*Not posted the day it was written

Right then- this one is going to be a pointless rant full of medical jargon and misdirected anger so feel free to just skip on to the next thing you want to do online right now. But I’ve got to journal about this so if you are still reading hang on. Yesterday, after spending the morning with Lazaro, I had a few other things I needed to do so planned to spend a few hours in town, checking some things off my list. Not to be. I got a cryptic phone call from the mother of little Adebo. The baby was really sick and they were at the clinic in town could I please come?  So, I dropped what I was doing and headed over to the clinic. I found them there and discovered that they have already seen the Medical Officer (MO) and were waiting for a malaria smear to come back. I joined them on the backless bench and tried to get a handle on the background. For more than the past week Adebo has had fever and is refusing to eat. She just cries and cries. They went to the clinic in the village where they put her on quinine drip. No malaria test, just straight to drip. I can’t stand that!! That crap is poison and no matter what the complaints or symptoms are that is what they use here. Anyway, Adebo got 3 doses over 2 days (I can’t figure that out either considering the correct way to administer it as a continuous drip so how did she have 3 doses?)    

As I take screaming Adebo from her mother I can feel her fever through her clothes. She is inconsolable. Her tiny body feels like it’s going to break she is so fragile and weak. She is nearly 11 months old now but I’m guessing she doesn’t tip the scale at 15 pounds. She isn’t hitting a single developmental milestone. (No response to her name, not sitting up independently, no sounds that resemble words, unable to eat anything besides breast milk…)  I knew when I first met her that she was going to be mentally handicapped but I had hopes that she would not be so developmentally behind. Add to that it is becoming apparent she is completely blind. 

Anyway, I looked at the paper she had been given and it was all incomprehensible gibberish. I asked one of the nurses if she would read it for me and she looked at me like I’d grown a second head. “I can’t read that!” So I tracked down the MO asked what he had written and what his plan of care was. Waiting on the labs. And in the mean time? A few minutes later he was back in his office and called them back in. An abrupt conversation took place in Ateso and then he yelled some comments out the door to a nurse. She guided us back to a room with some beds and told me the baby was being admitted and would get some medications while we waited. Good. Then I saw her drawing up, what’s that?, Valium?! Excuse me?! For the crying. Right. Not over my dead body. I was thinking a little acetaminophen. The nurse just walked out. I hadn’t even gotten an attitude yet!  With the baby on the bed I did my own assessment. Rales and crackles in all lung fields. Fever of 40.3 C (104.6 F). Unable to be consoled at the breast of her mother. Vomiting. Screaming and arching her back. Dehydrated. One more time I went to track down the MO. I asked him what he thought of pneumonia? How about bowel obstruction? Can we rule out meningitis? His response: Maybe I wanted to have the baby see the doctor?  Yeah. I think that would be great. Discovered that the doctor was out to lunch. Wonderful. So knowing that it was only 1pm and lunch break can easily last until 2:30 I tried to take a deep breath and remind myself that getting pissed doesn't help and waiting is a way of life. Amecet is next to the Dr's office so I walked over there to get the other nurse's opinion while we waited for the Dr. to come back. She didn't have much consolation for me but helped me put an IV in and start some fluids and give some stuff to bring the fever down. At least by the time the doctor got back from lunch Adebo had fallen into an exhausted sleep so he could wake her up and make her cry again. He confirmed with me that is probably wasn't malaria (though in the meantime we'd gotten a positive test back from the lab- ridiculousness.) He wanted to treat it as pneumonia and see what happened. It doesn't make me feel better when they say things that remind me that they have almost no quality education. An no resources at their disposal. 

Anyway, enough ranting. I guess I just ran out of steam.

*It has been a few days and I've gone out to see Adebo. She is eating again but still feverish. I've put her on Septra (Bactrim) for the rest of her life and we'll see what happens.