Not Connaucht...

I have to admit that one of the mistakes I have made over the past 4 years was to send a 12 year old child to the main government hospital. Maybe it was bad luck, maybe it was this particular case, maybe I do not have all the facts, but I feel like this child’s fate was decided for him the moment he stepped into that hospital. Okay, so that’s probably not entirely true. I think he was so sick, that maybe the outcome would have been the same had he gone to the Children’s Hospital. Either way, things did not go quite right at Connaucht Hospital. I do not want to be too critical since I am not very familiar with that hospital, but I will tell you what happened in this one instance, as relayed by the family…

It all started late March. Actually, it started mid-March, because by the time I saw the child he had been sick for at least 2 weeks with a fever, headache, abdominal pain and bloody stools. He was staying with his granny who did not take him anywhere. It was only three days prior to seeing me that he arrived at his mom’s house, who immediately took him to the local pharmacy for ‘drips’ (iv fluids). On Monday morning he showed up at the clinic, too weak to stand. He was thin, jaundiced, had a fever, palpable liver and spleen, blood and protein in his urine, blood in his stool; in short, a somber picture. At 10 am I heard there was no bed available at the NGO hospital. I checked again at noon, but no luck, I would have to send to a government facility. By this time he had been in the clinic for 4 hours, drank 2500 ml of ORS, had 9 watery stools and was still looking terrible. Because the child was quite tall, and my staff thought that he would be too big for the beds at the Children’s hospital (on the main wards they only have pediatric cots), we sent to Connaucht. Later we found out that they do have ‘adult-sized’ beds on a ‘special ward’ at the Children’s hospital.

At 1245 the child was referred. At 630pm I called the family to see how the child was doing. He was STILL waiting to see a doctor. He had been at the “Emergency Department” since 2pm. Meanwhile he was still passing watery stools. I was furious, the family was annoyed. I called again and talked to a nurse. Finally at 8pm a doctor arrived and the child was seen. He was started on iv fluids and was told that in the morning, he would see the doctor again and be given a prescription for drugs. Talk about delaying treatment!

Day 2: I called the father. The child was again waiting to be seen by a doctor. By mid-day he was transferred to a ward, but still not seen by a doctor and so still not on any medication. Finally that evening he was seen by a second doctor and given a prescription.

Day 3: The father came to visit me and had the prescription in hand but no money to pay for the medication. He had paid Le 30,000 for blood tests ($10), Le 50,000 ($17) for a bed and Le 20,000 ($6) for consultation. I sent him off with some money for the drugs. The father was discouraged; he said 4 people died on the ward that day.

Day 5: I visited the child at the hospital. He was still very weak, sick and pale. He had been seen by a doctor and on the previous day two of his uncles had each donated a unit of blood. He was to be transfused today, but the nurse on the ward that day was not qualified to assist with transfusions. He would be transfused in the evening when the doctor was in. That evening the father called, the transfusion was put of until the next day. Another delay.

The child was eventually transfused, and did receive various medications. But it sounded like there was little improvement. For a little while I did not hear anything. Then, on Easter Sunday, the father called me. His son had died. It was the end of a drama; a bad ending. Who knows, maybe this child would have died no matter where he was treated. I do not even know the diagnosis. All I know is that there were numerous delays and a lot of money changing hands. And, that in the end, another life was lost. My lesson learnt was that I will stick to Children’s hospital if the NGO hospital is full.