Why oh why...

I ask myself this question over and over.
I also ask my patients’ parents this question over and over.
Why oh why do they not take their children to a decent hospital sooner?
The most common answer: no money.
Other answers: aunty said to try syrups first, father said to go to the pharmacy, the father was upcountry and so the mother was waiting for his return to get money, decided to go to a nurse’s house first, and the list goes on.
Basically there’s never really a good reason.
Granted, many clinics are not great here.
And the city is overloaded with pharmacies who love to do business.
But it’s still not a great excuse.
There’s our clinic, a few other decent clinics, a Children’s hospital and NGO hospital.
No need to sit around and wait till the child is ‘sick past mark’!

Today a mom came with her almost 2 year old.
She’s brought her to the clinic at least 2 times previously.
They had gone upcountry for a month and returned to Freetown exactly 3 weeks ago.
On arrival in Freetown the child became ill.
How long did it take her to come to the clinic?
Three weeks.
Why?
Because she had no money to come to the clinic.
What did she do instead?
She went to a pharmacy where the child got half the dose of malaria treatment needed!
Now, after being sick for three weeks the child has an Hb of 4.0 g/dL.
She is ‘white past mark’ and needs a blood transfusion.
How much did the mom spend at the pharmacy?
At least Le 5,000, if not more like Le 15,000.
How much would she have spent at our clinic for consultation, lab, medication?
About Le 2,500-3,500 - total!

Another mother came with her 5 month old.
He has had boils and a fever for some time now.
Why did she not come to the clinic sooner?
The aunty said to go to a pharmacy first and try syrups, so she bought ampiclox.
The child’s fever continued so she finally came to the clinic.
And yes, the child had a few boils left, but surprise, the blood also showed 3+ malaria!
Again, why didn’t she just come to the clinic to begin with.
Do these people not realize that the pharmacies here are run like business.
The more medications they sell, the better.
No prescriptions are needed here, basically the employees decide what meds to sell!
So, yes, the syrup from the pharmacy can sort out the boils.
But in the meantime the malaria parasites are increasing by the day!

Why oh why do they wait so long?
They end up wasting so much money on medications bought from nurses and pharmacists.
When what they actually need is a decent consultation, lab tests and specific medication.
It’s no wonder so many children die here.
Parents keep them at home so long trying all sorts of things at home until their child is ‘sick past mark’ and then rush to the hospital, often too late!
They wait so long that either they end up spending a lot of money once the child is admitted or they wait so long and the child is dead.
When will they learn?