We missed something

There’s no medical help close by for the Kovol people. The nearest hospital is in Madang town, a 2-3-day journey away (a brutal, tough hike), which is a hard journey to make when you’re healthy. If you need medical attention you don’t tend to be at your strongest…
There may be an aid post two-day’s hike into the valley, maybe another in another one-and-a-half-day’s hike in the other direction, and I say ‘may be’ because the building may or may not be staffed, and they may or may not have medicines.

Thus we get a lot of people coming to us for help. We’ve been trying to do as little as possible, which sounds terrible, but it’s so easy to get snowed under with people asking us to check out their sicknesses. We’ve tried to draw a line at what we help with and what we don’t, and we’ve also said “only come on Wednesdays unless it’s an emergency”.

Looking at my time sheet I see we’ve got people coming every other day or so, and we need to give them some time to figure out if they are seriously sick or not or can wait till Wednesday. Many aren’t that sick; they’re just here anyway and thought they might as well ask to be checked out. Lots have sores and we can just tell them wash them with soap (after making sure there’s no fever). Many have symptoms of malaria and what’s nice about that is that we can test for it.

We offer malaria tests for free and charge K20 for malaria medicine (it costs K25 or so in town). K20 is a reasonable sum of money for them and we don’t want them buying medicine when they don’t need it. The catch with the tests is that we tell people they have to wait until their fever spikes before we can test them. Some people decide they don’t want to wait and buy the medicine.

We get a string of mothers most days showing us babies and young children who had a fever 3 days ago, but now seem fine. Again it’s the “I’m here anyway so I might as well get my baby checked” mentality. So we see a lot of young children who just have run-of-the-mill illnesses that don’t need any medicine.

There are other cases though, and on this last one we missed something. In the last blog I mentioned the 2-year-old girl brought with mouth ulcers. The reading I did on mouth ulcers said they weren’t much to worry about, but there was obviously something else going on.

The parents brought the girl back 2 days later and she was in bad shape. The ulcers had cleared up, but she was having a really hard time breathing and her pulse was way up. We could see her ribs sucking in with each breath and there was a barking cough and wheezing. Our oximeter said she had an O2 saturation of 68%…. which seems really low. We assumed that the reading was wrong (because it’s an adult oximeter and her fingers are small), but nonetheless confirmed some kind of respiratory problem.

It’s times like this I wish I’d gone to medical school instead of engineering. M ppppll..p.,.pp. all y go-to respiratory problem that I know about is pneumonia. We see a lot of it here and some of the symptoms were there but not all. It looked like a respiratory problem as trouble breathing, wheezing, sick appearance and cold sores are all symptoms, but there was no fever and the breathing rate was a little high, but not as high as we usually see. We started treatment with azithromycin and started praying she’d make it.

She didn’t we found out yesterday,. She died a day or two later. We’re left wondering what we missed and what we could have done differently. Was there anything we could do? Do we need to go with tears and apologise to the parents? If children can die so quickly can we look after our own well enough out here? Is it right to put it out of our minds completely so we can celebrate Christmas as we’ve been all looking forward to doing? Can we put it out of our minds or will our hearts be at the same time both happy as we watch our kids unwrap presents and sad as we remember a family missing their daughter.

Likewise weighing on our minds is Juli who is due to give birth any day now. She’s a higher risk pregnancy but Juli and her husband weren’t aware of that. We laid the risks out to them (of a repeat of whatever the problem was for her first pregnancy in town which required a c-section and her scar possibly (very unlikely as we’ve been told) from tearing. We asked them to give serious thought to hiking to town, but she is 38-40 weeks pregnant.. We told her in her situation we wouldn’t know what to do.

She’s decided the road is too risky and to stay. We’ve told her that we fully support her and that it’s a good decision. Now we’re worried that we’ve unnecessarily scared her. The mother’s confidence is vitally important and now we’re concerned about whether we’ll be able to keep our own anxiety from her.

Gerdine has a bag ready and we’re expecting the call anytime. Is it selfish to want it to happen after Christmas?

So these are the thoughts swirling in our minds as we go into Christmas. Oscar notices and starts asking questions like “If you give children the wrong medicine do they always die?”.

I think our family is a little shaken so I don’t know if we’ll be able to retreat into warm, festive Christmas celebrations. I’d like to though.