Monday, January 26, 2009

Monday's thoughts...

11 hours and 45 patients later.
Time to think.
Or maybe it's better to stop thinking for a bit.
Time to rest.

This morning was strange.
With 35 tickets handed out there were still over 20 kids waiting in line.
Tickets done done I said.
And then diverted some of the children to other facilities.

It's hard to know how best to handle the line.
Take the first 35 or pick the sickest 35 (but who is sickest; potentially ever fever can be malaria)
One can argue that since we're outpatient, any we can't see can go to the hospital to be seen.
But then there's the whole financial dilemma; can they afford the hospital?

A dilemma that eats away at my conscience all day.
A severly malnourished girl at the end of the line.
See her anyway, or just tell her to go straight to the feeding centre.
She does not NEED a referral letter, she can just show up there, but can she pay???

A child with moderate to severe ARI.
Really just needs to be admitted and receive oxygen.
Should I have seen that child or just sent from the gate.
Not much I can do at our facility except maybe get the child into the NGO hospital.

An 11 year old with some dehydration.
Really the child was stable but definitely needed to be seen at a health facility today.
Did I have to keep feeling guilty for not seeing the child?
Or was sending her to a decent health facility 10 minutes away enough?

Maybe I will put my mind to rest and just remember the patients I did help today.
Because there were enough of them.
Some with small things and minor illnesses.
Others with malaria, dehydration, moderate chest infections, malnutrition, etc.

The most bizarre thought today was that while I was alone in the pediatric clinic,
there were 4 surgeons walking around in the VVF part of the centre.
Too bad they couldn't help me tend to the 20+ kids I had just sent away...
Why is it so hard to find a doctor to help out in the clinic?

In the end it was a good day.
Only sad part was that Namina is not looking too great. (see post)
Although not acutely ill, the hole in her face seems to be getting bigger rather than smaller.
And it saddens me to see her mom cry everytime we do the dressing changes.

Her mom is really worried that she'll lose her left eye.
And to be honest, I am a little worried about her eye as well.
I can only pray that the infection stops and that the destruction comes to an end.
And that the healing process begins...

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~ Act Justly. Love Mercy. Walk Humbly. micah 6:8 ~