For Lack of Printer Paper

An ongoing theme in my work here is inaccessibility. Treatments, medicines, medical machines exist--but very often they're inaccessible to people for really frustrating reasons. 


Last Friday in the hospital canteen, a girl ran up to me and grabbed my arm.  It was only when I saw the mother of the girl that I realized this was a patient I had taken care of a few weeks ago.

About a month earlier, this 10-year-old girl was admitted to Bugando for recurrent seizures.  She was diagnosed with epilepsy 3 years ago. Medications had initially helped to control her epilepsy but over the past year things turned for the worse.  Within 6 months, she was admitted to the hospital 10 times for seizures.  

When I first saw her in the hospital, she was lying in bed groaning, tired and speaking in incoherent sentences.  Her mother was tearful; she had never seen her daughter like this. The medical team and I observed that her epilepsy medication had not increased as it should have been according to her weight. The dose she was on was not enough to control her seizures. We also wanted to get a head CT scan to rule out any other causes for her recurrent seizures.  

But of course we ran into a few problems. 

Barrier number one: a CT scan costs 150,000 TZ Shillings (110 USD), which is more than a months’ salary here for the average person.  Her mother didn’t have enough money.  But my Baylor colleagues generously put up the funds, so barrier one was overcome.  

Barrier number two: the printer for the CT machine was broken.  No images could be printed.  The machine could only save images for one day, then they would be bumped off because there wasn’t enough storage space.

We talked for a long time about whether a scan was a good idea given that there wouldn’t be a hardcopy to review later. We decided to wait. The patient’s mental status was improving and she did not develop any further seizures so it didn’t seem as dire.  She was discharged after a few days, but her mother noted that she was not quite back to her normal self. We promised that when the CT machine was able to print, we would get her daughter’s head imaged.

That day in the canteen, my patient’s mom reported that her daughter was doing great, and she was back in school, but what about the head scan? When would her daughter be able to get her CT scan? 

“Pole sana,” was all I could say.  Last I heard the printer was still not working.