Introducing...

Aminata* and her 9 month old son, Alpha*, came to our center on Wednesday the 19th of October after a day long journey from Kabala to Freetown. Aminata was to be admitted for her vesico vaginal fistula operation.

They arrived at the center just as I was leaving for the day. However, it only took a minute to see that the baby was pale, had a terrible skin rash (scabies with infection), was underweight (5.6 kg) and had pneumonia. I had a few minutes to get him started on the proper medication, before going home. The next morning I did a complete examination- the baby had developed a fever overnight, had a large spleen and was quite pale. He was vomiting and not tolerating oral medication. Blood tests confirmed malaria and a hemoglobin of 5 g/dl. Usually when treating a VVF patient’s child it is like treating one of the out patient children- see the child, prescribe medication and explain to the mother how to give them. The only difference is the out patient children go home, the VVF patient’s child stays on the ward. With Alpha, I knew it was not wise to treat the baby as an ‘out patient’ on the ward. What made the decision of what to do difficult is that I knew that Aminata’s surgery was supposed to get her surgery within the enxt hour. I decided to cancel Aminata’s (elective) surgery and refer Alpha to the pediatric ward at Emergency hospital. In the end it was good that the child was referred- his Hb dropped to 4.4 g/dl and he ended up needing a blood transfusion as well as intravenous antimalarial treatment.

On Monday the 25th mother and child returned to us. Alpha looked much better. He did still have a chest infection and scabies, so I treated those and checked up on him everyday. I also had to make sure he was breast feeding frequently as well as eating solid foods. He was a joy to have around and it was great to see him improve so much. Aminata was able to have her surgery the following day and recovered quickly. Two weeks later, on November 9th, we were able to send home a healthy dry mother and a healthy happy baby. It was great to be a part of their lives.

*names have been changed