Who is Pika?

Pika is a seriously disabled child who was required to beg in the streets of Bali for many years.

In December 2009, Pika was rescued by the Bali Street Kids Project (www.ykpa.org). Her care has required extensive treatments, many medical specialists and transports, as well as social working to help her and the other children adjust to a normal life. She endured 4 surguries in 5 months, the last was life saving. She needs ongoing medical and social care for her to become a normal kid; and donations to afford it all. Please read her story (from the bottom up

Friday, June 11, 2010

Sitting up after almost 2 months down!

JUNE 7, 2010: Between surgeries and now since the last one,
Pika has been visiting her neurosurgeon Dr. Cok, at the hospital every Monday (when not in the hospital as a patient) for her endless post-surgical checks. She has had to go to there in the back seat of a taxi lying down, as the orphanage little jeep doesn't fit her well, and then carried to a hospital rolling bed. An expat friend of hers gave her a pretty scarf to wear now that she has no hair.

Pika reached a milestone, as Dr. Cok said she was ready to sit up for brief periods, but can still not lean back for some time to come. For the first few days, Pika became nauseated and vomited after sitting up for just a few minutes. Over the next week, she has slowly adjusted, and now sits up for extended periods.

After so many years suffering the humiliation of being on display from her deformities on the streets begging, of living in squalor and constantly smelling of urine and in social and intellectual isolation, she has now had to endure the loss of her (diseased and deformed) lower leg and forced to lay flat for 2 months loosing most of her body strength. She must now exercise carefully to be able to once again use the crutches we gave her after loosing her leg. After some time, she must learn to use a prosthetic leg, learn to read, learn math, and learn some skill to see her through life. She really likes the sewing classes she started when first in the orphanage.

A local NGO, Yakkum Bali (http://www.yakkumbali.org/en/home/index.htm) is going to provide a prosthetic lower leg, and two expat physical therapists will also assist her with physical therapy for recovering her strength.

Currently, Pika's outpatient medical care is costing about $85 USD/month. This is in addition to the $12K already spent.

PHOTO: Putu feeding Pika in the hospital.

Post Surgery (we hope)

JUNE 4, 2010: Pika came home from the hospital today, with no hair and thinner than ever after being required to lie on her belly for some 7 weeks so far. The other kids in the orphanage must hardly know her now that she has been gone so much to the hospital, and the girls are in fear of having no hair like her.

With the just recent renting of additional buildings for the orphanage, big renovations are happening these weeks, meaning big mess everywhere. The only good place for Pika is in a clean room that is somewhat isolated, meaning she is isolated even more from the other kids.

Every day we check her back in fear that her sutures are leaking again, but no, she is still okay.

Thursday, June 10, 2010

Surgery 2, 3, and 4!

MARCH 2010: After much daily attention, it became clear that the large ulcer to Pika’s foot was not healing and the bones of an already badly formed foot had been too damaged by years of ignoring the infection. The doctors were saying “amputate the foot”!

Amputation was Pika’s first surgery. We gave her lots of support. We showed her youtube videos of kids playing football with prothetic legs like she would have later, even one of a horse with the same. She cryed, was afraid, and went into surgery holding… not her mother or fathers hand, but Putu’s hand (YKPA Founder). Putu was her new mother.

Before her amputation was healed, her neurologist was telling us he wanted to put her on the ‘urgent’ list for rep
air of her spina bifida lumbar mass. This should have been corrected as a baby, but the parents are poor and from a remote village, with no education. The parents told us later that they took her to the local village healer and asked him about her 15cm round mass, and was told to not do anything about it, because it was given to her by God. Sad that he didn’t know that these birth defects will slowly cause the loss of all nerve function to both legs as well as bowel and bladder function loss. When we found her she had already lost bladder function and both lower legs were numb… the cause of her getting the infection in her foot which caused her to loose the leg instead of having it surgically corrected as a young child.
APRIL 2010: Pika was into her second surgery for correcting her spina bifida, before her leg had healed. There are two main complications in this type of surgery that happen occasionally to some children. Pika ended up with both. First, because her body kept making enough spinal fluid to replace what was lost with the mass removed, she started leaking spinal fluid from the sutures… a lot! We found her sitting on the floor with a wet shirt and shorts, and as usual, not talking. This led to an outpatient procedure of resuturing the surgical wound. Unfortunately, this leak happened again and again, and finally resulting with infection setting in. The infection entered her spinal fluid tract and caused meningitis, for which she was hospitalized immediately for her leaking fluid, headache, and fever. This is the other of those complications that happen. Now she had both!
Quickly Pika was started on IV antibiotics and went in for surgery #3 to repair the leak again. It took only a few days for the neurosurgeon team to realize that she was going to keep leaking spinal fluid and that she needed what some 80% of kids with spina bifida require… a plastic tube ‘shunt’ ($1000 USD for that tube) placed into her skull to drain away excess
fluid into her abdominal fluid. She went into surgery #4, this time crying more. Her threshold of being ‘strong’ was passed.
Two weeks later, she was discharged to ‘home’ (the orphanage). She was to continue what was now almost 6 weeks of lying on her belly in bed to heal.
It is easy to forget Pika has parents, as the father has not returned for 4 months, and the mother only sometimes visits. However during the events around surgery #4, her mother visited the hospital once and the orphanage.

