Thursday, May 28, 2009


Today was our first day of clinical rounds. We shadowed the head pediatrician through the emergency pediatric ward.

Childhood illness here is at a level of intensity I never could have imagined. Almost every child we saw was malnourished, indicated by a large head and eyes but a tiny frail body, reddish colored hair, and lack of responsiveness. Malnutrition has a tendency to complicate all other health needs; we saw everything from typhoid fever, pneumonia, TB, malaria, and so on. One child had consumed a large amount of kerosene, which has complicated the diagnosis of his chronic breathing problem (already difficult to assess). Another girl had a protruding belly, caused by a swollen spleen (most likely malaria).

Walking through the ward is so overwhelming. There are 2-3 mothers with their babies on every bed. Some are crying, some just sit and wait for the doctor to arrive. I am learning how to analyze a child first with my eyes and individual scrutiny. In this health center, there are very few diagnostic tools other than skill and intuition. Some children bring in chest xrays, but other than that, we depend on what mothers tell us, family history, visible signs from the child, and expressed pain.

The head pediatrician is one of the most incredible doctors I have ever met. He works entirely from his intuition. There is much that western medicine can learn from this system, although the intensity of disease and number of patients is something we are not used to (nor would we be equipped to deal with it). There is no time to wait for lab results- the child must be treated right away or risk death. We are not allowed much of a margin of error.

On a brighter note: we found the NGO grocery store yesterday and splurged on frosted flakes.

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