A listless and dehydrated young woman was admitted today through the outpatient department. She presented with a 38.6C temperature (37C is about equal to our 98.6F), and a two-week history of abdominal pain, vomiting and diarrhea. Upon examination, many one-centimeter parallel cuts were visible over the patient's upper torso; a sangoma, or traditional village healer, had been applying treatments, apparently to no avail.
Several of our patients are "discharge-ins": they board (at half-price) and can at least receive decent nutrition while they wait for their families to gather enough money to pay for the services rendered. Arrangements can be made for partial payment and discharge with a payment plan. Occasionally Dr. Hardison or a visitor discreetly assists. Registered orphans and their caregivers receive free care at Maseno Hospital, but there is no financial safety net like Mass Health for the others, and the hospital must sustain itself in order to continue to provide care. Today our pediatric ward is empty for the first time since I've been here. The two babies admitted yesterday have been successfully rehydrated and were able to go home, their fevers now abated.