-- Matthew 19:14.
I faced
death this week.
I had met
with her a few times since April, but this time, she slapped me in the face…And
it ripped my heart apart.
Before I
tell you my story, you have to know three facts:
- The rain has not come yet. We are seeing
more and more malnourished children coming to our hospital in serious
condition, very serious condition…We are often the last resort for these
mothers and fathers, desperate to save their child;
- During the rare vehicle movements we are
conducting – often to transfer patients to another facility – we go from
village to village until we reach our destination. Sometimes, in passing,
moms come running after our vehicle in order to get some help; and
- Since the coup, the government has not
been able to support his health posts and the latter often contact us to receive
some help with supplies, medications or simply for medical care.
Knowing
this, here is what happened to me last Wednesday…
We left
Boguila early (0600hrs) because we were transferring patients from our hospital
to Bossangoa to bring them back home. We thought that we were likely to bring
back some patients to Boguila as our facility is more functional in the moment.
The MSF project in Bossangoa has just started and it needs to get established.
In the meantime, we are trying to support them as best we can.
A few days
before our trip, the health post from Nana-Bakasa, normally supported by the
national Health Ministry, sent us a note requesting our help with an increase
in malnourished children. They also asked for vaccines for the newborns and
other medications. We had decided, with the approval of the project
coordinator, that we would stop in passing to assess the situation.
When we
arrived in Nana-Bakasa, Zéphirin, the person in charge of the health post,
tells us that he examined a few children lately. Most are malnourished but not
critical, except for one case that he considered urgent. «It’s a three stars», he said. Since I did
not have any experience in malnutrition, I made sure before my departure that I
found out what our admission criteria was and I was confident that I would make
the right decision.
As
anticipated, this child, let’s call him Joseph, suffered from advanced
malnutrition. He was very thin and weak. He did not even have the energy to
cry. All he could do was whine gently in his mother’s arms. I decided that we
would bring him with us to Boguila upon our return from Bossangoa. We told mom
to be ready for 1400hrs that afternoon.
We
continued our movement to Bossangoa. While en route, we had to stop in a
village called Léré, where a mother started running after our vehicle with her
child and the rest of the village. After a short discussion to find out what
was the matter, I decided to take the child and his mother to Bossangoa where
he could be assessed for the fever, diarrhoea and loss of appetite that plagued
him in the last few days.
In Bossangoa,
the OPD (Outpatient) team took the child and his mother under their wings
immediately.
While
waiting our departure, we had a look at the facility of this new project.
Bossangoa had a beautiful hospital, well managed and well equipped. But during
the coup, it was looted and vandalized. The staff and the population fled to
the bush. The health services were reduced to nil. Now, the population was
returning to the city and the needs were urgent. That is why MSF decided to get
involved and started a short-term project (three-six months) in order to reestablish
the health services and give time to the government to take charge again. The
local staff nurse, André, tells me that there are now conducting around 300
consultations everyday lately. There is
a great demand for health care and follow-ups. André usually works with us in
Boguila but we sent him to Bossangoa for a short time so that he would give
them a hand to start the project. He is really happy to help the new team out.
Around half
past noon, we leave for Boguila. Good news! The child brought from Léré does
not require an admission nor a medical follow-up: he can return to his village
now. However, we will be bringing back with us two children sick with malaria
and dehydration. In Nana-Bakasa, everyone
is ready – we pick-up Joseph and his mom. The baby appears stable and
continuously whines weakly. I say a quick prayer so that he makes it alive to
Boguila.
During the
trip, I communicate regularly with the team of the second vehicle to ensure
that all the passengers are well and stable, especially Joseph. A few kilometres from Boguila, I call ahead
to inform the team that we are bringing back three children, one of them in a
critical state of malnutrition. I ask that Dr. Flo be ready at our arrival to
take care of that child immediately.
Finally, we
see the hospital – we park the vehicles. The next few minutes resemble a scene
from a Hollywood movie: the whole team is there and ready for action! I direct
Dr. Flo to Joseph and she takes him in her arms to bring him to the emergency
while the other two nurses take the other children. I accompany Dr. Flo to give
her a hand – we need a venous access quickly so that we can give some glucose
to Joseph: he needs energy. When we enter the emergency, all the equipment is
layed out and ready for use. We attempt many times to get an intravenous into
Joseph but he is so dehydrated that we are unsuccessful. As a last resort, we
attempt an access of the femoral vein, trickier to get. Dr. Flo gives it a try
– we think we have it. We quickly give the glucose dose and start the fluids. Unfortunately,
the site becomes interstitial, which means that the solution we are giving is
not only going in the vein but also in the surrounding tissues – our access is
not good. With all this commotion, Joseph
hangs on – he continues to whine and I am holding his little hand. I whisper in his ear: «Don’t give up little
guy…You are strong…We can help you! I know it hurts but you will feel so much
better after! Hang on little man. » I also pray to God to give him the strength
to fight. His mom is also there, a little behind so that the team can do its
work. After five or ten minutes, that’s it! We have an access – a vein on his
head has decided to cooperate! We continue our treatments, get the oxygen
tubing on, take his vital signs, and give him the prescribed medications. We breathe
a little easier now!
It’s the
end of the afternoon. I am reassured on Joseph’s status. I think all is well
now that he is in good hands.
I leave to
have my shower. I take my supper and go to bed.
The
following morning, as I am walking to the hospital for report, the guard at the
entrance stops me and says: «Please, would you mind helping me with this mom.
Her child died last night and she wants to bring him back to her village for
the burying. » I turned around and saw Joseph’s mother, sitting on the bench,
pain written on her face. My heart just stopped for a few seconds. Tears welled
up my eyes. I did not understand what had happened. I was in shock. Regaining
my mind, I asked the guard to tell the mother that I was very sorry for her
loss, to give her my sympathies, and that I would take care of it. During
report, I found out that Joseph had had a respiratory arrest in the middle of
the night and that efforts to resuscitate were not successful. The staff
immediately saw that I did not take this news very well – they offered support
and good words. I kindly thank them for this. But when I got to the house for
my breakfast, I could not keep the tears from rolling down my cheeks and I
cried just as if Joseph had been my own child.
 |
| Another malnourished child... |
Death had
taken another victim.
«Your children are not your children. They are
the sons and daughters of «Life’s longing for itself. They come through you but
not from you. And though they are with you yet they belong not to you.»
-- Kahlil Gibran, The Prophet
-- Kahlil Gibran, The Prophet
Janique
PS:
The names in the text have been changed to respect the privacy of the patients
and personnel. 
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