Friday, October 24, 2008

Triage Redux

It's "deja vu all over again!" Last year I wrote from Maseno about the oxygen problem here. It's not about altitude; it's about allocation of resources. We had a desperately ill child who needed oxygenation, but that meant removing the only equipment we had in the hospital from a mama who also needed it. Triage, Kenya style... Thankfully, both patients survived.

This week Eunice, with probable PCP pneumonia, TB and an 02 sat of 84% on room air, has been dependent upon oxygen for her slow road to seemingly miraculous recovery. Carol, however, with widespread consolidation in her lungs and a similar saturation level (normal is high 90's), also needs help breathing. We moved a large, unwieldy tank over from the surgical suite three days ago, but it ran out of oxygen yesterday. Dr. Hardison said it may be weeks before it will be refilled. Meanwhile, Samuel presented in acute respiratory distress. His O2 sat was a startling 67% (which we hope might also be r/t impaired circulation and finger-clubbing), so last evening we moved the equipment from Eunice's bedside to Samuel's. Then we had to wait for the electrical power to come back on in Western Province.

All three patients survived the night, TG, and today we are going to order three xray view boxes, two new suction machines and an oxygenator from Nairobi, thanks to the generosity of the Rotary Club of Martha's Vineyard and St. Barnabas Episcopal Church in Falmouth, MA. Thank you/asante sana, Everyone!

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