She thought nothing of it when she first saw the small black spot on her face. But it got bigger and bigger – two days later it was the size of her hand and it had a putrid smell.
What was wrong with her? The diagnosis was far worse than anything she could ever have imagined: an aggressive flesh-eating bacteria was consuming her from the inside out.
Doctors had to remove dead skin and tissue during an emergency operation to try to stop the bacteria from spreading. If it succeeded in reaching her organs, they warned, she’d be dead in days.
This isn’t the plot of a horror movie. It’s the living hell Madelein Carelse (42), from Vanderbijlpark in Gauteng, has been in for more than a month. She contracted a condition called necrotising fasciitis – commonly known as flesh-eating disease – a highly aggressive and life-threatening condition caused by the bacteria Streptococcus anginosus.
When we visit her in the Midvaal Private Hospital in Vereeniging the left side of her jaw, neck and chest is bandaged. She’s accepted her disfigurement, she says. She’s just thankful to be alive. But she still can’t believe she landed up in so much trouble because of an abscess on her tooth.
Early in June Madelein, a stay-at-home mom, started experiencing toothache. “It hurt a lot, so I lay down and tried to sleep,” she recalls. But three days later the left side of her face was so swollen that her husband, Jacques Evert (42), took her to their doctor.
“There was a small black spot on her jaw by then. You could smell it too, which worried me,” he says. The doctor prescribed strong antibiotics and sent her home. “But the black spot just got bigger,” Jacques says.
“It was scary – you could see the infection spreading. Once the skin started turning red, it would be black 30 minutes later. Dead.”
Two days after the doctor’s visit, Madelein started complaining of shortness of breath, which is when Jacques took her to Sebokeng Hospital where the dead tissue was surgically removed.
She was discharged 21 days later but she didn’t feel well. Friends told her she “looked like death” and urged her to seek a second opinion.
When she arrived at Midvaal Private Hospital doctors had bad news for her: the bug hadn’t been entirely eradicated.
She needed more antibiotics and further surgery. Madelein has lost 12kg in the past month and now weighs only 42kg.
When she speaks, there’s a faint whistling sound – air escapes through her trachea when she breathes. Because of the damage the infection did, she had to breathe through a tube in her throat until a few weeks ago. “I felt as if I was dying. You get panicky when you can’t breathe,” she says.
Jacques shows us pictures of his wife’s wound after doctors cut away layers of skin and tissue at Sebokeng Hospital to stop the gangrene from spreading. In one photo the white of her jawbone is clearly visible.
He and Madelein met about seven years ago on now-defunct messenger app Mxit. They got married within six months of meeting.
“I’m a tough guy but it nearly broke me to see my wife like that,” says Jacques, a car salesman.
“She didn’t get to see herself immediately after the operation. I did, but I had to hide my feelings.” He cried a lot in private, he says.
Madelein explains both of them have been “in survival mode” for the past month. Jacques Jnr (20), Jacques’ son from a previous marriage, and Jett-lee (7), Madelein and Jacques’ son, are here too. Madelein has two other children, 18 and 24 years old respectively, from her previous marriage.
“I have to get well. Jett-lee and my husband need me,” she says, touching the bandages on her neck.
“The pain isn’t as bad anymore.” The couple don’t have medical aid so the extended hospital stay is taking a huge financial toll. Luckily, Charmaine Britz, a local Good Samaritan, started the We Care for You Madelein Club on Facebook, which so far has managed to raise more than R25 000 for her treatment.
“If it hadn’t been for people helping to get her in here [Midvaal Private Hospital], I don’t know what would’ve happened,” Jacques says. Madelein is still very sick, says hospital spokesperson Hettie Fowlds.
“The bug isn’t quite dead yet but we’re nearly there.” Her GP had prescribed the correct antibiotics, Fowlds says, but her body had already developed a resistance to them. She’s now on ones that seem to be working and have stopped the infection from spreading. Madelein shrugs and says she’s okay with how she looks.
“God made me this way.” But she acknowledges that her emotions have been up and down in the past month. “I want only the best for Jacques. He’s a good man but I started wondering if he’d be able to accept me if I look like this.”
“I told her I’m standing by her,” Jacques says firmly. “She’s my wife and she’s gold.” At the time of going to print Madelein had undergone an operation at Midvaal Private Hospital to close the hole in her trachea. Doctors also removed five of her teeth, which had been affected by the abscess. As soon as her stitches from her first operation dissolve she’ll be able to undergo reconstructive surgery.
“We have a team of doctors caring for her and we also have a psychologist supporting her,” Fowlds says.
Madelein gingerly gets out of bed for a picture. “Are you okay, Mommy?” Jett-lee asks, taking her hand. She smiles, then winks at him.
“At first he hadn’t wanted to visit his mom. It was too upsetting,” Jacques says. “One of his classmates’ mom passed away last year. I think he’s scared of that happening to him.
“Yesterday I told him his friend’s mom is with Jesus but his mommy isn’t going anywhere,” Madelein says. The couple never gave up hope during her nightmare ordeal. “When I walked past her hospital bed and gave her foot a tickle and she smiled at me crookedly, that’s when I knew everything would be all right,” Jacques says.