A difficult week...

This week is not over yet, but already it has proven to be a difficult week. One day this week 4 children died within a 5-hour period. It was a difficult day. I was actually only involved with two of the patients, and only towards the end. Still it was emotional. The magnitude of death was overwhelming.

As I walked through the corridor towards the Emergency Room I passed a mother and aunty wailing. They were frantic. I assumed that either a child was dying, or had just died and thought I better check if anyone needed a hand. I went into the very low-tech ‘intensive care’ unit with over 30 patients and saw the VSO doctor and nurse resuscitating a child. After checking the blood sugar and getting an airway for the child we assessed what could still be done; unfortunately, not much. The child was on appropriate medication, on oxygen and receiving emergency care at the level at which it can be offered at the Children’s Hospital. What more could we do?

Silently the father sat nearby. Watching. Waiting. There was nothing he could do either. We soon realized we had to come to terms with the fact that we could not save this child. He died. As we went over to condole the father, tears welled up in his eyes. He was speechless. The aunty, who had been looking on during the resuscitation, started wailing again. Another 5-10 minutes later the child’s mom came in. Her wailing was ear piercing. I cannot begin to describe it. It was pure, raw emotion. It was the sound of a mother losing her beloved child. Watching the mother grieve over her child and seeing the father in a trance brought tears to my eyes. On the bed opposite the patient sat a mother cradling her own child, tears rolling down her face. Other mothers were trying to encourage the distraught mom. And as I listened to what the mom was crying out I sensed her desperation. “I have given birth to two sons, and now I am left with none.” This mother had already lost a child. Today she lost another. Heartbreaking.

Around the same time, a mother and child came to the Emergency Room. Two months ago the child was referred to the hospital due to severe malaria but made a quick recovery. This time the child was referred due to convulsions and pneumonia. He was seen by the doctor in the Emergency room and commenced treatment. Four-hours later I saw him again, looking worse. His breathing was very labored and he was very irritable. It was worrying. The doctor reassessed him and the care available was continued. I left there that evening not knowing if he would pull through or not. Sadly, the next morning I found out he had passed away. I felt awful. I knew that another family was grieving the loss of their child. And I felt it even more since it was a family I knew. I questioned everything that had been done, wondering if we could have done things differently. I do not know that we could have. For some incomprehensible reason, this child passed away.

Working at the Children’s Hospital is tough. It is challenging to deal with the constraints, difficult to cope with the deaths and frustrating managing the slow pace. There is still so much to be done. Yes, the hospital has improved greatly since I first arrived in 2005, but the road is still long. Fortunately, working here can also be rewarding. We have some great projects underway, such as the development of the laboratory services and starting up a postgraduate training program in pediatrics for doctors. And yes, children do get better everyday. While attempting to resuscitate the boy, the little girl lying next to him on the same bed was struggling to fight meningitis. Now, two days later she looks much better. Likely she will survive. And that is our aim; improving pediatric care so more children will survive. That is what I am going to hold on to for the rest of this week.