Triage: to prioritize which patient gets treatment first, or even at all. Not to be confused with the French word "tirage", meaning to hold a draw. as in, "the luck of the..."
I have three patients to transfer to Kilwa but I only have room for two in the car. So I decide that the woman who is most likely dying of aids and the little girl who has something very wrong with her eyes get to go. The woman is so weak and if I leave her she will die. If I bring her she may die anyway, but I can't leave her behind. The little girl arrived at the last minute. There is no more white left in her eyes, only blood red and I don't know what to do for her, but I am worried she could go blind. This means that the Papa with the malnutrition and severe bilateral, pitting oedema that I had planned to transfer has to wait until next week for a spot in the car. His feet are so swollen that he can barely walk as it is, so the two-day bike ride, if you are lucky enough to have a bike, is out-of-the-question. Triage is the hardest job in an emergency department. You prioritize who is the sickest, who is in the most pain, who gets relief first, and sometimes, whether you want to or not, who gets to live, and who gets to die... or at least it feels that way. I'm not sure who has luck on their side. the patient who is the sickest and gets to see the doctor first, or the patient who is perhaps less sick but has to wait?
We hear on the radio that the other team has gone to Mubanga, this means there are more Cholera cases. I know this because they were supposed to go to Lukonzolwa and because the water sanitation specialist is in the car with them. The sick woman has a high fever and she is vomiting and shaky and I am worried she will be hypoglycemic so I give her a spoonful of sugar since it is all I can do when the car is moving. We stop at our health centre in Kabangu and start an IV drip and some medicine to bring the fever down and then continue the trip to Kilwa. We take the patients to the hospital but all the doctors are in surgery, which is lucky for the surgical patient, but not for the two I have brought with me, they will have to wait. I see Thierry and his father outside. Thierry has started tuberculosis treatment and is getting better every day. Maybe he has a bit of luck on his side.