PHOTOS TOP: Putu YKPA Founder consoling Pika before her amputation surgery.
PHOTO BOTTOM: A fellow patient in the hospital came to give Pika some emotional support after she awoke from surgery in shock at having no hair.

Pika's story: December, 2009 to June, 2010

DEC 2009: The life of a neglected and abused 11 yr old child changed dramatically.
Pika (her new name), after being brought to a hospital for medical care again by the efforts of the Bali Street Kids Project (YKPA), was finally assigned to living in the YKPA Orphanage, with her father threatened with jail if he took her away again. This came about because over the previous year, several different expats had gotten Pika to medical care, but while doctors who wanted to have her admitted for care were looking elsewhere, she was spirited away by her father. He took her back to his daily routine of, as he readily admits, his using her for begging.
Pika and her father both lived in the orphanage for a few weeks, where he kept her isolated from the other children by constantly sitting with her and whispering. As she began being taken to the many medical evaluations needed, the father quickly stopped his attention and left for increasingly longer periods.
Pika life before all this was one of accompanying her father on his back around the tourist areas of Kuta Bali. Sometimes she would sit on the road side alone begging. Since being ‘rescued’ from this life, many local Balinese and expats have recognized her as the sad looking child they didn’t know how to help, besides giving her father money.

Pika lived with her mother, father and brother in a very poor shack, next to a rubbish area in Denpasar Bali. Her parents are from a poor remote village in the environmentally harsh area of eastern Bali. Most of the ‘street children’ who are ordered to ‘work’ by their parents in the tourist areas of Bali come from this area.

JAN 2010: The YKPA Founder, Putu Etiartini and volunteer began the long process of getting medical care for Pika. Over the next 5 months, the trio repeatedly visited multiple medical specialty clinics at the crowded public hospital in Denpasar. This included pediatrics, dermatology, neurology, orthopedics and surgery and required many xrays, scans, and
laboratory testing. The cost of this care initially came from the orphanage savings, and was slowly supplemented by concerned expats.
Her medical problems were found to be the following:

* Anemia and underweight (the first month of living in the orphanage, she gained 4 kg)
* Small
for age (stunted)
* Birth defects: right club foot, left foot tendon weakness, large spina bifida mass to her lower back with associated progressing neurological damage causing loss of feeling to both lower legs
* Loss of bladder function (incontinent of urine)
* Large, deep and foul smelling ulcer to her right foot with multiple drainage points, diagnosed as osteomylitis which had ‘eaten’ a large amount of the bones to that foot.
Socially, her problems were found to be the following:
* Very poor personal hygiene
* Socially isolated (it took a month for her to start smiling and talking)
* Total illiterate, had never attended any school, and did not know the days of the week
* Little enthusiasm to interact with the other children, who shuned her because of her smelling of urine and foot infection
* She had no interest in learning, seeming content to sit quietly alone

PHOTO TOP: The public hospital emergency staff checking Pika's foot.
PHOTO BOTTOM: Pika's badly infected foot with multiple bone damage.

The purpose of this blog

Pika is an abused and neglected child with multiple birth defects, physical and social problems, and entrusted to the care of YKPA, an organization helping street children in Bali Indonesia.

She needs a large team of people to help her heal her previous trauma, and afford the cost of her care.

The following posts will first give her history and history of care at the orphanage, then follow her ongoing care.

We hope you will join her team, and how about following her story at the link above!

PHOTO: After years of being carried around and having to beg, Putu got the police to finally stop it!