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Thursday, September 21, 2006

Follow-up

Mbambu died last night, the little girl whose silence signaled her need.  Too little care too late, her absence on the ward this morning barely discernible, leaves me numb.

On the other hand, a potential redemption.  Dorothy, whose picture and story Scott posted a few days ago, left a child.  Mumbere is 2 years old, having clung improbably to the margins of life throughout his mother’s relentless decline.  As soon as she died his grandmother, Dorothy’s mother, brought him for care.  I realized that while both he and Dorothy had been started on TB therapy, she never gave him his medicine.  So we admitted Mumbere for a week for “DOTS”, directly observed TB therapy, which is supposed to be the standard of care.  The idea is that a responsible staff member WATCHES the pill go into the person because compliance with a once-daily medicine for six months sounds so simple but in practice is so difficult to achieve in the lives of our patients.  The grandmother is diminuitive herself, a quiet lady whose ragged clothes and meager possessions witness to her own desperate state.  A couple of us helped her with food and other things, and we gave Mumbere a double portion from the nutrition program.  Within days he had put on almost a pound, which for him is a nearly 10% increase in weight.  Then he started to smile.  In all his pitiful life I had never seen him smile before.  

Yesterday his grandmother begged to go home.  I asked her how I could be sure he would get the medicine if we let him leave the hospital?  She replied that she would give it faithfully because “this baby is the only picture I have of his mother, my child”.  She said that over and over and it struck me that that is so true.  When someone dies here there is little left to remember that person by, except their children.  I’m praying for the tragedy of Dorothy’s life to be redeemed in the love between her mother and her son.

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