Sick sick...

Today the children were quite sick. "Sick Sick". 1 out of 3 had malaria today. And two of those had to be referred.

Christiana is 3 years old and was sick for a week before her mom brought her to the clinic. She had been giving paracetamol at home. Not only did she have a lot of malaria parasites in her blood, but she was also anemic resulting in shortness of breath. Although she took her oral malaria medication fine, I ended up sending her in for admission due to some respiratory distress. She was also underweight at 10kg.

Gifty is 10 months old and had also been sick for a week. Her mom had been giving her paracetamol and aspirin. She had a fever, diarrhea and vomiting. Her blood showed some malaria parasites in her blood as well as a milk anemia. She also was breathing very fast at 82 breaths a minute. I monitored her in the clinic for awhile, but by early afternoon she was not looking much better, so I referred her for admission.

Respiratory problems were also a bit of an issue today. There were a number of colds and coughs, a few kids with bronchiolitis and two kids with more severe respiratory problems.

Alison is 2 months old and has been sick for the past 2 weeks. Two weeks! Today he was breathing at 80 breaths per minute. He was having major coughing spells and could hardly get any normal breaths in, much less breastfeed well. His mom had gone to a pharmacy(!) and bought various syrups (antibiotics etc.), all of which did not help. I sent him to the hospital fairly urgently for admission.

Unisa who is 7 years old was also breathing fast. His aunty who normally takes care of him had gone upcountry for over a month. When she returned to Freetown, her nephew was sick. He has had a fever, cough and weight loss for over a month. One month! He had been left in the care of a 17 year old. Obviously not much had been done for him. He was very anemic as well as jaundiced, very very skinny and had various other problems. I am actually treating him as an outpatient for now but did refer him for a chest xray as well as some other blood tests. I will see him again later this week. An interesting case.

Then for some bizarre reason, I have seen 2 children with Burkitt's Lymphoma in the past week. I saw 6 year old Mohamed last week with a large tumor of his right jaw and referred him to the Children’s hospital for further treatment. He came back to see me this morning to take care of some logistical (read ‘financial’) issues. I then went out to the gate and was met by another child with a large facial mass. This was an 11 year old with a 6 month history. This child actually sought help at various places but due to financial constraints had not been able to get the correct treatment. Sad but such a reality here. The other reality is that Burkitt's remains difficult to treat in Salone- lack of medications, cost of drugs, uncertain protocols, failure of follow-up. We'll see how much I can help, and what can actually be done for these two at the local hospital.

It’s been an interesting day. Long but good. And now it’s time to get back to some packing…