Monday, December 28, 2009

The Children's Wards

I woke up this morning to the sound of a rooster crowing and it was a lovely way to wake up.  I was going to accompany Saeed to the hospital where he works.  i didn't know how much I was going to see, but i really looked forward to seeing whatever i could.  The hospital itself was composed of essentially two separate parts.  The main building was the hospital and where they saw outpatients, and where outpatient care happened.  I got a very nice tour, and it was a modern building (built in 2006) and the facilities were very modern, so much so that i wondered whether my preconcieved notions about health care and Africa were a liberal middle class creation.  But, sadly, it was not the case as Saeed took me with him as he did his rounds in the Wards, which is where the in-patient care took place.

I linked a sound file to give you all a sense of what it sounded like, and post these pictures to give a sense of what it looks like.  But I wish i could also link the smells in the wards.  Don't worry, it isn't a terrible smell, but there is a smell that is both very human and very sick.  Saeed told me that the wards were very empty today as the it was a holiday schedule, but i can only imagine what it would be like normally.

So, here are some simple facts.  First, many of the children in the ward all have HIV, and as such have HIV related illnesses such as K-S, (a malignancy) or PCP,  But that isn't the truly tragic aspect.  It is the fact that many of these children are treated for simple malnutrition.  I am not sure if the pictures get across how malnourished and small some of these children are.  Saeed explained to me that one of the most revolutionary changes in medicine was this substance that is essentially vitamin enriched peanut butter.  Prior to using this peanut butter the mortality rate for malnourishment was quite high (i think 50% or so), but after it started to get used, the mortality rate dropped to single digits.  A simple change from using a milk to peanut butter meant more ability to discharge children, less risk of contamination and poof, a great increase in the number of lives saved.

Maria asked me what i thought after seeing the wards, and i don't really have any words.  In a way, we in the States are bombarded with images of what i saw, children who are malnourished, crowded, and just plain sick.  So in that sense, i saw what i expected to see, and sadly it reinforced some stereotypes of Africa.  But, despite seeing images i expected to see, i don't think there is anything that can convey the sense of absolute waste and senselessness. It is one thing to have children and people die to wars, famine and pestilence, but it is something else to know that so many children are also dying to dehydration, poor hygiene, and simple malnutrition.

So before this devolves into a mush of pessimism and tragedy, I did want to point out a few things. What i found remarkable was the community that was created in the wards. Women with sick children on their backs were in the middle of caring for their children, also talking with their friends, sitting and eating.  This one child, who was 5 years old and suffering from K-S,  was the most stoic and brave boy i have ever seen.  His name translates to "Happiness" and I hope he gets a chance to live up to his name.  The doctors i saw working there were amazing, Saeed included.  Remember when i said it seeing Saeed seemed like glancing into high school, well, watching him treat these children certainly reminded me how far we are from high school.

We drive off to Balyntre, the biggest city in Malawi and off to the tea estates soon.  Needless to say, i don't think i could forget the hospital and the children's wards.

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