Watching but not Acting

I have never felt more like a witness and less like a doctor than here in Burundi.  I felt like I was watching but not acting, checking under the hood, and saying “sorry, we don’t have the part here.”  Not able to intervene.

I saw an 8 year old with an acute abdomen.  TB peritonitis with superinfection of bacteria.  Pus came out when we put a needle in him.  We rushed him to the regional government hospital.  The doctors were still on strike, but do emergencies.  They operated and when we checked on him a week later, he looked worse.  Nobody was changing the dressings.  No doctor followed him up.

A 3 year old with anemia. On exam.  We got some labs on him.  The lab said his hemoglobin was 9.  It was actually much much lower than that.  The labs are so often unreliable.  Then, he went into a coma and died.

25 year old that was breathing a mile a minute.  But her lungs sounded okay, she was coughing up blood.  It took us two days to get a chest x-ray.  An hour trip to the local hospital.  No electricity, and their generator did not have enough electricity to power the chest x-ray.

Let the witness take a stand.  Well… we’re working on it.

By Sriram Shamasunder, MD, DTM &H


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