The muezzin’s call is crackly over the loudspeaker. I was jerked awake by thoughts of our little guy in the new TB isolation tent. He’s here with his mother, a woman whose dramatically-beautiful face is emphasized by three small decorative scars under each cheekbone. Her shoulders are bony under her robes. This, combined with a wretched cough, meant that Dr Modeste decided that day to admit them to our brand new TB tent.
It turns out that Djibouti has the second highest prevalence of TB in the world. Last year, we found about 150 new cases of TB in the kids admitted to the CNTH. Luckily, kids with TB aren’t that contagious: they don’t end up with much of the contagious bacillus in their sputum and so don’t need to be isolated. But the kids have to get it from someone, and that someone is usually family, and each child here stays with a family member. This means that there are coughing adults amongst malnourished kids with limited immune systems. So the project realised it needed to set up a more formal TB arm to help isolate and diagnose the moms as well as take care of the babies. Hence, we have the TB isolation area, which is just now getting set up.
Little Ahmed started to desaturate earlier this evening, and we realised it was time to move an oxygen concentrator into the TB tent. Fabien, the logistician, figured the small electricity supply currently set up would support it. Ahmed is in there now, on IV Ceftriaxone and Cloxacillin, breathing away. His heart rate hasn’t changed much since admission, and he doesn’t have a fever.
The muezzin calls again now. I wonder if that’s a bit like the snooze alarm of prayer. I am going to do the opposite. Try to snooze. I have discovered that going over the continent of Africa in my head is a pretty good way to drift off to sleep. I started memorizing it from the bottom because that part is easiest to see from the chair of my desk. I’m on Mozambique.