Make haste...

There are few times in Salone that people hurry. Unfortunately, one of those times is when a person is very ill needing urgent medical care. Often it is parents frantically rushing to the hospital with a sick child they have kept at home for too long. When the child is near death they run, expecting the doctor to be able to do a miracle. Of course, there are cases in which the child has not been sick for very long but gets very sick quickly and needs urgent care.

The times that I am making parents rush like mad, and calling out 'make haste' is when a very sick child comes to the clinic and needs to be referred from the outpatient clinic to a referral hospital. "Make haste" I say when I hand them their referral letter and send them outside with a nurse to charter a taxi to the hospital. To be honest, it's not like they can speed up the trip, traffic is traffic. However, what I really mean is: go straight to the hospital. Unfortunately in the past some mothers have gone home first. This leads to various outcomes: they delay admission, they reach the NGO hospital too late and the bed is taken, they wait too long till the child dies at home, the relatives discourage the mother to take the child to the hospital. When I say 'make haste' I mean get to the referral center as fast as possible.

I used this phrase a couple of times today. I referred 6 patients of which 4 were very sick and 2 were sent for non-urgent matters (physio and to start TB treatment). I hope they all arrived at their destinations in time. I worry about some of them. But, what can I do now. I have seen them. Assessed them and sent them on for further care. These are the children that were rushed off today...

- A 3 year old weighing 9.7kg. Kwashiorkor malnutrition needing urgent admission at the therapeutic feeding center downtown.
- A 10 month old with a bacterial skin rash, moderate anemia and respiratory distress. Possibly septic. Needing urgent admission and sent to the NGO referral hospital
- A 1 day old brought to the clinic at 230pm looking as blue as a smurf. Multiple congenital defects including cleft lip and palate. Very floppy. Mother ran away after seeing the child. Here with father and granny. Sent to Childrens Hospital in desperate need of Oxygen. Unfortunately I think the chance of this child's survival is nil.
- A 2 year old with severe malaria. Deteriorating during the day so in the end sent to the Childrens Hospital for iv quinine.

I hope they all took my advise and went as quickly as they could to the referral centers. What can I say. It has been a long day. And I suppose an even longer one for these families...