Friday

Today was an emotionally exhausting day. During morning report, I learned that one of the patients I had cared for since Monday died in the ICU overnight. Though I knew her prognosis was poor, I was hoping that somehow her life could be saved.

The patient was a one year old malnourished female infected with HIV. She was brought to Bugando Hospital last Monday after suffering from 2 weeks of cough and fever. She was initially admitted onto the general pediatric ward and started on antibiotics, but her respiratory condition quickly deteriorated over the next 24 hrs and she was transferred to the ICU for closer monitoring and placed on a breathing machine.

We first thought the patient’s HIV status was negative. We had asked mom her HIV status, she denied having it. Because of the stigma of the disease, many mothers are afraid to disclose their status in hospital rooms shared with 10 other families.

Despite what the mother said, we sent off an HIV test on the patient (which came back positive), because of the patient’s rapid respiratory deterioration even after starting antibiotics and her wasted appearance. Both of these can be signs of chronic immunological suppression. This girl had so many odds stacked against her, and unfortunately we could not save her in the end.

After morning report was over, I faced the second death of the day. While rounding on the wards with the medical team, a mother from the next room ran over crying, holding her 5 month old baby in her arms. The baby lying in mom’s arms was motionless and had lips turned blue. I quickly discovered that her heart was not beating, so we performed CPR; but our efforts were futile. After a minute we pronounced the baby dead.

As often happens in hospitals like Bugando, there is a shortage of health care workers prepared to deal with the overflowing numbers of sick patients. Some patients may only be seen by nurses once or twice a day. Families often aren’t aware of danger signs and can find their child dead beside them on the hospital bed.

Thankfully, there were no further deaths while I was in the hospital but I still came home exhausted.