Rates of Hepatitis B transmission among young children are thought to be high and have prompted some health workers to say we should rethink the immunisation schedule

Rates of Hepatitis B transmission among young children are thought to be high and have prompted some health workers to say we should rethink the immunisation schedule

In September, Ngeseki noticed that her daughter’s eyes had yellowed and the girl became listless. Two weeks and four visits to health facilities later, the Ngeseki’s little girl would be dead after contracting Hepatitis B. From Hombe village outside Lusikisiki in the Eastern Cape, Ngeseki blames poor care and a shortage of ambulances for her daughter’s death.

Although Hepatitis B can be contracted from needle prick injuries and passed from mother-to-child, large numbers of children contract the virus during their early years probably from playmates, according to Tygerberg Hospital’s Dr Monique Anderson.

Anderson has called Hepatitis B the “white elephant in the room” as the virus kills more in Africa than HIV or malaria but remains largely undiagnosed and untreated.

From pillar to post and back again

Affecting the liver, Hepatitis B can cause jaundice, or yellowing of the skin and the whites of your eyes. Ngeseki’s child had developed jaundice when she first took the girl to Goso Forest Clinic where she says she spent hours waiting.

“She just told me that it was lunch time and left me standing there”

“At 13:00 the nurses went to lunch, but I did approach the nursing sister about the condition of my child and explained what happened to the baby,” Ngeseki told OurHealth. “She just told me that it was lunch time and left me standing there.”

An hour and a half later, Ngeseki claims her child had still not been seen and that nurses were busy chatting amongst themselves. She went to the waiting room to try to find someone to attend to her before leaving to return home and feed the child.

Her child spent the night crying in pain before Ngeseki sought help at the Village Clinic the next morning. At the Village Clinic, she was moved to the front of the queue and attended to immediately. She credits nurses’ active triage system for the quick attention.

Although the pair was sent home treatment, the child’s condition did not improve.

No ambulance available

On Sunday, Ngeseki rushed the little girl to St Elizabeth’s Gateway Hospital, where blood samples were taken. She was told to return five days later for the results.

“To all the mothers out there, you must stand up for the rights of your children”

When the girl’s condition deteriorated, Ngeseki rushed back to the hospital.

“The doctor in attendance told me that the child had a liver infection,” she said. “He gave her some treatment and then tried by all means for us to be transported to Nelson Mandela Academic Hospital in Mthatha.”

Four days later, Ngeseki’s daughter was dead.

“The problem was that there were no ambulances available,” Ngeseki told OurHealth. “My child died on 2 September in the evening in the hospital.”

“I am not saying this for compensation or anything, just so that the staff in our health facilities should take note,” she said. “To all the mothers out there, you must stand up for the rights of your children.”

Goso Forest Clinic nurse Nokwanda Mbane saw the child and says she did not think her condition was serious.

“I did not notice any unusual sickness of the child and took it (like an illness) in need of regular attention by the mother,” Mbane said. “I am very sorry and wish I could turn back the hands of time.”

According to Anderson, the high rate of Hepatitis B transmission among toddlers may be grounds to vaccinate babies at birth against the virus. Currently, children receive their first vaccination against the virus at six weeks.

The Hepatitis B treatment entecavir, which can be used in children, currently costs more than R4700 month in South Africa due to patent protection. Only eight patients have access to it due to the high cost of the patented drug, said Anderson at a recent civil society meeting on patent reform in Pretoria.

Additional reporting by Laura Lopez Gonzalez

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