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Commence Final Week of Clinical Work Begins
Entry 26 of 41 | show all | print this entry |
I don't know why breakfast was as delicious as it was. It was the standard breakfast I have become accustomed to; an omelet with diced green peppers, two slices of fresh tomato, chips, tea, and biscuits. I suppose I was just hungry.
The formerly-monotonous drives to Balaka have become more interesting. This can be attributed to the book I have had my nose in. I can't put it down. If fact, right now I have the desire to stop and read. I wouldn't though. I have a commitment. Jitterbug Perfume can wait. After all, what would I do to expedite the drive to Balaka?
The morning was fairly busy at the clinic. Five patients were consulted. There were two cases that stood out apart from the normal gonorrhea, malaria, and pneumonia patients.
The child was 2.5 years old. He had been vomiting for the past three days. The well-dressed mother had brought him straight from the district hospital. The clinical officers there had prescribed to him fansidar and aspirin. Fansidar is supposedly a one-pill cure-all for malaria. Dr. C has never condoned the drug for malarial treatment. Neither has the WHO. I don't know why aspirin was prescribed, but it's foolish to waste time questioning the mistakes of others.
The child was visibly and audibly upset. Not once did he child stop crying during the exam. Going through the motions of a normal consultation, Dr. C took the child's temperature. When the temperature is taken from the armpit it should be very close to 97.6 degrees during normal healthy conditions. The thermometer read 103.5 degrees after Dr. C pulled it from the child's body. This was grounds for major concern.
Vomiting and high temperature was enough to diagnose the child with severe malaria. When malaria is this serious, the parasites have often migrated to the brain. This is known as cerebral malaria. Many die from malaria at this stage. Dr. C explained to mother that her child's condition was serious and life threatening. He made it exceedingly clear that immediate treatment was essential. The cost of treatment was a mere 800 kwacha ($5.71). Keep in mind, this mother was healthy, clean, garnished with jewelry, and stylishly fashionable.
"I only have 120 kwacha," said the woman seemingly unbothered by her inability to produce adequate funds. "I would like to consult my husband. We'll decide whether or not we want to pay for the child's treatment."
I think we were all generally shocked by her reaction. WHETHER OR NOT WE'LL HAVE THE CHILD TREATED? She handled the situation with such little care and concern. Her son was in a dangerously threatening state and she wanted to check with her husband?
With an indifferent expression she muttered, "I'll be back if we decide to have the child treated," and slothfully walked out.
Dr. C had adamantly explained the situation, yet this indifferent woman just left. She left with her dying child; her child who went without treatment. We found out later that Mrs. C had spent fifteen minutes prior just talking her into the consultation.
This was difficult for me to understand. I couldn't comprehend why this woman wouldn't have her child treated immediately. All she had to do was make a phone call on her cell phone to her husband. That was all. It wasn't as if money was an issue.
The mother and child did not return. The child went without treatment and is most likely dead right now. A two-year-old child is dead, because of the negligence of her parents. Is this behavior legal in Malawi? Legal or not, it's definitely not reported or prosecuted. How tragic.
What happened was hard to swallow. Dr. C explained how this situation is somewhat common. Children are neglected. Children die because of refused treatment. What's sad is that the dying children have no say. They don't have the ability to make or understand decisions. Their lives are in the hands of their parents, who at timeslet them die before they allow treatment.
Other patients filtered in. We were forced to put the patient behind us, maintain emotional distance, and move on.
The next consult was a first with respect to his illness. He was 25 years old. The right side of his face was severely swollen. It was as if he had been struck from the right with a 50lb. ping pong paddle. His right eye was nearly swollen shut. There was no bruising, abrasions, or lacerations, though. Upon removal of his shirt, it was seen that his neck was completely swollen on all sides. It was nearly as thick as his man's head. Extending down his neck, the swelling continued all the way down to his right shoulder.
When I palpated this man's neck and shoulder area, it felt hard like a rock. Like there was cement poured underneath his skin and molded to conform to the shape of his body. It was the one of the most peculiar things I have seen. The man said he had no history of trauma, meaning he hasn't endured and impact-related injuries. He also said that his face and shoulder have been swollen since February of this year.
What pain this man must have been in! Every time he used his arm pain shot through his body. His blood vessels throughout his neck and shoulder had been restricted for months. Severe edema was evident.
According to his medical history, he had been treated on three separate occasions for cellulitis. Each time, the treatment was unsuccessful. He came to Dr. C because each of the last three clinics attempts had been futile.
Dr. C was quite concerned with this patient. Dr. C prescribed some very strong antibiotics for a long period of time as well as steroids to reduce the man's painful swelling.
No more for tonight. I'll leave you with a quote from the book I have been reading.
"The word desire suggests that there is something we do not have. If we have everything already, then there can be no desire, for there is nothing left to want. We have it all, each of us, all the time. Therefore, desire is simply unnecessary. To eliminate the agitation and disappointment of desire, we need but to awaken the fact that we have everything we want and need right now."
Goodnight. The journey is still unfolding. More to come.
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| 26. | Commence Final Week of Clinical Work Begins - Balaka, Malawi Jun 26, 2007 |
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