Morocco - A question of life or death
10 Mar 2011 Specialised careMorocco
The illness of a child turns the life of a whole family upside-down. Faced with a test like this, parents, accompanied by some extraordinary people, struggle heart and soul to ensure that these children from impoverished families might have the chance to live. This report comes from Morocco and the heart of a Terre des hommes project that provides care for children aux enfants.
For the last fifty years, Terre des hommes has led a project which remains unique in Switzerland: taking care of children here who cannot be healed in their own country because of their particular illness. Since 1960, Terre des hommes has organised operations for more than 10,000 children in the university hospitals of the Lake Geneva region.
Morocco was the first partner country in this project. Last year, 51 children with extremely serious illnesses, usually heart disorders, were transferred in order to receive care. That’s about one every week.
Rendez-vous with Amina
In Rabat, we followed the day of Amina Smimine, project coordinator for specialised care, who has been working for Terre des hommes since 1984. From the first moment, we were thrown into her daily tasks. “I’ve just had an urgent call,” she told us, “from a member of parliament with whom we work and who is bringing us Agardir, a baby who needs help.” He had travelled 600km with the child and her parents. A heart malformation had just been diagnosed and little Ismaan was not doing well. We met them in the office. A tiny baby, just 45 days old, wrapped up in a huge blanket, looked at us straight in the eyes. Her bluish skin colour was the sign of poor blood circulation. Amina was worried. She picked up the telephone and made a few calls to arrange an urgent consultation and more specific diagnosis with the specialist she works with. The meeting was arranged in a few minutes.
Seeing beyond the heart
The child’s mother, a young woman, was despondent throughout the interview. “Women are often held to blame for their children’s malformations. In this case, this young mother has already given birth to four babies, of whom one died. They have all been girls, without a break between pregnancies. She’s probably trying for a son. I’ll need to speak with her further, especially about contraception. But now is not the time.” To our surprise, Amina added, “We can’t just look at the child’s heart. An overall approach is necessary.” The need to make parents aware of and responsible for the fundamental rights of the child: access to health, the right to a family, to an identity and to education, are all integral to the Terre des hommes project.
A few hours later, we met up again with Ismaan at the cardiac ultrasound practice which accepted to see her as an emergency. Dr Layla Zniber, the first doctor in the country to be trained in cardiovascular paediatrics, gave us an update. “Her case is serious, and she needs intervention which we are unable to provide here in Morocco.” Amina sighed. “It’s always difficult to organise the transfer of babies less than two years old, because there are a limited number of places in the hospitals.” She held Ismaan’s medical file in her hands. The baby’s survival depended on her management of the situation, and on her persuasive force.
A difficult return to school
Terre des hommes’ work doesn’t end with the transfer of the child. The family needs to be helped for the child’s reintegration to succeed – especially when it comes to returning to school. Marwan was operated on in Switzerland, and returned home two years ago. He is nine years old, but physically he looks only five. His delayed growth is linked to his heart disorder.
Because of his illness, Marwan went for a long time without schooling. On his return, he went back to school – but at his level, not according to his age. Consequently, Marwan is several years older than his schoolmates. But he is much smaller than them, and is subject to teasing that can be hard to handle. “It’s going very badly at school,” his mother told us, “Marwan is constantly getting into fights and is regularly sent home. I don’t know what to do anymore.” She explained that she sends him out with his brother to earn a little extra money for the family. In the countryside, children are often victims of numerous forms of exploitation. Little girls are often sent into towns as early as the age of seven, to work as domestic servants. The boys, meanwhile, are sent to work as shepherds.
The coordinator and the boy exchange a few words. “Why do you get into fights?” “The others are horrible to me. And in any case, I don’t care about school. As soon as I can, I’m going to go back to Switzerland.” “In that case, it would be better to go to school and learn a skill.” She added, “And in any case, in Switzerland they’re not looking for shepherds!”
A father fighting for his daughter
The family plays a key role in the recovery of a child. A mischievous little girl of six, Imane owes her survival to the grim determination of her father not accept her fatal destiny. When she was being vaccinated, a paediatric doctor with knowledge of heart disorders listened to her heartbeat. The doctor detected a malformation and, after providing a primary palliative intervention, referred her parents to Terre des hommes.
The illness was serious and required intervention abroad. At the time, Terre des hommes was overwhelmed with work and Amina was unable to handle the case. But Imane’s father insisted so hard and for so long, that his daughter’s case was eventually taken on. Nevertheless, it took months of patient waiting before she could be sent to Switzerland and begin her journey towards life. It finally took place in 2008. After several months, a profoundly changed child came home. Now, Imane has developed well, and is full of energy and good health.
For Amina, this family is exemplary. “It is extremely important that the family is committed and makes an effort. Too often, we find parents who have given up; they’re totally overwhelmed by their child’s illness.” The parents need to be a part of their child’s development. It is these parents who do what it takes to ensure the best conditions.
Imane is learning to read, write and count. She is taught in Arabic and French. When we ask what she would like to do when she grows up, she responds without hesitation – just like so many of the children in the specialised care programmes – “Me, when I grow up, I want to be a doctor.”
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Facts & figures 2010 – Transfer and care of children in Switzerland
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More on the intervention of Tdh in Morocco, on the specialized health care and on the report in Morocco made in December 2010.
