El-Nathan J., 10

10-year-old El-Nathan lives with his parents in the city of Kaduna. He has two older siblings. He was a pupil at LEA Primary Mahuta in Kaduna State until he fell ill. He was in Primary 3 and was known for his energy and speed, often running faster than his peers during playtime. El-Nathan dreams of becoming a Medical Doctor when he grows up so he can help sick people get well. He holds onto hope that he will fulfill his dreams someday. El-Nathan was apparently healthy until October 2023, when he received the Yellow Fever vaccine at school. Shortly after, he became unwell and was admitted to a hospital for treatment. One morning, while at home and having failed to join in for family morning prayers, it was discovered that he was unable to walk. Since then, he has been confined to his bed, where he developed severe Grade 4 bed sores due to prolonged immobility. When he was brought to facility, he underwent a thorough examination and investigation, which revealed a diagnosis of Paraparesis—a condition causing partial paralysis of the lower limbs—along with the severe bed sores. El-Nathan underwent an operation to address some of the complications caused by his condition. While the surgery was a critical step in his recovery, his journey is far from over. El-Nathan’s condition requires ongoing treatment, particularly physiotherapy, which is essential for his quality of life. Without regular physiotherapy, there is a significant risk that he may never regain the ability to stand or walk again. Physiotherapy will help strengthen his muscles, improve his mobility, and prevent further complications. It is a vital part of his recovery process, offering him the best chance to regain independence and return to a more active life. Despite the challenges he faces, El-Nathan remains determined and hopeful. His dream of becoming a doctor continues to inspire him, and he looks forward to the day when he can not only walk again but also help others in need. With the right medical care, including physiotherapy, and the support of his family, El-Nathan is determined to overcome this difficult chapter in his life and work toward a brighter future.

In October 2023, 10-year-old El Nathan Joseph developed sudden-onset paraparesis following an adverse reaction to the yellow fever vaccine administered in school. This led to prolonged immobility, Grade 4 sacral pressure sores, and significant mobility challenges. Through the generous support of Helpster Charity, he received 72 sessions of intensive physiotherapy. He showed remarkable early progress, regaining the ability to stand with minimal assistance and demonstrating improved lower limb strength. Unfortunately, the sudden death of his father caused a major interruption in his therapy schedule. This setback led to regression in the gains previously achieved. El Nathan is currently in a palliative phase of care, where further aggressive rehabilitation is limited due to the chronic nature of his condition and underlying sickle cell disease. Our focus has now shifted to comfort care, wound management, pain control, and maintaining the modest mobility he regained. We continue to provide psychological support to him and his family during this difficult period.

The prognosis is guarded due to the severity of the pressure sores and the underlying sickle cell disease. However, with consistent physiotherapy, aggressive wound care, and comprehensive sickle cell management, there is potential for significant improvement in mobility and quality of life. Recommendations: 1. Adherence to the physiotherapy schedule is critical for achieving the desired outcomes. 2. Regular follow-up with the wound care team to monitor the healing of pressure sores. 3. Close monitoring for complications such as osteomyelitis or sepsis. 4. Psychological support for the child and family to cope with the challenges of the condition.