This medical incident is not just medical, but reveals a real darkness that has gripped these people. If they don't care about life and death for their children and for their patients, how are they to care about their souls? In all the different aspects of culture shock in moving from Pittsburgh to Uganda, it seems this indifference to death has been the most troubling and frustrating for our missionary doctor. It would be good to keep all our missionaries in our prayers for the grace to navigate the waters of their environments, to handle their frustrations well and keep pressing forward.On Monday an infant came into the clinic with severe diarrhoea and vomiting for three days. My nurse actually came to get me and said, "I have an emergency." So, I am thankful that she has learned something and did not wait several hours before coming to get me. We told the parents that this child needs an IV for fluids ASAP. We told them that it would cost 1,200 shillings (there are about 2,200 shillings per dollar). The father said that he only had 1000. I said that is fine, we will start the IV, but could he go and look for the other 200 shillings. He refused. I refused to start the IV if he was not willing to go look for a few shillings. If he is not willing to help his child, then what does he want us to do. I was really annoyed. My nurse actually went to her home and got the 200 shillings. I actually told the man that he was not a very good father--how could he let his child die over 200 shillings, I asked. I was so frustrated. Then, as it turned out, none of my staff nor myself could get an IV started in the child. He had sunken eyes, floppy arms and legs, was lethargic, and was about to die, it seemed to me. Finally, due to some supplies brought by a visiting nurse (thank you, Kate!!), I decided to place an intraosseous (IO). This means that you actually drill a needle inside the leg bone to be able to get fluid to the child. While it sounds absolutely terrible, it actually works extremely well and is the current standard of care even in America if you can't obtain IV access. It is supposedly not any more painful than a regular IV needle. I have done one several times on a plastic maniken (sp?), but I have never done one in real life. I have to say that I was kind of grossed out and my hands were shaking. However, I was able to put the needle in and we were able to begin fluids. Finally, after several hours of fluids, my nurse was able to start a regular IV so that they could be transferred to the hospital. The patient was actually improving very well--a stronger cry, the legs and arms weren't floppy, the eyes weren't as sunken in. So, on Monday afternoon, they headed to the hospital. By the way, this child was one of a pair of twins. They were also malnourished and had to be admitted to the malnutrition program.Today, the mother came back to the clinic to get something that she had left at our clinic. She informed us that when she went to the hospital on Monday the nurse on duty refused to see her. The nurse told her to go back to Nakaale since they had already started the treatment. Why not finish the treatment at the place where you paid for it? the nurse apparently asked. This makes no sense as we are only a health centre 2 with no admitting provisions, while they are a health centre 4 with a very large ward for admissions. They didn't come back to Nakaale, but they just went home. The child died this morning at around 5 AM.I have to say that I am furious. When I try to call the hospital, the in-charge denies it, stating that the nurse probably just told the mother to wait--the mother became impatient and then just left. I don't believe it, though.So, what to do?
"And God is able to make all grace abound to you, so that having all sufficiency in all things at all times, you may abound in every good work." 2 Corinthians 9.8