Foot drop also called drop foot entails having difficulty in lifting the front part of the foot. It is a condition that makes walking very difficult for those affected. However, living with this condition affects not only the movement but also the quality of life of those living with it. Some persons with this challenge shared the story of how the injections they were given in childhood for minor ailments resulted in irreversible nerve damage that caused the foot drop and made walking and standing difficult for them. ANGELA ONWUZOO reports<
When Chekube Ezeokafor was born in 1992, she was healthy and had no form of deformity. She had no issues with her ability to walk, run, and play normally like her peers. Moving around was not a challenge at all for Chekube when she started walking at 10 months old.
The Anambra State indigene received all her childhood immunisation without any issues. But at the age of two, she was sick and was taken to a private hospital in the state by her mother for treatment.
But little did Chekube and her mother know that the injection that was given to her on her buttocks by a nurse at the facility will cause irreversible injury to her nerve and affect her movement and quality of life for life.
Sharing her experience with PUNCH HealthWise, Chekube, a Higher National Diploma student of Home and Rural Economics Department, Federal Polytechnic, Oko, Anambra State, said she walked with her two legs with her mother to the hospital but couldn’t lift her left leg again after receiving an injection that was given to her by a nurse for a fever that brought her to the hospital.
She, unfortunately, left the hospital with a deformity that she is still battling with to date.
The dark-complexioned lady said the injection caused the foot drop, lamenting that life has never remained the same since the unfortunate incident as walking has become a challenging task for her.
She said going to primary and secondary school was quite challenging for her as she could no longer walk a long distance, noting that she experienced excruciating pain in her knees each time she walks.
According to the United States National Institute of Neurological Disorders and Stroke, foot drop is the inability to raise the front part of the foot due to weakness or paralysis of the muscles that lift the foot.
The NINDS says as a result of that, individuals with foot drop scuff their toes along the ground or bend their knees to lift their foot higher than usual to avoid the scuffing, which causes what is called a ‘steppage gait’.
Experts say serious sciatic nerve injury or injection nerve palsy can result from improperly performed injections into the buttocks and cause foot drop, adding that the most common scenario for nerve damage is improper needle placement.
Auxiliary nurses causing problems<
A Senior Lecturer at the Department of Paediatrics, College of Medicine, University of Lagos, Dr. Beatrice Ezenwa, told PUNCH Healthwise that only trained and qualified nurses should be allowed to administer injections.
According to her, untrained health workers and auxiliary nurses are the ones causing these problems.
The Consultant Neonatologist/Paediatrician with the Lagos University Teaching Hospital, Idi-Araba, said, “There are particular areas for giving an injection.
“If somebody follows the guideline and protocol, they are not likely to cause any problems. It is those who do not know the rules that cause problems.
Leg became paralysed immediately after injection at age two<
Sharing her experience with PUNCH HealthWise, Chekube said, “I was born normal in 1992. My mum told me that she gave birth to me without any form of deformity. And that I received all my childhood vaccines without any health issues. But at the age of two years, she told me that I was sick and had a serious fever which prompted her to take me to the hospital.
“According to her, when she took me there, a private hospital, a nurse gave me an injection on my buttock. She told me that after taking the injection, I fell and could not walk again. She said she tried all she could to make me stand and walk, all to no avail.
“She said she screamed and started crying. She said she told everyone in the hospital that her daughter she brought for treatment came in with her two legs and was even walking around when suddenly she could not walk again after being injected by a nurse.
“She told me that while she went to the nurse to confront her, she saw two women quarreling with her over the same issue. My mum said staying back and quarreling with the nurse may worsen my case.
“So, she said she quickly rushed me to another hospital and after examining the leg, they told her that the injection had caused injury to my nerve and that the damage may be irreversible.
“My mum was told that my nerve was injured by the injection needle which they blamed on the nurse that gave me the injection. And that is how it resulted in foot drop.”
Chekube told our correspondent that she experiences pain in her legs often and walking a long distance is always a problem.
