Today was my first day rounding. I worked with Dr. Denise, a Congolese woman training to be a pediatrician.
We covered the neonatal intensive care unit, a small room with five old fashioned cribs and two plastic incubators. The room houses premature and sick full term infants. It is immaculate, and everyone who enters is asked to remove their shoes. Unfortunately, due to limited resources the mortality rate is high. During the month of September 13 out of 31 patients died!
Dr. Denise and I started rounding in the far corner with a relatively healthy premature infant. She was gaining weight well. When I started to listen to the infant’s heart, I felt a painful sensation on my left forearm. I pulled away quickly and looked down, but saw nothing. I went in for a second listen and I felt the pain again. It was coming from the base of the incubator. I touched it with my hand and realized that I was getting shocked. The nurse handed me a pair of plastic slippers. I was not properly grounded for the antiquated and electrically charged equipment.
At 1:30, Dr. Denise approached me in the out-patient area and asked me to come urgently to the ICU. A premature patient born to a HIV positive mother began to have abdominal distention. As I was examining the patient, he began to pass bloody stools and to have bile coming from his mouth. We suspected his intestines were becoming necrotic (dying). His body soon progressed from a pink color to a shade of gray. We tried to work quickly to give the correct antibiotics and fluids, but again, resources were limited and things did not happen quickly.
I sat with his mother and informed her about the extremely dire condition. She sat silently, stared at the wall and cried. I have been told that communication with families of sick patients in the DRC is minimal. Hopefully this was helpful for the mother.
I stayed with the patient until darkness approached. As I left, I felt nauseous. Please do not let this patient die on my first day.