Sad but true...

Eleven days ago I treated a 6 year old girl with pretty bad malaria and anemia. (Hb 6.3). She tolerated oral medication well but because she had so many parasites in her blood I asked her to come for follow-up two days later. Although she was feeling a bit better on review and there were no more parasites in her blood, her hemoglobin was dropping (now at 4.6). Since she made a somewhat lethargic impression I thought it was better to refer her for a blood transfusion. After calling the doctor at the (NGO run) referral center I sent mom and child there with a referral letter, assuming the child would quickly improve after receiving a unit or two of blood. Sadly, I found out today that she died 4 days ago. She never went to the referral center, she never received blood. Instead her mother took her to some small clinic and the child only received iv fluids.

In a country where the child mortality rate is the highest in the world, I guess this shouldn’t take me by surprise. However, this child had passed the age of 5, supposedly suggesting that she had survived the worst. I guess not. I guess this explains the low life expectancy in Sierra Leone too. If only the mother would have taken the child to the referral center. If only the small clinic would have realized that the child needed a blood transfusion. If only we had reinforced the fact that without blood, this child just might die. If only children would stop dying from preventable and curable diseases.

If only…