Case Study

Maedo Moloto and daughter

Maedo’s baby daughter is one year and five months old. In the past year she has been admitted to hospital three times for treatment of pneumonia.

Her symptoms and subsequent hospital admittance and treatment have followed a similar pattern. First she started coughing and crying a lot, which made her vomit, and then she became hot and started sweating. She had less and less of an appetite and her breathing became increasingly labored, which made her chest draw in deep.

Upon recognizing the symptoms the last time, Maedo headed straight for hospital. On arrival at the outpatient clinic at Baragwanath hospital, Johannesburg, staff admitted the baby to the pediatric ward where a diagnosis of bronchial pneumonia was confirmed. She was immediately put on antibiotics. After a week, her symptoms subsided and baby Moloto looked markedly better. She was able to sit up in her cot with a lollypop and cuddle a soft toy that the pediatrician had brought along to cheer her up.

Baby Moloto’s story is a common one. To further complicate matters, she is HIV positive which means that she is up to 40 times times more likely to get pneumococcal pneumonia than children without HIV/AIDS.

Frequent hospital admissions and general anxiety impact on Maedo, who is only twenty-one. She used to go to college, but she has given up thoughts of further education and a more secure future to care for her baby. At home, all she can do is provide a stable diet and ensure that her baby has her multi-vitamins and antibiotics whenever illness strikes. Baby Moloto was due to start HIV treatment on the day that she was last admitted to hospital, but she was too weak. Maedo hopes these life-enhancing and life-extending drugs will be made available to her daughter now that she is visibly sick and growing ever more susceptible to opportunistic infections.

Maedo doesn’t have a partner to share the hospital visits, or even to share a little of the worry. Her former partner has been avoiding them since he found out that they were both HIV positive.

When Maedo needs to take her daughter to the hospital she must take two separate taxi trips, which can take up to two hours in peak time traffic. Every day that her baby is in the hospital, Maedo makes the journey to and from the hospital to be by her daughter’s side. The taxi journey costs her 14 rand (over $2) each way – a total of 196 rand (over $31) per week. As Maedo doesn’t work, it is up to her mother to find the money for these trips, and to ensure that she has enough left to support herself and her other children.

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Stories and photographs of the case studies are courtesy of the families and children with permission to PneumoADIP for use in educational and non-commerical purposes only. Reproduction or translation of the case studies, requires explicit, prior authorization in writing. Applications and enquiries should be addressed to pneuadip@jhsph.edu.