‘I was rejected for giving birth to baby with eczema’

As we enter her tin-roofed single-room house in the remote Kamere village in Naivasha, Judith Muyuka, 30, is lost in thought. Tears race down her cheeks involuntarily.

The mother of two  is on the verge of losing hope. Lately, she says, she has been contemplating taking her own life.

When she gave birth to her second-born son Mustafa Ramadhan 10 months ago, Judith was overjoyed. But this bundle of joy would soon turn into agony.

“The birth was normal and without any complications. Three weeks later, my baby’s health took a turn for the worse. He developed very itchy rashes all over his face,’’ she narrates.

‘‘The rashes would then develop into wounds that oozed water and pus,” she adds. Judith notes that the baby would cry and wreathe in pain all day and night.

She says her community did not make her situation any better. At the flower farm where she was working, her colleagues started speaking behind her back about her baby.

But it is not just her co-workers and neighbours who shunned Judith. She says her relatives too abandoned her, saying she ‘had given birth to a frog’. 

“They claim my baby’s condition is a punishment from the gods. Others say he was bewitched. This breaks my heart to shreds,” the mother narrates.

When the baby’s condition worsened, the young mother sought treatment at Naivasha Sub-County Hospital, where doctors ran a series of tests. The boy was found to be battling eczema.

Also called atopic dermatitis, eczema is a condition that causes dry, itchy and inflamed skin. According to Mayo Clinic, a nonprofit American academic medical centre, eczema is common in young children. It can, however, occur at any age.

It is long-lasting (chronic) and tends to flare sometimes. The condition is, however, not contagious. People with atopic dermatitis are at risk of developing food allergies, hay fever and asthma.

At the hospital, Judith was given an emulsifying ointment for her son. While the remedy worked for a while, the condition started to deteriorate.

In the months that followed, Judith would make numerous trips to the hospital while trying out other remedies recommended by chemists. None of these worked.

It was then that she was referred to Kenyatta National Hospital(KNH). At the national referral hospital, Baby Mustafa would be admitted in intensive care for a month, an experience that drained Judith emotionally and financially.

“My grandfather had to sell his two cows to raise Sh112,000 to settle the medical bill. My parents and I crowdfunded Sh70,000 to facilitate the boy’s other needs,’’ she adds.

It is now five months since Mustafa, now aged 10 months,  was discharged from KNH. His condition keeps declining. For Judith, visiting Nakuru County Hospital has become a daily routine. Without a permanent solution in sight, the mother is helpless.

Judith is not alone.

For Koneli Ngaira, baby eczema experience is a familiar and painful experience. From early days of birth, her now eight-year-old son had sensitive skin. At first, she thought it was just a normal rash that would go away after some time. Except it did not.

Koneli was lucky. Her parents are medics and they had seen the condition before. They recommended specialists for her son. The turn of events would surprise her.

“The first time he was misdiagnosed, we realised that the medication prescribed worsened the rashes. These would turn red, ooze water and blood,’’ recalls the founder of Brightlight Events and Digital Services.

Koneli was prevailed upon by her family to stop the medication. “To our surprise, it got better.’’

But only for a short time. She went on looking for help before finding a doctor who had just started her practice as a paediatrician. It is this doctor who would deliver an accurate diagnosis.

After being diagnosed as baby eczema, the doctor put her son on medication. Subsequently, he started to get better. “The rashes have since disappeared. Thankfully, he has strong immunity, according to the doctor, which has helped his recovery.’’

Having gone through this experience, she has words of encouragement to mothers with babies suffering from eczema. ‘‘It is a tedious and traumatic journey. It is especially difficult for a first-time mother. The government should do more to provide specialised care for these children.’’

Dr Janette Karimi, the head of newborn and child health at the Ministry of Health (MoH),  says eczema is a chronic inflammatory skin condition that frustrates many Kenyan mothers and their newborn babies. She discloses, though, that the government does not keep any records on the disease.

“It could be caused by many factors. These include genetic predisposition and the environment. The state of a patient’s immune system is also a possible cause,’’ Dr Karimi says.

She highlights that the disease affects up to 25 per cent of children, mostly those between zero and five years. An estimated 60 per cent of people with eczema develop it during their first year of life.

“Atopic” refers to an allergy. People with eczema tend to experience allergies or asthma along with itchy, red or hyperpigmented skin,” Dr Karimi adds. 

While there is no cure, most cases can be managed with a customised skin care plan. This may include applying moisturisers, prescription medications and strategies to eliminate triggers.

The American Academy of Allergy, Asthma and Immunology notes that eczema is a common chronic skin disease that typically starts in early childhood. ‘‘The skin becomes inflamed, red, irritated and scaly and chronic inflammation below the surface of the skin.’’

Patients with brown and black skin commonly develop small bumps on the torso, arms and legs too, the institution says, explaining that this condition can also occur due to a variation in a gene for a protein called filaggrin.

This alteration in the gene leads to a “leaky” skin barrier that allows excessive water loss from the skin.  This occurs in up to a third of people in Northern Europe and Eastern Asia.

The manifestation of the disease varies by age and race. Among people with darker skin pigmentation; lesions may appear more violet-coloured. In terms of global distribution, eczema affects 11 per cent of white people, 10 per cent of black people, 13 per Cent of Asian or Pacific Islanders and 13 per cent Native Americans.

