5th Sep 2010 7:09:24 AM The Charities | The Children | Dorah Mokoena | Health | Schools / Training | Community | Regional Reports | UMashesha Home Amanda Simanga New Amukelani Dube New Andani Mphaphuli New Anele Nyongwana New Babalwa Debele New Bafana Nzima New Balombo Bambula New Basheeba Worlotoe New Boipelo Mosegedi New Bongani Madlala New Bongani Phakati New Bonginkosi New Brendan New Chris M New Deon Slabbert New Dikeledi Mboko New Doreen New Ernest Tshabalala New Evelyn Minto Essono's New Feleng New Franklin New Fursy Mogobe New Gabriel New Gloria New Gontise Mogotsi New Habiba New Helen Matondo New Irene Peta New Jabulani Malungane New Jacques Abrahams New Janine Barends New Jaun Henning New Jeffers Zitha New Jose New Jose Mvula New Kagiso Maphoso New Kagiso Mathebula New Kagiso Mphuti New Karabo Thebedi New Kedibone New Kenyan New Kjetil Sandivk Havnen New Koketso Sekuru New Lee Branco New Liane Grond New Lida Basson New Linda Nana Tshbalala New Londeka Ngidi New Maje New Marco Bronkhorst New Mbali New Mfundo Ntamehlo New Michelle Mthenjwa New Mimi New Mittah New Mlungisi New Mohau Qumpula New Mpho Maja New Musa Zwane New Musiwa New Neliswe Radebe New Nelson Tsabalala New Nkululeko New Nouna boy New Nsizwa Vilakazi New Nyakallo New Oscar Mlondolozi Hadebe New Phindile New Piet Moloja New Reagan New Rolivhuwa Matodzi New Rose Wambua New Rumbi New Saloma Aphanye New Sameh Chiboub New Samkelo Sole New Samukelo Radebe New Seif New Seizo New Selamawit New Shirley Seqobane New Sicelo New Simamkele New Sithembiso Hlatshwayo New Siyabonga Morwasetla New Siyabonga Nokumbi New Siyamthanda New Sizwe New Steven Marakeng Mpyana New Sunday Mukaza New Tapera Jani New Tavonga New Thapelo New Thomas New Thulani Nhleko New Tshepiso Sekuru New Vhahangwele Matodz New Vivian New Vusi Mathibela New Xavier New Yassine Ben Ali New Zanele Jeza New Zenette and Precious Van Wyke New Zianda Ndlovu New Zipho Zwane New Mimi                 On 17th January, 2000, three children were left in the care of a nanny in a brickbuilt house in Maputo, Mozambique. Michella Dinis Timba, daughter of Dinis Ernesto Timba and Josina da Conceicao, was two-and-a-half years old. Her sister Lucia Dini Timba was five years old and her cousin Katia Antonio Sono was three years old. The children are believed to have taken matches to play with in a bedroom. They locked themselves in. Neighbours raised the alarm when they saw part of the house on fire. Michella and Lucia's parents were at work. For two of the children it was too late, but Michella survived. Michella is called Mimi by her family. She was burned on her face, ears, arms, hands, neck extending chestwards into a bib shape, stomach, and on part of her legs. She has had extensive skin grafting with the crocodile-style finish to cover large areas, at the Centro Infantil da Banca Estatal. Mimi's face would benefit from further surgery but it would be complicated. Her mouth cannot smile properly nor open fully. She could maybe benefit from use of transparent plastic masks as used by Colin Haylock at Charing Cross Hospital in London, UK. When she is older (maybe nine years old) her ears could be reshaped with cartilage. Mimi is quite overweight and spoiled by loving parents who cannot cope and who have received no counselling for their bereavement, let alone for how best to help their surviving child. They wait on her hand and foot. Mimi had pressure garments but didn't like wearing them so her parents did not persist. They do not think that they will fit any more. Much of her scarring is probably permanent because of the time delay in helping her properly. Action should ideally be taken within two years of the injury. No surgeon or doctor has taken Mimi under their wing and made a plan for her future long term surgery and therapy. The parents did not know where to turn for clear advice. The family mostly understand Portuguese and would need counselling in that language, although they have some Zulu-speaking relatives. Mimi was seen by Dr A Kadwa at the Park Lane Clinic in Johannesburg in late September 2001 and in early October 2001. She had a skin graft to the left hand with skin taken from the buttock. She also had lip contractures released. There seems to have been no followup since October 2001 and the lack of attention and family knowledge has resulted in a lot of unneccessary damage. Mimi's family contacted Children of Fire for help in August 2002. She then visited the offices in Auckland Park with five relatives. Mimi was wearing a bandage on her left hand on September 1st, 2002. She was reluctant to have the bandage removed and underneath it became clear that there was no need to wear the bandage; in fact it was causing her harm. Mimi has contractures to the left arm at the elbow and the armpit. Her hand is badly malformed. An occupational therapist should have been involved early on and much better splinting of the hand should have taken place soon after the injury. It is hard to tell what can be salvaged now as even the fingernails are there but the fingers are fused and shortened -- compressed almost and have not been used for a long time. Mimi cried when we threw her bandages into the bin. Her mother said Mimi liked the hand to be swathed because she found it too ugly to look at. We said the hand must not be concealed but that it should be used. Her father seemed to cringe away from the sight of it, which makes Mimi's self-loathing easier to understand. Mimi holds her left arm like a sparrow with a broken wing but when I gently massaged it with Vitamin E creams, she unwittingly relaxed and the contracture seemed to be less severe than it had at first appeared. She would not actively use the left hand but when I encouraged her to rub cream into the opposite arm, she used her left forearm a little. Mimi can raise both hands above her head but the arms are not fully extended. The arms are easily crossed at the front but if she puts them behind her back, her movement is again restricted. I asked her to undress herself. She has clearly not done this since she was injured. She could not undo dungaree-like buckles on her pinafore dress but eventually managed one of them. She struggled to remove a T-shirt and dress, but took socks and shoes off fairly easily. Putting socks back on was much harder and she did not want to do it. She could not manage the buckles of her sandals at all. Despite putting her socks on inside-out, I gave her a floral animal mug as a reward for trying. Mimi also received a doll, a special non-wood pencil, some vitamin e cream and a book about Snow White and the witch. I said to Mimi that she should direct her sadness and anger at the witch, because everyone else in the room loved her and did not want to cause her pain. I referred the family to Dr Gavin De Aguiar at Milpark Hsopital as he specialises in hands (though he assisted us before with surgery on Mfundo's head). I also suggested that they should talk to Janet Bydawell, the occupational therapist, about thermosplastic splinting. Mimi's mother in particular will struggle not to spoil her child, even wiping the little one's nose when she cries. Children of Fire offered to take Mimi occasionally for one week at a time, to give the parents a break. Mimi's relatives commented in Zulu: 'If she can come right, she'd come right here.' The family will arrange what surgery they can, and the charity will continue to assist with advice and, if need be, assistance with operations as well. Bronwen Jones, Johannesburg, Sept 2002. This material is Copyright © The Dorah Mokoena Charitable Trust and/or Children of Fire , 1998-2010. 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