UgandAshis 49 Fort Portal blues

UgandAshis 49

August 14, 2009

Fort Portal blues

Zuco 103 is playing in the background and I am reflecting on the day. It started with a ward round on the pediatric ward. One of my patients is a 7 year old girl with chronic osteomyelitis (bone infection) of the right leg. Often we have to ask patients to go to the pharmacy to buy drugs. I never realized that we have run out of canulas (to give i.v. drugs with). Therefore the patient’s family members have to go and buy it. The mother of the child was crying – and as I asked why she told me that she did not have the required 1000 shilling ($0.5) to buy the canula. Clearly I slipped the nurse a banknote so the young child could start her intravenous antibiotic treatment. The girl however has a poor prognosis as the treatment is at least 4 weeks in the hospital and the mother has to hustle for food for the two of them.

Another child has a similar problem. He is crying and shouting while complaining of severe abdominal pain. To rule out some of the possible causes we asked for some lab work to be done. As I returned the next day I realized that the sickle cell test had not been done. To do this test you require a certain chemical which is cheap yet is not available at the hospital. The discussion I had with one of the laboratory technicians was frustrating. He was narrating a story of chronic under supply of many chemicals and supplies. When I then asked him if I could do a blood film myself he became very defensive. It was not really possible unless I would come the next afternoon. In the mean time the patient is not responding to all the different drugs we are giving.

Still in the ward we have an 8 year old girl who had meningitis and is currently suffering from the neurological deficits that have remained after the infection. She has a lack of appetite, cannot swallow properly and is too weak to sit up. Another baby was admitted with failure to thrive, oral thrush and a chest infection. The baby is 1.5 months old and her mother is HIV positive. It is likely the young baby has HIV as well. A large proportion of our patients has malaria with vomiting, convulsions and anemia.

One of the most remarkable things about the pediatric ward is to see how fast children can rebound from potentially lethal disease. With over 100 admissions per week there are 1-3 deaths per week which is a very low number given the late presentation and the severity of the majority of the patients. Every day I visit the ward I learn and aim to teach as much as I can the clinical officers, nurses and young doctors that join me on the ward round. As my colleague is out to a training the work is mine to do and I Love it.

Namaskar,
Ashis Brahma