I received good news in the morning. The neonate I was worried about survived the night and he had progressed to a slight shade of pink. We will continue to watch him closely.
I spent the day rounding on the pediatric patients outside of the neonatology unit. The area we began rounding was the size of a single patient room in the US. There were six beds huddled together. The mattresses were without sheets and unclean. Each bed contained two to three people, some looking moderately ill, some seeming to barely hold on to life. The first two patients had pneumonia and were being treated with antibiotics. The third had malaria and was recovering. The fourth was the patient I had seen on my tour a few days earlier, the malnourished child. He had received medication, a blood transfusion, food and seemed to be doing a little better.
As we moved on the fifth and sixth patient, I had to aggressively fight back tears. They were children with AIDS lying listless, nearly naked on the bed. They were truly skeletons and owned only a thin layer of unhealthy skin. They did not have the strength for the slightest movement and flies hovered about. I was living the images from Ethiopia.
We went to the next small building, but it did not get better. Patient after patient had AIDS with tuberculosis, pneumonia or diarrhea. There was little we could do for them.
After rounding, I returned to the ICU. A new patient had arrived who is 17 days old. She presented with fever for many days and weight loss. Her birth weight was 3500 grams and she now weighed 1500 grams. She had a temperature of 39.3, had a bulging fontanelle (soft spot) and a very stiff neck. The patient likely has meningitis. Frankly, I am unsure how she has remained alive.