I’ve been here for a few weeks now and I feel as though I’m adjusting to the routine and finding a rhythm. This is largely due to the national staff who I am lucky enough to be working with. Many of them have been working for MSF for several years and they have all been very accommodating. Though conditions are tough here the local staff members work through adverse conditions and hot, hot days.
Due to the heat one of the difficulties we face is managing children with a fever. Most of the sick children in the clinic are already malnourished and have difficulty regulating their body temperature. Despite the use of medications and fluids many fevers persist longer then we would hope. The hospital building where we have our inpatient wards has been without city power for three days now and our generators are only able to provide power every 2nd hour. This results in the hospital wards being 40+ degrees Celsius. How do we bring children’s temperature down without A/C or even fans? At the moment we try to use cool water (although even this is difficult to maintain) to sponge their foreheads and the mothers are constantly hand fanning their children. Unfortunately the heat and the distance from families results in some parents deciding to take their children home before they are better.
This week I visited one of our outposts where we run an outpatient feeding service for severely malnourished children. The clinic is in an old ministry of health building which is also used by several other services. The inside was dimly lit with only a few lights. From the front entrance you could see the building was crowded. Mothers holding babies with small children at their side filled the corridor and were coming in and out of rooms. Parents and siblings jostled at the MSF desk, each trying to get their child seen next, and the crown controller struggled to keep everyone in line or at least some sort of order. Half way through my visit the power died, the fans stopped and the lights went out, leaving only natural light to examine children and dispense medications. However there were still many more patients to see so we worked on through.
One small child with his mother had a fever and looked unwell. I wanted to send him to our inpatient ward where he can get 24hr treatment, however the ward is 40 minutes away by car and even though we can arrange travel the mother wouldn't go as she has a sick husband and two other children at home. The best we cold offer was to show her to the ministry of health clinic which isn’t open 24hrs but she will be able to come back the next day if her child needs more treatment.
It was a busy day and many children were screened, reviewed and given another weeks supply of plumpy nut (fortified peanut butter). They will come back again in one weeks time and repeat the process until the have gained enough weight and are healthy again. Hopefully next week when we return we can try to fix some of the problems with lighting, power and overcrowding