Friday, 2 December 2011

30th November 2011

Like buses, (well perhaps not Ethiopian buses) things always seem to come in runs here. So there was another fitting woman admitted yesterday afternoon. She had delivered her baby at home the previous day but started fitting this morning. With all the pandemonium going on in the ward, it was almost impossible to understand the history of events but it seems that she also had malaria and so there was some concern over whether she had cerebral malaria. She had protein in her urine suggesting a possible eclamptic fit but other than that we don’t have a clue. So she was treated for both possibilities and by this morning she was making a good recovery. So a happier story than the previous one. A big problem here is that you mostly don’t have much of an idea about what you are treating. The laboratory facilities are minimal and so you can’t measure simple things like potassium or sodium. Mind you, even when you can make a diagnosis, you often don’t have the necessary treatments available. So perhaps it’s better not to know what is wrong.
Today I have been entering the data I collected from the antenatal risk assessments. I came across information obtained from a 16 year old, 140cm high girl, 38 weeks pregnant, with a breech presentation of her first baby. I remember telling her that it was important that she made her way to hospital over the next few days where she should have her baby. The look on her face suggested that she did not think this was going to happen. She didn’t have the 60 Birr return bus fare (£2.00) and she also didn’t have anyone she could stay with in Gimbie where the nearest hospital is. Gimbie is about 2 hours on the bus and I fear that she may turn up here in the next week or so with a prolonged and obstructed labour. Let’s hope that she doesn’t run into too many problems.

This afternoon I bumped into a little 5 or 6 year old girl who I see often with her polio-crippled mother. One of the staff told me that her mother had been admitted to the hospital with Typhoid. ‘So what happens to the child?’ I ask. Yes it’s sad says the woman, but her mother is sick and can’t look after her at the moment. As I sit here writing this, I wonder where she is sleeping tonight and who will feed her. Maybe people rally round, although I fear not.

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