As you all probably know, I’m no longer in Matoso. Through a series of visa issues and other unforeseen circumstances, I was transferred to Lalmba’s other facility in Chiri, Ethiopia. This is a very different facility in that it has a 14 bed inpatient hospital in addition to the outpatient clinic and children’s home. Chiri is at a very high elevation and a very different climate than Matoso, so we see very different illnesses. Life is always an adventure and always gives us opportunities to learn. So, by way of introduction to Lalmba Chiri, here is a tour of the inpatient ward and the patients we are caring for there today.
In the first bed is an 8 month old with tuberculosis. He has been coughing for 4 months and now has pneumonia on top of it. He also has a giant lymph node on his neck that may or may not be TB. Oh, and he has a vitamin D deficiency, too. But, he is doing well on antibiotics and we have talked to the mom about making sure he gets enough sun exposure. Unfortunately, Ethiopia has a shortage of Vit. D supplements so we can’t provide it to the family.
The second bed is a four month old girl with pneumonia. She has scars all over her abdomen from visits to a traditional healer. The method of drawing out anything bad is to burn the skin over the affected area. The burns are healing without any complication, but the cough continues. The good news is that she has been weaned off oxygen and is breathing fairly well on her own. We are just waiting for the fever to subside.
The third bed is a one month old boy with apnea. When he came into the clinic he would stop breathing every 3 or 4 minutes. His heart rate would slow from 140 beats per minute to 40 beats per minute. Finally his brain stem would kick in and wake him up, but he was getting so tired. He’s been on IV medication for over a week and has not had an episode. Now we are weaning him off and seeing how he does. Hopefully he’ll go home soon.
Bed four is a baby who is going home tomorrow. He was admitted with dehydration and pneumonia, but is now eating and drinking well and his lungs sound great. His parents, who can’t be more than 16, are getting prepared for the 6 hour walk home.
Bed five is empty. There was a two year old girl with a lung infection. She had been improving and then took a turn for the worse. The referral hospital didn’t have the equipment to treat her and the family didn’t have any money to pay them anyway. We told the grandmother that we could try one other antibiotic and keep her on oxygen, but the grandmother declined. She wanted to take the child back home to see her mother before she died. We had to respect that decision. Unfortunately, they live a 2 hour walk from Chiri. Without oxygen the child likely died in her grandfather’s arms on the way.
Bed six has a little boy who came in severely dehydrated. He got IV fluid and hasn’t vomited since. Right now, he’s screaming his lungs out and trying to pull out the IV. Around here, that’s a really good sign. He should be going home soon.
The three beds in our isolation room are filled with adult TB patients. One is a man with very severe anemia. He has been on TB treatment for 2 months, but is still coughing up blood. Fortunately, his anemia has improved with Iron and he has not required a blood transfusion. Another is a man who came in with pneumonia and then revealed that he had been coughing for a few months and had lost a lot of weight. So, we started him on TB treatment, too. The last is a woman who came in so weak that she could barely stand. She said that she had only been coughing for five day. We did a test anyway, and, sure enough, it was positive. So, she went to join the isolation club and started on antibiotics and IV fluids.
The last patient is in our malnutrition room. His mom is one of the patients in the isolation room. She has been so ill that she has not been able to feed him well for almost a month. He is 5 months old and looks like a newborn. But, he is hungry, which is a good sign. His goal is 1 ½ cups of special formula a day; he is averaging 3 cups. We will treat him with the formula until he gains weight and mom is able to feed him at home.
So, those are our patients. What I have learned during my time in Africa is that if you focus on the patients you can’t help, you will lose hope. The only thing you can do is focus on the victories and know that you did the best you could for the others.
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