Fieldset
The Perfect Storm

Today is a rainy day in Aweil. This should not be surprising. After all, it is the rainy season here, but up until today the weather has not been all that different from Florida.  

Today is a rainy day in Aweil. This should not be surprising. After all, it is the rainy season here, but up until today the weather has not been all that different from Florida.  

A lot of heat and humidity, a quick rain in the afternoon or early evening and then some cooler temperatures as the rain clears (and by cooler, it maybe goes to the 80's from the 90's). Today though, the sky let loose, thunder and all.  

So as I sit in my tukul trying to stay dry, I figured it was a good time to blog, as some days in the hospital feel like the perfect storm.

This week, a mom brought her four day old, less than two kilogram newborn into the hospital for poor feeding. It was a Thursday and the child was born prematurely on a Monday (home births are extremely common here). Mom states the child has never gone to the breast. Four days now and per mom the baby has never fed. On arrival, the baby was ill appearing, had a very low level of blood sugar and a heart rate close to 60 per minute (very low in a newborn) and the infant was gasping for air.  

I asked mom why she waited until today to come to the hospital and her response was that it has taken two days of travel for her to get from her village to the hospital.  

Two days with a very sick infant must have felt like an eternity.  

We quickly warmed the small infant, gave a bolus of sugar water through a feeding tube while trying to get an IV line in place, and ventilated the baby (helped the baby to breathe). The baby started to perk up a little as her blood sugar level improved and we secured an IV to give more fluid and to give antibiotics. We also placed the child on oxygen to assist the breathing.  

The child remained stable for quite a few hours but sometime during the night she passed away. I will never know the exact reason the child passed as I was not there but I do know two days of travel for help is two too many for a child that fragile.

To come so far and to still lose the child is so heartbreaking for me.  

I cannot begin to comprehend the struggles of the families here.  

Our hospital is the only option in this region. It serves thousands of people and most travel from far locations to reach us. When facing the loss of a child, I often have to remind myself of the numbers we save. More than nine out of ten children admitted to our hospital go home healthy. A lot of what our hospital has been able to treat is miraculous given the limited supplies we have. We treat severe malaria, neonatal tetanus (which has a very high mortality rate), burns, wounds, meningitis, respiratory infections, preterm infants, diabetics, animal bites, and the list goes on.

Our obstetric team brings many healthy babies into the world every day.  

But I still struggle with that one, the one that does not make it.  

I have cried every time I lose a child (those that know me are probably not surprised as I may be described as sensitive).  

Most of the time the families are the ones telling me not to cry. They tell me they know I did what I could so they place no blame as this is the plan of god. They accept that not all children can be saved, but coming from the world of medicine that I come from, I struggle with each loss because I know in a different setting many of these children could survive.  

But I also know, that without the work of MSF supporting this hospital the number of healthy children would be nowhere close to one hundred percent.