a friend of mine once told me of an idea for a newspaper that carried only good news instead of advertising avarice and fomenting fear. headlines like:
MAN OPENS ICE CREAM STORE
THE TEN MOST PEACEFUL PLACES ON EARTH
franck, our logistician, just stuck his head into my tukul and said, "the car just returned from the transfer... they picked up that woman, the one you sent down last week for surgery. she is fine. so is her baby. they drove her to her home. just thought you would want to know."
good news. even in a day where it seems far away, it can happen. just like that.
the patient we transferred down today, the other player in the patient shuffle, was a 3 year old boy who was bitten by a snake. his family waited for weeks before bringing him to hospital, and when they did last night, his leg was withered and useless. it needs to be cut off.
as the truck was being prepared for the three hour transfer to the nearest surgical hospital, where he can be offered amputation but no prosthesis, no replacement leg, we prepared the operating room. our plan was to more carefully examine the woman i spoke of the other day, the one with the severe burns to her perineum. she has continued to bleed, and we needed to find the source. we transfused her yesterday because we could not tell how much blood she had lost. the family had dutifully cleaned it up.
as we put her on the operating table, she arrested. stopped breathing. no pulse. alivealivealivedead.
we resuscitated her. breathed for her until she found the energy to do it on her own, gave her the fluid necessary for her heart to push out a pulse. within a few minutes, she moaned, confused, deaddeaddeadalive.
she had several long lacerations from the childbirth. most oozed blood, one pumped. we tried to close them, but every time the tissue was grasped with the forceps, it wept. we sutured the ones that were the most severe, and left the others open. they were all deeply infected.
i left the operating room to look for donors. it is a constant struggle here in sudan to find someone to give blood. they are afraid that what we take will be gone forever. no explanation to the contrary will suffice.
i found her group of family and acquaintances, explained the need and the urgency. they all shook their head, turned away. her father, the man who had donated to her yesterday, offered to give again. i told him he could not, that he should find others who would. anyone. tell them it's ok, that blood comes back. it's like your hair. it keeps growing.
i spent an hour arguing, imploring. of ten, none would agree. the father sat on a bed, holding his head in his hands. he was despondent. his daughter's fate was in the helpless hands of friends who drifted away, one by one.
without telling the family, i left to get my blood tested. so did two members of our staff. we resist this as often as possible, and some MSF sections forbid it. it is not a solution to the greater problem, and there are concerns that if the population knows we will give, they will be even more reluctant. further, if the outcome is bad, the blood can be a source of blame. but, the esotericism is best understood on paper, or in a blog. in the hospital, however, with a young, burned, bleeding woman, all that seems to make sense is working in units of one world at a time.
i got tested, and an hour or so later, found out i could give.. i asked our lab tech to do a cross match and screen me for viral diseases. as i sat outside the lab, waiting, my translator came and tapped me on the shoulder. there was someone who had come to donate. he pointed to a sunglassed soldier sitting on a bench in green fatigues, his cap askew. he had heard, somehow, that there was someone who needed blood. haj, our dressing room nurse, came up to me and, standing tall, said in thick English, "my sister's son".
i walked over to him, explained the procedure. he agreed. i'm glad you came, i said. may your kindness find its way back to you. he shrugged, proud.
we took a unit of blood from him, and it is dripping into her right now, red pearl after red pearl.
i will see her tomorrow, and if the family can't solve the problem, i will give her some of mine. it grows back. it's like your hair. we should all donate if we can, give someone good news.
after we resuscitated the woman today, and i left the family conference on a carpet of round refusals, i stopped by the pediatric ward to continue a discussion i had left the evening before. i was trying to convince a woman to allow me to start TB treatment on her child, but she refused. the medicines were red, she said. i told her that red medicines were the best, that they were the strongest we had.
i asked her again. no, she said, it was not tuberculosis. the problem was the bones in his chest, and if i couldn't fix them, she would leave. her child who was lying listlessly beside her, began to
wail. behind me sat two more children, teetering on the fence, their mothers watching the battle carefully. in the middle of it, another family walked into the room. it was of a patient who i had admitted for malnutrition twice before, and here she was again, a third time, bones tied to bones.
i have to stand outside for a minute, i told my translator.
i stood outside, and listened to the wailing. i thought about counting the days left but decided against it. instead, i counted out a few deep, slow breaths and went back inside.
he starts TB treatment tomorrow. good news.