As part of my briefings, I spent a few hours with the expat Doctor on her morning rounds of the intensive care ward. 5 beds, a few drip stands, emergency reflective blankets and an oxygen concentrator. That's about it. And this is in an MSF hospital where we provide the best kind of care around. Man, that was a tough morning and it really reminded me how different it is to run a hospital out here in the bush...
This is how I met Molaw. He was just sitting patiently on an empty bed waiting for his turn. He looked tired and, more than anything, sad… like a child who has too many responsibilities when he should really just be at school and playing with the other kids.
Upon closer look, you can see that his face is a bit too round and there seems to be some sort of growth on his left cheek. The doctor tells me it is cancerous, common in children and that it could be treated by a simple course of chemotherapy. Unfortunately, we don’t have the resources to do this in the bush so we are left trying to reduce its size, slow its spread and to treat the side effects.
Molaw comes in once a week – Tuesdays – to get his weekly supply of pills. He’s an orphan and living with a great aunt so he comes in on his own and just waits. He is slightly malnourished so he also gets a weekly ration of Plumpy Nut to help him out.
The doctor does a brief examination. Feels his cheeks, looks inside his mouth, listens to his breathing, asks about side effects. Molaw says – through a translator – that his head really hurts and that sometimes he sees double. The doctor tells me that it is the same every week but that he is doing much better then when he first showed up in intensive care.
Too much responsibility
This week, she decides that his treatment needs a slight change...so she has to tell a 10-year old boy that he now needs to take the little white pills 4 times a day instead of just 3. He nods his head slowly to show that he understands. She writes out a new prescription for a pretty powerful cocktail of drugs and off he goes to get it filled in the MSF pharmacy.
It just doesn’t seem right that no one is there to hold his hand and tell him it will be OK…or to at least go to the pharmacy and pick up his drugs and to tell him which ones he needs to take and when. That is such a weight to bear for a 10-year old. Although he had stopped going to school because his head hurt too much, he is feeling much better now and has started going again. The reality is that this will only last as long as MSF is here…but how do you tell that to a 10-year old!?
On a basic human level, this is what MSF is all about. We can’t do everything and we can’t be everywhere. We don’t pretend to solve the greater problem or to offer sustainable solutions.
…but, wherever we are, we do everything possible for each individual patient. For now, that means Molaw has a chance at a normal life: fewer headaches, clearer vision, and maybe even school. I had to hold back tears, though, when I realized that "everything possible'' is likely not enough in the long run.