(written after our first trip to Sierra Leone.)
Imagine you’re in Sierra Leone, West Africa. You’re bringing a malnourished 4-year-old girl to the local “medical clinic” because of her parents’ plea for help. She’s on day three of a fever and hasn’t been eating. Your trip has taken a serious tone as you ride to the clinic wondering if this quiet little girl will receive help or if she’ll become a statistic. You think that just maybe, because you happened to stop by her remote village that day with a vehicle….just maybe you could be saving her life. This appears to be the most important thing you could be doing that day. Until you get to the Mokanji clinic.
The Community Health Officer (CHO), Theresa, has a more urgent case. She can’t see the girl at the moment. You walk through the dark outer room and into the “exam room.” There on the gray plastic mattress, surrounded by dirty orange walls, lies a naked ashen baby boy struggling to breathe. He’s taking noisy shallow breaths and his eyes are rolled back into his head. No one is attending him at the moment. The CHO, Theresa, is visibly shaken, holding her hand to her forehead as we walk in. She speaks in angry tones to your guide and shakes her head. He explains, “She’s upset because they try to treat their sick in the villages with herbal remedies until they’re so sick that nothing helps. Then they drop them on her doorstep expecting her to do something. The mother just took off.” Theresa interjects, again so fast that we can’t understand her. Our guide interprets. “She says she knows what to do but has nothing. Nothing that could help. If she had oxygen and IV’s, she could help him. But she has nothing.”
You begin to ask questions. “How old his he?” Ten months. “What’s his name?” Jonathan. Your medical training kicks in as you grab a stethoscope and listen. Heartbeat…impossibly fast. Breathing….dangerously shallow. Fever…it’s hard to tell, as it’s 100 degrees outside but you know it’s critically high. Clinically, you know the score. Emotionally, he makes you think of your one year old baby at home. You take a moment to compose yourself. This is just wrong. There must be something we can do!
“Is there anywhere we can take him to get help?” Yes, about an hour and a half away is the hospital at Moyamba. It’s decided. How can we not try? You know it doesn’t look promising but there’s really no question. A frantic search is made for the mother who is found. She agrees to come but has a vacant look as she sits like a stone beside you, holding her fourth child as if he’s already dead.
The bumpy ride in the air-conditioned car is good for Jonathan, though. As you wipe his head down with a wet cloth and the cool air streams from the front seat, he seems to come around. His eyes which have been closed for a while, open. They are no longer rolled back. Maybe this isn’t a hopeless trip!
But those hopes that have risen on the ride are dashed as you see what they consider a real hospital. It doesn’t look that much different from the clinic you’ve come from. Yes, they have IV’s here, but it will be an hour before they make up their mind to even attempt an IV. And even then, they go through 12 needles trying to find a vein in baby Jonathan’s head. (They are so accustomed to severe dehydration, they never even consider starting an IV in the arm. It won’t work.) But Jonathan’s too dehydrated. No one present can do it. As you give up and leave the room, the nurse runs out to tell you they got it. You breathe a sigh of relief. Maybe he will be okay. Maybe.
You pay for three days worth of care and transportation for the mother. Then you head back to the clinic, hopeful again. Maybe you made a difference. But then, over an hour later, your guide gets a call as you pull into the Mokanji clinic. Baby Jonathan didn’t make it.
This is a true and tragic story. It happened in February 2010. And sadly, children like Jonathan die daily in Sierra Leone because of diseased water. Jonathan was so severely dehydrated that we couldn’t help him. But what if Theresa, the CHO, was able to give him some oxygen and hydrate him with an IV when he first came in? What if she had the supplies necessary to visit the villages and provide real health care? Things that we take for granted here are desperately needed there. What if a community here can help a people there?
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