Unfortunately, children die frequently in the DR Congo. Despite the high incidence of pediatric mortality, the subject of death seems to be taboo.
Yesterday, during a family conference with the mother of an ICU patient, I said “I think your daughter may die soon.”
My translator at the time, who is a doctor, froze. She stopped speaking, looked at the ground and refused to relay my message. I was forced to find someone else to interpret. This is not an infrequent occurrence.
Today on rounds we spent more than 30 minutes talking about end of life care. We detailed how to engage a family in a discussion about pain management prior to death, how to talk about “do not resuscitate” orders and how to elicit a family’s wishes regarding the death of a child.
Hopefully things will change.