You may think that the calendar picture below indicates that I am counting down the days until I leave. Well, ok I am. But not because I am looking forward to returning to grey skies and drizzle; but to remind myself to make the most of my limited time!
I thought I would share a story about a family I met a month ago. Unfortunately I did not take any pictures, so the photos in this post are from around the hospital.
The hospital priority list displayed on a billboard at the entrance
A father brought his son and two daughters into hospital. The son was 18 months old and particular unwell. Despite a week of treatment, he was not getting better. His wife had come down with a similar illness and was also admitted to hospital. The dad was ill himself, but would still work as a labourer in the morning and tend to his children in the afternoon.
Just in case you were not sure about the hierachy
I remember the family pretty well because I was as stressed as the father, racking my brains to think about what could be the underlying cause. While Dr Mesa does have a limp and I have a flip chart, somehow we were missing the genious diagnoses of Dr House. I would have searched the patients house for clues, but they lived in a fairly remote village.
I had tested for malaria several times, all negative.The limited number of blood tests I could do were all normal and yet, every day the young boy had a high fever and would lay lifeless on the hard wooden bed frame. A high fever, enlarged liver and general oedema. The causes are numerous, but the number of treatments the hospital can give are limited.
Formerly used to fire a laser at James Bond's private parts, this machine now resides in radiology
Antibiotic resistance is a problem because everyone takes them like candy. The hospital has a limited choice of antibiotics, so if I wanted a particular one I would have to purchase it from the market myself. Strange that the local market is better stocked than a hospital. The child got a bit better with the new medication, his swelling came down and he started eating and drinking. However, he still had a fever every day.
It had been almost 3 weeks in the hospital now and I knew I had reached the limit of what I could do in the hospital. After 2 seasons of House and 4 seasons of Scrubs, I was none the wiser. I didn’t want them to go home knowing that he was still unwell. I suggested to transfer him to Phnom Penh, but the father said that he could not go. Coming to Stung Treng town was difficult enough, he could not imagine going all the way to the capital. In addition to this, there was no way he could afford the transportation costs. He told me that he is a labourer. He does not have any assets he can sell, only his body to work. Even now, he has to go to work because the income is not regular.
Believe it. Blood in the Blood Bank.
There is an organisation called YWAM that funds patients to travel to Phnom Penh. However, he will have to see them personally in order to receive the grant. He said he dared not to go. Speaking to barang about his situation will be too difficult. Then apart from transport, how can he afford to stay and eat in Phnom Penh? How can he afford the return journey?
I felt a bit frustrated. Not with him, but with the whole situation. At the end of the day, I could only do so much. I told him that I have done everything I can with what I have in this hospital, even buying medications with my own money. He must take responsibility and be courageous enough to visit this organisation of strangers; to head to a big city for the sake of his children. He went to the NGO the following day and I added an extra $40 from my allowance for their food and return journey.
The following week, my VA bumped into a relative of the family. All the children had been diagnosed with malaria in Phnom Penh. They had received treatment and were now all better. The father wanted to come and say thank you but had not been able to.
My chief nurse
The moral of the story? Perhaps it is that you don’t need to be a foreigner to experience culture shock. The father showed a lot of courage speaking to foreigners in an NGO and travelling to an unfamiliar city. Or maybe the moral is that sometimes the answer to a complicated medical puzzle is actually the obvious. Or really, is it that if you have money then your problems can be solved? Either way, I was happy with the outcome in the end. No capacity was built, but one family was saved.