Fieldset
Today is a Good Day

Today is a good day in the emergency department, however on other days it can be overflowing with patients and their caretakers. Different seasons bring different diseases and challenges. The most difficult thing, though, is seeing the high rate of child deaths.

Today, in Boost Hospital, it is a pretty calm day. The emergency department is not overflowing with patients, for a change, and we actually have an empty bed on the female inpatient department. Some days are better than others. Sometimes the emergency department is absolutely overflowing with patients, mostly female and pediatric.

At those times, the female observation room is so noisy and crowded it is hard to think. Each patient will have a caretaker with them, so there is no less than two people sitting on each bed, but often three to four people will crowd on, causing great confusion as to who are the patients. Our emergency department will see between 175-200 people per day, and our outpatient department will see an additional 300 people. When you consider that the number of people is double the number of patients, you can imagine the crowds and the noise. How our doctors and nurses manage in this mêlée is beyond me.

Gratefully, the burn season is about over now, and we are moving into the diarrhea season. I have never seen burn patients like we have had here over the winter. Often the burn victims are, again, women and children, as the women prepare the meals over open flame stoves and the children play around their mothers. We often had multiple victims from the same families. While we do our best, we lost quite a few of the patients to infections or they were simply too badly burned to survive. All we can really do is provide sterile dressings, increased calorie foods, and hydration. It has been hard to watch, and I am glad this season is pretty much behind us.

Certainly, the most difficult part of this mission, for me, has been the child deaths. Of course, everyone dies, but I am not accustomed to so many pediatric deaths. In Afghanistan, about one in 10 children die before their fifth birthday. While I knew this before coming here, nothing could have prepared me for the reality of watching it day after day. Some die of trauma, some burns, some disease, or malnutrition. For me, it is always a tragedy when a child dies and I feel it intensely. I am very grateful I don’t work in our pediatric ICU or our neonatal ICU, as they see much more than I. I think those nurses and doctors are amazing, in that they work with this day in and day out, and somehow manage to stay sane. I only see a small number of these children and it is very wearing on me. I really don’t know how they do it!

Today, however, it is a good day. I was greeted by a number of very healthy, laughing little girls, who all ran to tug on my dress and give me Pashto lessons. I got hugs from some of the little old ladies in the inpatient department and got some personal gratification in seeing a number of our patients discharged home. No one died in my departments today, and so, for me, that is a good day.

Tomorrow, I leave for Kabul for a long weekend. I’ll be able to eat in a few restaurants, catch up with some friends, and relax for five days. I am looking forward to the break.