma (bowel opening into a bag on the abdomen) to prevent bowel obstruction.

He added, “In a child with ARM, the sphincter muscles surround the anal canal and are usually still present in the correct place despite the rectum connecting to other structures. The definitive surgery would involve disconnecting the rectum from whatever it’s attached to, and re-plumb it through the sphincter muscle.

“Once a stoma is formed, the child can feed and grow until definitive surgery can be planned to construct a new opening for the anus, usually after a few months. So, once the reconstructive work is done, the stoma can then be closed, so that the new bottom can then be used”.

The family can be reached through Hamza’s cousin 08144404901 and account details are as follows
5331234864 Hannatu Mani Habu (Fidelity Bank).