Chad 2.0 Déjà vu 4July2015

Chad 2.0 Déjà vu  

4July2015

     Returning to Chad for year #2 has felt like déjà vu. Everything has a season and I've seen this season before. Chad has endured its typical dry season when it likely doesn't rain one drop from November or December until June. The rains came late this year but finally,  everything is now green and alive. 

     The rains don't only bring life. Malaria season is now in full swing.  We see plenty of malaria year round but this is an explosive time. Typically I have 12 or so babies on the Pediatric ward. Recently I was down to only 4! But the past few weeks have been very rainy and I had 35+ kids on my Peds service today. There are a few with typhoid and 4 with severe malnutrition and one 12 yr old boy had symptomatic rabies from a dog bite 4 months ago!  It is 100% fatal. He will die and we can't stop that. 

     The other 25+ kids have a chance to survive. We cover them with assorted meds, IV quinine and prayer. We treat their severe anemia with blood transfusions (hemoglobin of 2 or 3 is an everyday occurrence here). Sometimes we don't have the patient's blood type and there is little we can do except wait. We test the parents, neighbors and anyone willing to be a blood donor. Twice this week we had kids with convulsions from severe malaria with hemoglobin of 3 and O-negative blood type. We couldn't find a donor. Unfortunately I recently gave 10 units of O blood to a pregnant woman who was bleeding to death from coagulopathy from a snake bite. Danae had to perform an emergency C-section and hysterectomy. Sadly, that young mom still bled to death that night. Her baby girl was dead on delivery. And now 10 units of precious O blood are gone that we desperately needed for these other children. 

     So, I asked every family member & visitor on the pediatrics ward if they would donate. In exchange I offered to buy ALL of their child's medications. No one would give (or claimed to be the wrong blood type... O neg is a bit harder to find). We even went to the Emergency Department and asked all nurses and families if they would let me buy meds in exchange for their blood-- no takers. People are afraid to give blood here.  I did finally find one student with the right blood type...but he was HIV positive. We never pay for blood. Its a bad precedent but I was desperate.  

     It poured down rain again today bringing relief from scorching temperatures. Tomorrow we will see the mothers straggle in...trudging for an hour,or two or three hours  through muddy paths and roads with gravely ill babies tied to their backs. And we will be waiting at our little bush hospital. Waiting and ready to give the best care we can. It's déjà vu. 

     -Mason