Day of the African Child

(Press release):  Nairobi, June 16^th 2009: Africa observes the Day of the African Child, in memory of, thousands of black school children who were maimed and killed in 1976 Soweto uprising, as they took to the streets to protest the inferior quality of their education and to demand their right to be taught in their own language.

Today is a UN-sponsored day to draw attention to the plight of the African Child, which is all too often a life of marginal nutrition, sub-standard education, fragmented family (in spite of our stereotypes few kids here grow up with both parents), and too-early shouldering of adult roles and responsibilities.  I suppose I celebrated it in my own way today, struggling for the real lives of a few real African children.  All in a day's work:  a newborn baby with spina bifida who could be helped by referral to a neurosurgical mission hospital on the other side of Uganda; a newborn whose mother died in the process when her uterus ruptured who could be helped by milk until the family sorts out a surrogate breast-feeder; a convulsing baby whose anxious and misguided parents had been treating him for days at home with herbal enemas which were ineffective for his real problem of meningitis,  but who could be helped by IV antibiotics; a five-year-old inexplicably malnourished little girl who tested positive for AIDS and could be helped by the correct medicines and counseling; a child with newly diagnosed sickle cell disease who could be helped by prophylactic antibiotics and vitamins; an infant with severe gastroenteritis who could be helped by large and fast infusions of IV fluids; and the list goes on through a crowded ward and a line of consults.  

Too many days I have the sense that all the effort is for little gain.  But today a small supply of anti-retroviral drugs arrived (not much, but enough for the next week) and another consignment of anti-malarials, which is huge news.  Both evidence that prayers are at work, that good is gaining margin over the chaos of want.  And lastly I want to share one very satisfying victory.  Two weeks ago a child was admitted with severe malnutrition, and given his terrible respiratory status and his coughing skinny mother, we thought the pair probably both had TB.  But the mother's sputum tests from another hospital were negative.  The clinical picture was so convincing, though, that I set out to get her re-tested.  I have never worked so hard for one simple lab test.  It would be too tedious to describe every turn in this story, but here are a few:  no frosted microscope slides, which the TB program requires because the slides have to be marked with the patients' name and saved for review, phone calls, none at another lab but the idea of using tape to mark the slide, the lab refusing and demonstrating the slide would then not fit in the right slot in their storage box, more phone calls including the District Health Officer informing him that our entire public health effort to find and treat TB was failing for lack of lab supplies, who then suggested we send someone to beg them from another health unit, paying for the fuel for the motorcycle to do so, to no avail since they did not have them either, noticing a truck from Kampala with "TB and Leprosy Programs" painted on the side and shamelessly interrupting to beg aforesaid frosted slides which they happened to have stashed in the back seat (?prayers), then finding out that a certain acetone fixative was lacking for the stain, more money for more motorcycle fuel to track the fixative at another hospital, then having the mother turned away from the lab for lack of gloves, providing gloves . . . meanwhile the interns looked at this kid and couldn't believe he was still alive.  By Friday this was still going on and I decided to just start treating the child for TB anyway.  He actually improved over the weekend.  And today his mother FINALLY (AFTER TWO WEEKS OF RUN AROUND) got her sputum sample:  triple plus positive for TB.  So instead of a dying child and a more slowly dying mother, or a child who was treated empirically for TB only to be orphaned when his mother died of the disease or re-infected when he went off therapy  . .. now we have hope of two people being cured and living normal lives.  

And the real story here is the same story as Kevin's . . . it is God who is looking out for individual lives.  Most times the degree of difficulty involved and the sheer volume of other demands would have meant that this child and his mother slipped through the cracks.  Many mothers might have also wearied of the rigamarole and gone home by now.   But in this one small case, God kept prompting one more step, one more try, until the diagnosis and treatment were complete.  Because He cares about the African Child, not just as a politically correct concept, but as an actual flesh and blood and tubercle bacillus-infested individual who will one day take deep breaths and perhaps graduate from high school or build a house or write a story.  Or just carry water for his mother.