Because she was on strong pain medication which included opioids, the hospital’s multi-disciplinary medical team was reluctant to discharge the child as the result could be fatal.
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The Western Cape High Court has granted permission to The Red Cross War Memorial Children's Hospital for a 6-year-old child's bilateral lower limb amputation, overruling parental objections in favour of traditional healing.
The application was instituted earlier this month on an urgent basis, but Judge Mas-udah Pangarker issued her reasons for the order on Friday.
Apart from giving the go ahead for the lower limb amputation of both legs, the court also gave the greenlight for any associated treatment, including psychological counselling to the child.
Only AD’s (the child's) father was present at court together with his sister, as the mother spent every day at hospital with her daughter. The hospital explained that AD suffered from a blood infection caused by bacteria that releases toxins which damage blood vessels, leading to clots, poor circulation and necrosis. This condition caused necrosis of the tissue in her feet which resulted in gangrene in both feet.
She was critically ill when she was admitted to hospital in January and had gone into septic shock. It was noted that AD’s feet had become progressively discoloured, and due to pain, she was administered morphine.
According to the hospital, the only medical treatment for AD was amputations of both her legs. Her parents refused consent for the operation and wished to explore traditional medicine/healing as an option because, in their view, her condition could be cured without surgical intervention and without amputation of her legs.
The parents told the hospital that the traditional healing would have to take place in the Eastern Cape, and this would entail that the hospital would have to discharge AD to enable her to travel. However, the parents were also not against traditional healing taking place in Cape Town, but it would still mean that AD would have had to be discharged from hospital.
Because she was on strong pain medication which included opioids, the hospital’s multi-disciplinary medical team was reluctant to discharge AD as the result could be fatal. The hospital tried its best to accommodate the parents' wishes and even considered allowing her to travel to the Eastern Cape with her parents to meet with the family elders regarding treatment with a traditional healer and to discuss surgical intervention. But the hospital decided against it due to her condition.
The father remained steadfast that his daughter was to attend a traditional ceremony in the Eastern Cape to heal her and said he would not return her to Cape Town. Discussions between a multi-disciplinary team and the parents eventually resulted in the parents asking traditional healers to come to the hospital to assess AD. They said that they would use oral traditional medication and lotion to cure AD’s feet and there should then be an improvement within four days.
One of the healers said he would be informed spiritually if there was no improvement in her condition and in that case, there would be a change of plan. The difficulty which the hospital faced was that traditional healing was not allowed within its premises. The hospital then spoke to the child’s uncle and explained that the infection could spread further up her legs.
Judge Pangarker remarked that this was not a case where AD, the medical team and the hospital had time at their disposal. She said while she would not lightly interfere with parents’ rights to consent and care for their child, this was a case where intervention in terms of the Children’s Act was justified.
The judge commented that while the religious beliefs of the family are respected, the medical intervention was in the best interests of the child.