I want you to imagine your local hospital. The one with thirty something floors and glass windows all the way around it. With specialists for everything imaginable and nurses tending to every need. With its up to date equipment and sanitary, organized rooms.
Now I want you to squish the hospital down to one, expansive level with disjointed buildings. I want you to take the patients from their personal, spacious rooms and squeeze them all into a single one so that there is only a square of space left in the middle for doctors and nurses to stand and take notes. I want you to take the perfectly painted walls and scratch half of the paint off. I want you to let jars of cockroaches loose so that they constantly run up and down the walls. I want you to break the door hinges and pop out a few windows. I want you to throw away 85% of your supplies, so that you’re left with not enough anesthetic, not enough gauze, not enough oxygen tanks, not enough tubes, no pulse monitors, and for the sake of this post never ending, not enough anything. I want you to flicker the electricity on and off randomly throughout the week and leave any patients dependent on electrical machines struggling for air. I want you to put up bulletin boards, but then water stain them and cover them with out of date papers. I want you to fire most of the nursing staff, so you only have three or four nurses for an entire ward. I want you to… okay you get the point.
The mental image you are left with is a depiction of Queen Elizabeth II hospital: the go-to and most up to date medical facility in the entire country. I went there this past morning and shadowed Dr. Akash. He gave me a tour of the pediatric ward.
You first walk into the “main room.” It has a nurse’s desk and four patient beds protruding from the wall that are labeled with sharpied numbers on the wall above them. There’s a kid sleeping with a bandage on his face and blood covering his pillow in the first, two boys being served their lunch of beans, a pathetically small pear, and three slices of bread off of the meal cart in the second and third, and a boy sitting and staring out the window in the forth.
There’s a door in the wall that leads to the single examination room. It’s the size of a bathroom. Inside, there’s a single wooden bench with green paint peeling off, a metal sink coming out of the wall, a wooden stool, a dining room chair and a wooden picnic table covered with a pediatric textbook and a guide to tropical diseases. And, as if that wasn’t enough to make it cramped, there’s also a small desk with a beige, ancient looking computer with a printer balancing on top of it, and an orange swivel chair. Oh and don’t fret, Dr. Akash explained that the rancid, rotting smell was most likely a dead rat that was slowly decaying in some crevice of the room.
Then there’s the neonatal room. It has five cribs wedged inside. Each crib has a hodge podge of blankets and either one or two infants resting inside. The sides of the cribs are all down so that the mothers who are kneeling beside them can hold their hands and provide them with some sort of comfort as they struggle to breathe and wiggle around. There are three more patient rooms attached to this that are equally inadequate.
As I walked through I saw children who were so emaciated that their flesh was sunken in everywhere there wasn’t a physical bone. Their limbs looked like they could snap with a simple flex of their nonexistent muscles.
I saw kids gasping for air. I saw kids with rashes covering their faces and teeth that seemed to have an excessive amount of space between them as a result of decay. I saw a baby with a face so swollen that her eyes had been reduced to slits.
I saw kids walking with wooden makeshift crutches and a boy who was a hemophiliac and had broken his arm. Apparently, the doctors should have drained it immediately, but bandaged it instead. As a result, it had scarred and his arm movement was reduced to a 90 degree angle at the elbow with an extension of maybe 15 degrees in each direction.
I saw an HIV positive four-month-old come who was so severely malnourished that her attempts to cry came out as mere puffs of air.
Dr. Akash and I made our rounds. The air was suffocating and smelled like fermenting vomit and blood. About thirty minutes in, a doctor asked for his assistance in a procedure. I followed them to the treatment room and hastily put on the pair of rubber gloves that were thrown to me. I watched as they unearthed the room for anesthetic (luckily, there was some in the surgical room) and a needle. We proceeded to the neonatal room, squished around the first crib, and started the procedure. I was given the job of keeping the seven-month-old infant’s arm held up while they sutured the hole. She had a deflated lung. They had initially put in two tubes to help her recover and had recently removed one. Our job was to close the hole left behind. As soon as he lifted the bandage, the hole gaped open. It was about the size of half a nickel. He injected the anesthetic and blood immediately began to run down her side.
The doctor who had placed the tube had accidentally made it too large and had made it too deep: it reached all the way down into her lung. Ever time she took a breath I could hear the air being let out of the hole and her gasp to get enough oxygen. I watched as he took a needle that looked like the end of a fishing hook threaded with string and began to suture the hole. He skillfully threaded it through one stitch at a time and, stitch by stitch, shrink the size of it. I looked into her wide eyes and soon looked away as if my ignorance would make her hurt less. I desperately wanted to scoop her up and cradle her, but could only stroke her arm with a single latex finger.
I don’t know if it was the fact that I was dehydrated or that I was just shocked by the situation, but, in that moment, the smells seemed to intensify, time seemed to slow, and my vision began to blur. I was determined to stay standing and involved in the procedure, but as my vision became fuzzier, I gave up and told the doctor that I needed to get a drink of water. I gave him her arm, pulled off the gloves, and hastily went out into the ward. I walked out of the nearest door and ended up in a littered ally way. I sat on a semi circle of concrete and put my head in my hands. But, only for a few seconds. I owed it to the patients to get back up, brush myself off, and do everything in my power to help them.
If you’re still reading this post, wow, I’m impressed. I was hesitant to put something so long on my blog, but I figured that at least I have a chance of someone reading it if it’s up here. I know that right now I’m just an impulsive adolescent who makes decisions and commitments based on spur of the moment feelings and experiences, but I've decided that whatever I end up doing with my future, it involves coming back and helping: hopefully more competent and more able to give than to take.
And maybe, you’ll come with me.
