i am currently on a one year assignment in east africa. the conditions in which the people live here are dire at best and many suffer from easily preventable and treatable diseases. the story below details a recent event that i experienced, which happens here on a daily basis.
today was a really hard day for everyone at work. one of our employees died at the hospital. he was just 24 years old, married with kids.
earlier today i was in a meeting and was called by one of my locally employed staff supervisors and informed that one of our employees was in the hospital and seriously ill. he asked if there was anything i could and i agreed to go down to there and see if i could help out in any way.
we arrived at the hospital not long after he called and went in to take a look. walking into the teaching hospital, which is the only one in town, was like walking into a hospital back before wwii, where the wards are open and 30 patients are crammed into a room. there was no air conditioning and everyone just relied on an occasional breeze coming through the windows. there were flies and mosquitoes everywhere landing on patients, visitors, and equipment. sick patients were housed side by side. some had beds and others were not so lucky and just put on the floor where there was room. the place smelled like vomit and urine and i noticed a few patients were lying in their own mess, which no one really seemed to care about.
we found our employee on a mattress that was on the floor. for some reason, he was moved down there from the bed. his wife told me that he had been vomiting blood all night and was taken into hospital the previous evening. when she came to check on him, she found that he had urinated and defecated all over himself and no one had cleaned him up.
from what people tell me, patients pretty much have to rely on their family or close friends to take care of them in this hospital because they're understaffed and overbooked.
my employee was laying face down and moaning when we first walked into the ward. his iv had been disconnected and he was basically being fanned and rubbed by his family. i looked over his chart (which only one sheet with some scribbles) and saw that he came in hypotensive and was ordered to have continuous fluids and a blood transfusion at the earliest possible time.
i called the nurses over and asked them to get his iv re-established, which took quite a bit of prodding on my part. they stuck him about 9 times and finally was able to get a positional iv that only ran when his arm and the catheter was held at a delicate angle. once they were finished, i started assessing him, bp/pulse/and so forth.
he had no radial pulse, which revealed how critical he was. i was able to get a bp of about 50 systolic which is the top number and wasn't able to hear a diastolic pressure. i immediately started forcing fluids through the only iv that he had and requested that they bring supplies to get another one started.
we were finally able to get a doctor or med student; i'm not sure, over to assist. they only had one oxygen concentrator, which i asked for, but i am sure was being taken from another patient. i was basically telling this guy what was needed and he was ordering the nurses to do what needed to be done.
many of my employees started donating blood because they knew he needed a transfusion. unfortunately, he never got to receive any of it. his respirations became agonal and he died despite the efforts of the medical staff.
his wife, sister-in-law, and brother were there when he died as well as other family members. it was a very sad time for them and everyone else. my biggest regret in this whole ordeal is that i didn't intervene earlier when i probably should have. i thought i was helping by advocating and getting the medical staff to provide care, when i probably should've been doing it myself or at least helping with it.
it's really sad knowing that with the proper equipment, supplies, and training this guy probably would've survived or at least had a chance of surviving. we suspect that he had schistosomiasis, which is not uncommon in these parts, but something that is easily treatable if it is caught
i don't know if what i could've done would have saved him and doubt that it would have impacted the outcome, but i do know that should this ever happen again, i won't stand by and not use the skills and training that i have.
patients impact us in different ways. i've treated soldiers and iraqis injured in ied attacks and seen the worst of injuries from car accidents, but none of these patients impacted me as much as this one has. merely seeing the conditions that he was in and the lack of basic care was upsetting to say the least, but more so, knowing that in another place, he would have probably survived. seeing his wife and kids grieving around the body of their dead father and husband, just tore my heart out. i grieve for his young wife and children, who will grow up in the same horrible conditions, but without the support and nurturing of their father.
the things i see here on a daily basis make me realize that we, as americans, are so lucky to have the things we have. how many of you had to walk 5 miles to get water for drinking, bathing and cooking? it's the little things like this that we take for granted. we are so lucky....