“My mum told me that the pain that I went through after taking that injection was unbearable, wondering what type of injection could make a child writhe in pain.
“So, she said after that injection, I started sitting like a toddler again because I could not walk and as I was growing up, one leg became shorter than the other.
“Later, she started taking me to different traditional homes for treatment to see if I could stand and walk again. My mum said it took me time before I struggled to stand and walk again.
“That was what she told me when I asked her why I was not walking and standing normal like my peers and brothers.
“My mum said she and my dad, however, didn’t take any action against the nurse nor sue the hospital. She said their primary concern was for me to get better,” she recounted.
Chekube told our correspondent that she feels unhappy each time she remembers that her condition was caused by a quack and that she has to live with the consequence for the rest of her life
Getting married difficult<
Continuing, she said, “We are five in my family and I am the last and only daughter. My brothers stand and walk without issues while I walk in pain and with difficulty all the time.
“I am saddened by the development because my disability is man-made and no fault of mine nor my mum. The nurse that injected me, no doubt is a quack. If I had been injected by a trained nurse, I wouldn’t have come down with this condition.
“Each time I look at myself in the mirror and see that one leg is shorter than the other, I feel unhappy. My mother is not always happy whenever she sees me walking because she gave birth to me without deformity.”
Coping with foot drop the undergraduate said has not been easy.
“As a child, I didn’t understand the gravity of having one leg shorter than the other. I felt it was just a phase, which would pass. After seeking help without a solution, at a time, it dawned on me that I was not going to walk normally and stand straight for life. It was so painful for me, I must tell you. I just had to take my fate into my hands. I can’t walk long distances.
“Meeting up with my lectures sometimes is difficult especially when the venue is far. While others are running to get a better space and seat, I will still be struggling on the way. I feel pain in the leg most time when I walk and I also feel tired easily each time I walk. And sometimes, people make fun of me because of the way I walk.
“Though I can cope with my education, I can tell you that the condition has affected me in terms of getting married. I have lost three suitors because of my leg. They said their parents told them not to marry me because of the way I walk.
“But I have another suitor now, though his parents are against the marriage. He has, however, assured me that he would still go ahead with the marriage because he loves me,” she said.
Chekube who is from Anambra State told our correspondent that she has seen other people with foot drops which resulted from injections that they were given in childhood.
She urged the at all levels to address the challenge which she said was rampant in the rural areas where quacks are operating without being sanctioned.
“I want the to address the issue of quackery in our hospitals. If not for the fact that I was given an injection by a quack nurse that affected my left leg, I would have been married with children by now and would not have been struggling with everything that I do,” she said.
The World Health Organisation, says there is a need to reduce the number of unnecessary injections as a critical way of reducing risk.
According to experts, injections should only be given as a last resort to children while mothers are advised to ask questions whenever they visit the hospital and injection is suggested.
According to them, nerve injury is a common complication following intramuscular injection, adding that the sciatic nerve is the most frequently affected, especially in children, the elderly, and underweight patients.
Daily intake of painkillers to reduce pain <
Christian Ndiferek, 19, is another person walking with difficulty as a result of the injection given to him when he was an infant as one of his legs became shorter than the other after the injection though he was born with normal limbs.
Narrating his ordeal to PUNCH HealthWise, Christian said, “I can’t do certain things that my mates are doing because of my leg. My mother told me that she gave birth to me without any health issues.
“She said she took me to a private hospital where I was delivered for immunisation one month after I was born and a nurse gave me an injection on my buttocks and that was how my inability to walk normally and freely started. The injection affected my left leg making it shorter than the right one.
“That was how I developed foot drop. Since I started growing up till now, walking has remained a major challenge to me. I experience severe pain in the affected leg often and I am on pain killers daily to ease the pain. I can’t play football like my mates.