‘‘It may occur on the face, arms, legs, hands and feet. If the skin inflammation is not well controlled, infections can occur due to bacteria, viruses or yeast,’’ the academy says.

Exposure to soaps, detergents, house dust mites, pollen, animal fur and some bacteria that contain proteases can all flare up eczema. Research shows that proteases can further weaken the skin’s ability to retain water. In this case, moisturisers are used to improve the skin barrier and retain skin moisture. Patients may need to try out different brands of moisturiser to find the right one for their skin.

The American Academy of Allergy, Asthma and Immunology says there are about seven types of eczema. 

1.  The first type is atopic dermatitis, which baby Mustafa is suffering from. The rashes form in the creases of elbows and knees, making the skin in these areas turn lighter or darker. It could also get thicker. Small bumps may appear and leak fluid when scratched.

 Babies develop a rash on the scalp and cheeks. Their skin may be infected when the rash is disturbed. Doctors say this happens when the skin’s natural barrier against the elements is weakened. Consequently, the skin is unable to protect itself from irritants and allergens.

2. Contact dermatitis. If one has red, irritated skin, thick scaly region caused by a reaction to substances they touch, they may be experiencing contact dermatitis. This comes in two forms, namely allergic contact dermatitis and irritant contact dermatitis.

Allergic contact dermatitis is an immune system reaction to an irritant like latex or metal. Irritant contact dermatitis starts when a chemical or other substance irritates one’s skin, according to the academy.

In contact dermatitis, the skin develops an itch, turns red and is hyperpigmented or pinkish. It may burn and sting. There is also the presence of itchy bumps called hives that may appear on the skin. Fluid-filled blisters may also form, ooze and crust over. After some time, the skin may thicken and feel scaly or leathery.

Common causes of contact dermatitis are detergents, bleach, jewellery, latex, nickel and paint. Others are poison ivy, poisonous plants and some skin-care products. Makeup, soaps and perfumes, solvents and tobacco smoke also cause this type of eczema.

3. Dyshidrotic eczema causes small blisters to form on the hands and feet. This one is more common among women . Fluid-filled blisters form on the fingers, toes, palms and soles of the feet and may itch or hurt. The skin can also flake out and crack. It is caused by allergies, damp hands and feet, exposure to substances such as nickel, cobalt, or chromium salt, stress and smoking tobacco.

4. Seborrheic dermatitis causes scaly, oily patches of skin that produce dandruff-like flakes. According to the academy, these patches often appear where there are more sebaceous (oil-producing) glands on the body. This includes the hairline, scalp, upper back, nose and the groin area.

Experts highlight that this type of dermatitis, which is caused by a combination of environmental and genetic factors, develops in infants and is commonly called cradle cap. It does not reappear later. However, in teens and adults, seborrheic dermatitis will most likely be an ongoing skin issue.

“First, a trigger such as stress or illness sets off an inflammatory reaction in the skin. This causes the oil-producing glands in the body to kick into overdrive and create too much Malassezia yeast. This is an organism that lives on the skin’s surface,” states the academy. When yeast grows too rapidly, the immune system reacts and causes a series of skin changes that lead to the development of the patches of skin common with seborrheic dermatitis. Other triggers are hormonal changes, illness, harsh detergents or chemicals, cold and dry weather, certain medical conditions such as Parkinson’s disease, psoriasis, HIV/Aids and acne. Some medicines such as interferon and lithium are possible triggers.  

“For adults and teens with this type of dermatitis, symptoms may come and go. They may also disappear for a while, typically in the summer, but return when tit becomes cooler,’’ notes the academy.

5. Neurodermatitis is similar to atopic dermatitis. Thick, scaly patches form on legs,  arms, back of the neck, scalp, foot, sole backs of the hands or genitals.

The patches may be extremely itchy, especially when the patient is relaxing or sleeping. When scratched, they can bleed and get infected. The academy explains that neurodermatitis usually starts in people who have other types of eczema or psoriasis (a condition in which skin cells build up and form scales and itchy, dry patches). Doctors do not know the exact cause of this form of eczema, although they admit that stress can be a trigger.

6. Hand eczema only affects the hands.  “One may get this type of eczema if they work in jobs such as hairdressing or cleaning with exposure to chemicals that irritate the skin.’’

7. Stasis dermatitis happens when fluid leaks out of weakened veins in the patient’s skin. It happens in people who have blood flow problems in their lower legs. If the valves that push blood up through legs toward the heart malfunction, blood can pool in the legs. This causes the legs to swell up and varicose veins to form.

These fluids can also bring about redness in lighter skin tones, brown, purple, gray or ashen colour in darker skin tones, itching and extreme pain.

“The lower part of the legs may swell, especially during the day when one has been walking for long. They may make the legs to ache or to feel heavy. Varicose veins are thick, ropey damaged veins in the legs and the skin,’’ says the academy, adding that one may develop open sores on the lower legs and on the top of their feet.

Nummular eczema is triggered by a reaction to an insect bite or an allergic reaction to metals or chemicals. It causes round, coin-shaped spots to form on the skin.

[email protected]