Friday, March 2, 2012


so. let me introduce you to the illustrious pediatric re-hydration campaign

a plan that at its conception several hours ago proudly boasted of 17
bleached out juice bottles, 10 oral-re-hydration-salt sachets, 9 500 ml
bottles of Ringers, and one bent and battered yellow notebook where we
sign it all out.

already - we have 2 of our first patients

already - it is working.

you would think that drinking water is a simple things.
that knowing that children need water is intrinsic knowledge
that not giving a kid something to drink for 24 hours wouldn't be common
that hearing things like "he doesn't want to drink so he hasn't had
anything today" as I pinch up the skin into shapes and it stays in place
wouldn't be something i hear and do every day.

or, you would think, that after I explain that, for example, they should
give them X ml/hr for X hrs they would at least do it once or twice.

I don't know where the breakdown is
I don't know where the communication or lack thereof got lost along the way

I only know that almost every child in peds is de-hydrated.
and that no one has cups.
and i can't get it out of the pixus. or the supply closet.

and no matter how much they need it - IVF is the last thing that we
prescribe. because first on the list is quinine....or mabendazole....or
we have to conserve their resources for only the essentials.

imagine what would happen in American healthcare - if you had to pay
CA$H for every medicine, every consultation, every IV, every everything
BEFORE you got help. If you were sent away if you couldn't pay cash up

and we say, well, here, thats okay, because its so cheap. the hospital
services are so cheap. but they aren't. not if you look at how much
income they make here - approx. $1.00 a day. You can almost never get
out of this hospital without spending 10-20 dollars your first day - and
we call that cheap??

so, in actuality, this hospital is for the affluent. During our time in
the villages, we are learning that most people in Bere can't afford the
hospital. Most come from Kelo, from other surrounding areas....

anyway, this all adds up to the fact that almost every child in peds is
dehydrated and hydrating them is not simple. I've been trying for 4
months and it is the simple things that are accomplished only with a fight.

so - all the volunteers are donating their bottles - we will have a good
supply because it is so hot and everyone's weakness is going to the
market to find something cold.

people like bottles here. old bottles are sold in the market - most
people don't have a water bottle and containers of every sort are always
in demand.

I have tons of crystal light packets, juice packets etc.

so, for the kids that aren't vomiting, we will mix the salts with juice
and give them a bottle. They are told that they need to give their
child at least 5 cap fulls every hour. That the bottle needs to be gone
in a day - and then we will fill it up again.

now. they have a container. they have something measurable. they saw
us mix the salts and the juice - the kid likes it. so, at least today,
they are giving it. now - water is medicine.

for the kids that really need fluid and are too poor to buy it, the
nurse will sign out the Ringers and amend the count.

This isn't sustainable - i'm using the "needy neighbor fund" money i
begged from my mother - to use in Pediatrics - but at least while I'm
here, there is no reason any child should be dehydrated in the next 6

I am so excited.

i already can see dehydration running for the door, tripping on its
wrinkled skirts as it goes.

also - some good happy news - the picture I posted of the burned kid -
Felix - the one we spent so much time and grief and effort on, the one
we made the burn creme for - he got sent home like a month ago - and
today I ran into his dad. He is walking, his skin has healed, he is
healthy, he is alive. he made it.

it just shows you that good things can happen when you don't give up.
that you should keep trying because one day, all your efforts will
collide, all the small things, and someone will live because of it.

The nurses here and Olen too are convinced that the burn creme Amanda
and I cooked up in the kitchen saved the life of a 13 year old girl.
she is still here. 3rd degree burns all over her chest and face and
arms, but she is almost healed and when she got here they used only our
burn creme on here because there wasn't anything else and everyone said
it worked better. I'm not trying to brag, maybe I am just a little, I
just think its so amazing that a little effort and a little ingenuity
can actually save someone's life. it reminds you that ideas matter, and
that hard work matter even more.

so, those are some happy thoughts.

so. drink your water. and be glad you don't have to boil it first.

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