Three Babies, Three Days

No, not joyous births. Needless deaths. Kelvin had cerebral malaria, Juliet had enteric fever/gastroenteritis, and Mika arrived in end-stage renal failure. All three babies had been previously misdiagnosed and given inappropriate medications at other, more accessible area clinics. When they were finally brought to our outpatient department, they were promptly admitted to the hospital. But it was too late. Kelvin and Juliet were so dehydrated and anemic when they arrived that we could not help them -- not even with "cutdowns" to get IV fluids (and in Kelvin's case, blood) into them. Mika had been anuric for two weeks. His body was swollen, and he was dyspneic by the time we saw him. Although his lungs were perfectly clear, Mika had been misdiagnosed with "pneumonia" and given ineffective antibiotics at two previous clinics. If we were in a major pediatrics ward in Boston, three deaths might sound terribly sad but perhaps not unexpected. However, our small hospital only had seven pediatrics patients when three of them died.

Maseno Mission Hospital is located at the end of a long, rutted, uphill road. In the past several years, small public/private medical stations and government "sub-district hospitals" have sprung up along the highway below us. Most are sparsely-staffed by poorly-trained employees who have even fewer available medications than we do. But they call themselves clinics, and they are more accessible than our outpatient department. Sick people cannot easily walk to MMH for care, and poor sick people cannot get to us by any other means -- although some do try by boda-boda, piki-piki and even wheelbarrow. As a result, we are seeing increasing numbers of patients (most often, children, because they get dehydrated so easily) who are too sick to save. We have neither ICU equipment nor staff. Yes, I am upset; and, yes, I am angry. Above all, I am saddened by the broken "system" that provides an inadequate education for clinicians, zero funding for mission hospitals or even road repair, and absolutely no safety net for people of little means.

Keep watch, dear Lord...