Monday, February 11, 2008

Will this child survive...

At around 11:15 am 2 ladies enter the clinic with an infant.
He is 4 days old.
The nurse is quick to check the child’s vital signs and weigh him.
It’s then that I happen to enter the room.
I see the baby.
He looks very ill.

There is a history of prolonged labor.
Supposedly the child did not cry for the first 24 hours.
When he was 2 days old he was taken to a pediatrician.
The note states that he was having spasms, was cyanotic (blue) and cold.
He was treated with diazepam, 1 injection and a sugar-water solution.
He was referred to ‘somewhere’ for further management.

They did not take him anywhere else that day.
And on Sunday they also sat at home with the child.
Only on Monday morning at 11:15 am did they go seek further help.
They came to us.
A place that does not admit.
A clinic struggling to refer some of its patients for quality care.

The child is breathing.
His heart is beating.
But that’s about it.
For the rest he is floppy and lethargic.
He is not breastfeeding.
He looks like skin and bones.

I call the NGO run referral center.
They can’t tell me yet if they have beds.
I am caught face to face with the very recent dilemma of referral.
For some reason I am struggling to send my patients to the NGO hospital.
I have to call back at noon to hear if they have space.
The next 20 minutes feel like hours.

Meanwhile the mother is starting to beg, “please help us”.
I tell her I am trying.
Not realizing how stupid it is that she hadn’t been breastfeeding her child,
She was asking me to do something.
It is her first child.
Maybe she really doesn’t know what she’s doing.

Finally it is noon.
I call Emergency.
They have one bed.
We have 2 patients to refer.
This baby is worse off than the other child.
He is lucky to get the bed.

As he heads off in the taxi I am left with many questions.
Why didn’t they go to a hospital sooner?
Why did a pediatrician prescribe sugar-water solution?
Why don’t mothers learn to exclusively breast feed?
How many of these children don’t end up going to a clinic/hospital?
How many more children need to die due to ignorance?

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