“Because of the way I walk, when I approach any girl for friendship, they often refuse because of my leg. I feel unhappy each time I have pain in my leg and each time I am unable to do what my mates are doing. Even the little business that I am doing often suffers setbacks as a result of my inability to walk normally and the pain that I experience daily.”
Also speaking with PUNCH HealthWise, Mrs. Glory Ndiferek, Christian’s mum also shared narrated how one of the legs of her son who was born normal was later impaired after taking an injection.
“I gave birth to him in the village and he had no issues with his legs when I gave birth to him. But after one month, I took him to the hospital where I delivered him for Immunisation. I noticed that three days after he was immunised, the side of the buttocks that he was given an injection for became red and swollen.
“One week after, I took him to another hospital and when the doctor saw him, he was angry that the injection had developed an abscess and affected his leg badly. He asked me who the nurse that administered my baby an injection on the wrong part of his buttocks. That was how my boy grew up with movement and standing challenges”
Lekan Yusuf from Kwara State and others living with drop foot who spoke with PUNCH HealthWise shared similar experiences of how injections they were given in their childhood for fever and other minor ailments resulted in injection nerve palsy that caused them foot drop.
Speaking further with our correspondent, Dr. Ezenwa stressed that injections should not just be given in any part of the buttocks.
The paediatrician said, “There are anatomical places where you can give an injection which you learn when you are in school.
“But quacks because they see people give injections in the buttocks, they feel that any part of the buttocks can be given injections and they cause problems.”
“When you are to give injections, there are particular places you can give them.”
Why children are given injections in the thigh<
Another child health expert, Dr. Olatunde Odusote told our correspondent that there are ways to give injections.
Dr. Odusote who is a Consultant Paediatrician and Head of the Division of Allergy, Dermatology and Pulmonary Medicine, Department of Paediatric and Child Health, Lagos State University Teaching, Ikeja, said the risk of damage is reduced when children are given an injection in the thigh.
The paediatrician explained,” If you inject somebody on the nerve, it would cause irreversible damage.
“Nerves are not repairable once they are damaged. That is one way of causing the problem. So, that is an issue of quackery where somebody who is not trained to give injection gives injection and damages the nerve in that child especially if it is given in the buttocks.
“Usually, there is a way to give injections in the buttocks. When you want to give an injection in the buttocks, you have to divide it into four parts.
“It is the upper outer area that you will give the injection.”
Dr. Odusote, however, said, “But we also know from experience that although most nerves do not pass through that place, a few per cent of people, their nerves are in that area. That is why you find out that most vaccines in children now are given in the thigh. It is because of those findings.”
He also noted that when a child has a polio infection and runs a fever, if he or she is given an injection, it could make polio worse.
Also speaking with PUNCH HealthWise, a surgeon and former National President of the National Association of Resident Doctors, Dr. Uyilawa Okhuaihesuyi said, “Any time that an injection is given at a part that is not on the upper outer quadrant of the buttocks, it can cause injury to any of the nerves in that part and that can lead to foot drop.
“Also, when you have injuries to the upper part of the leg, around where the tibia and fibula meet together, mostly where there is peroneal nerve, it can also cause foot drop.”
He identified trauma, fractures, tumours, among others as other causes of foot drop.
In a 2016 report published in British Medical Journal titled, “Case report: An unfortunate injection,” the authors said though intramuscular injection has been used to administer medications for more than a hundred years, preventable complications such as injection nerve palsies are still prevalent in developing countries.
According to the researchers, injections account for one-fifth of all traumatic nerve injuries.
Indiscriminate use of injections<
“These injuries largely occur due to indiscriminate use of intramuscular injections for treating common illnesses, frequently by unlicensed or undertrained practitioners administering unnecessary treatment to impoverished patients.
“The sciatic nerve is the most commonly injured, and frequently the resulting muscle weakness and associated disability are irreversible. Such injuries can be prevented by proper awareness and training, the implementation of safer injection techniques, and quality assurance methods,” the author said.
The BMJ is a weekly peer-reviewed medical trade journal, published by the British Medical Association.
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