James’s Story

Site created on August 29, 2020

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Journal entry by James Opiho

am working with Dr. Antonio Loro to raise awareness and funds for total hip replacement surgery for affected young adults on the waitlist at CoRSU here in Uganda. 

Sickle Cell Disease (SCD) is a congenital disease of the blood which affects one of its components, specifically the red blood cells. These are the cells which contain the Haemoglobin, the precious protein that brings the Oxygen, namely life, from the lungs to every corner of our body. In people affected by SCD, they carry a different, faulty type of Haemoglobin, called type S. Under specific circumstances the red blood cells that contain the Haemoglobin S change their shape, from round to sickle. In this different shape they can not run smoothly along the arteries, they easily stick together and block the vessels, especially the small ones. This creates serious damage to the organs and tissues that are famished of Oxygen by the obstructed vessels; as a consequence, the tissues die (necrosis). The complications of the disease are therefore several, depending on which vessels are obstructed. They can be very serious, bringing quite a good number of children to death before the age of 5 years.

One of these adverse complications is the death of the femoral head in the hip joint of sickle cell adolescents and young adults here in Uganda. When the femoral head dies, it collapses and the round ball becomes flat and mushroomed, irregular in shape. As a consequence, the joint can not function anymore as a ball and socket joint. Problems start. These young guys come to our attention with severe pain, limping, limb shortening, inability to move for long distances, inability to squat and climb stairs, difficulty in sitting, night pain. Remember that they are in a state of chronic, severe anemia and blood transfusions are quite frequently needed. It becomes extremely difficult for them to carry out daily activities. From the social point of view, their education suffers, they skip social events, they can not take care of themselves in a proper way. They live a poor quality of life. Really poor.

There is a moment when the painkillers can not help anymore. The only solution resides in surgery. In particular, the diseased joint has to be replaced with an intervention that is called Total Hip Replacement (THR). This is a major operation, risky in these special patients but feasible here even in Uganda. The facilities are there as well the surgical skills. The obstacle is the cost of the procedure which stands at about USD 5.000 for one hip. Remember that bilateral hip involvement is not unusual, being present in about one-third of the cases.

Currently, I have more than 10 patients on my waiting list, their age ranging from 17 to 28 years. Their only hope is to find good Samaritans who can pay for the life-changing surgery they badly need.

Hip before surgery

https://www.dropbox.com/s/cc0x7ydf9q7ltfb/Corsu-hi...

Hip after surgery

https://www.dropbox.com/s/au5cq15ci7cc3fq/Corsu-hi...

Thank you for supporting these disadvantaged young adults.

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