Clinic day 3 with the students ended with many of the same feelings as the last two…hope being the overriding of the two but perseverance was also present.
Today was a children’s clinic and we saw about 40 patients, these students are some of the hardest working I have ever met. I know this experience will shape their future practice in ways they do not understand yet and has also touched so many lives. The patients love all the extra attention, stickers and new faces that the students bring to the table as well as the best care possible when you have so many people working together. There is not nearly as much chaos as I would have guessed would be present with all these people in one building and the relative lack of clinical experience most have. If you were to look in on an intake you would see professional compassionate men and women dedicated to patient care. I could not have asked for a better group of students to come, I am hopeful for the future of our medicine and those who benefit from it.
Emotionally it was a difficult day today as there were many challenging cases diagnostically, children with painful infections and the worst case of failure to thrive I have seen. A young mother brought her one month old child in to see us as he was “not happy”. The students did their best to elicit what this meant and mom noted that the child had seemed to be less apt to cry, wiggle around and fuss. As most babies are when they come to us, this little guy was all bundled up in blankets with only the top of his sweet little head visible. As the lead clinical student began to undress the baby to listen to his lungs I noticed his clavicles were very prominent (lack of anything but skin and bones is a better actually an adequate description). As we undressed him we were horrified to find an emaciated, dehydrated 2.5kg baby. The baby was listless and we could not elicit a good response from him, get him to nurse or take sugar water. The midwife came down and confirmed my decision to send him to the hospital. We made sure to let mom know she had done the right thing by bringing the baby to the clinic when she noticed he was acting odd though in the back of my mind I still wondered how a parent could look at a child this sick and not know something was wrong. Education. It all comes down to lack of education. This was a young mother who did not know any better. She had seen a doctor two weeks ago at a hospital and the baby had weighed in at 3kg, presumably healthy as the doctor did not make any other recommendations.
Perhaps a little more time spent with a young mother to discuss how often to feed would have been enough as this mom was feeding only 2-3 times per day. It is probable that if she had learned the signs of malnutrition and dehydration before she gave birth she would have been more apt to come in promptly. Of course, this is all speculation. This was the best case scenario as we were there to make the referral and to insure proper care of this child. What would have happened if our clinic was not here? The answer scares me as I know what happens when there is not adequate care…you end up with statistics like you see here in Haiti, the worst in the Western hemisphere.
But we ARE here and things WILL get better, one day at a time. We will persevere and so will all the patients like our little guy today, if given the chance to have access to adequate medical care.
No comments:
Post a Comment