It's March and finally the winter is over in Lashkar Gah. Spring has come and the weather is much warmer. In the meantime, I have been on vacation in Istanbul. It’s amazing how much you can miss just walking down the street or sitting in a café since our movements are restricted here for security reasons. When I came back to the project with fresh energy, we got a visit from a paediatrician from the MSF headquarters and we were able to discuss a lot of the issues in the hospital. She also came to give training on emergency triage and treatment, which I helped to facilitate.
When I came back to Lashkar Gah I also found out that one of the quadruplets that I told you about in my previous post had unfortunately died. Apparently while I was gone, all four of them got a respiratory infection and since they live far away from the hospital, one of them did not make it in time to be treated. Three of them were admitted to our hospital and were discharged before I came back.
On the one hand it made me really sad to hear that, but on the other hand, knowing that three of them are still alive and were apparently doing well at discharge is a huge achievement here in Helmand; I would not have expected this outcome when I saw them after they were born.
When I see patients like these newborns that are doing so well it makes me happy, but the challenges in dealing with death here can be quite hard. To see children dying or being the one who decides to stop the resuscitation because there is no hope left has become a daily routine for me. On average, we have two to three deaths every day.
There are days where it is hard to cope, but most of the time it is easier than I expected. I guess you need to develop a certain distance to the individual patients in order to survive. One of those survival mechanisms is to think about other things outside of work, such as playing card games, ping pong or playing volleyball which is exactly what I am going to do when I finish writing this.
We have had a lot of multiple births admitted in our neonatal ward recently. Last week we had six pairs of twins at the same time. I don't know if multiples are happening more often here in the population or if we get to see only a certain group of the newborns. I mean, yes, we have more than ten thousand deliveries a year in our hospital and yes, multiples are more likely to be born premature and also more likely to have a low birth weight and will therefore be more likely to be admitted to our ward, but it still seems like a high number.
For our neonatal ward this meant overcrowding – even more than before. On some days we had more than 30 patients (in 19 beds, including the incubators). On top of all the twins, a set of triplets were admitted today. They are a little premature but are doing so well that only two of them were actually admitted for care. The third one is just ‘accompanying’ his siblings to get breastfed.