Ambulances on the move...sort of

Yesterday was a typical day here at Maluti. Before I tell you the story, I should give you some background on where I live here on the hospital campus and how I get roped into things that are not remotely related to my research work or the project that I'm running. I live in/run house # 2 (sorry dear readers, I do not live in an 'exotic' rondavel nor do I slog water from the well or use candles often(that was Ghana and West Africa!)!!). House # 2 is a 4 bedroom slightly run down casa on campus that is used for visiting medical students, doctors, and other volunteers like me. This house has put me into contact with over 35 people this year alone (mostly medical residents from Boston University and Harvard and some med students from BU). Wonderful, amazingly brilliant folks, but all type A (I now have a growing taxonomy of type A folks, myself included!), which is not a good thing to be when working in sub-Saharan Africa!

One of these guys, a brilliant pediatrician who will one day go on to be the head of pediatric endocrinology at some uber academic center like Harvard Med, was deaing with a patient age 6 who was admitted in really bad shape (I will spare you all the medical details but the pediatrician diagnosed it as cerebral meningitis). The first doc who saw him did not treat him correctly and could have killed the kid. This did not go over well with the pediatrician, who was coming back from a satellite clinic, and so he dragged the other doctor back to the ward from his house and showed him how he should have treated the kid (lots of mea culpas coming from the lips of the first doc, no doubt). In the meantime the poor mother (a tiny, skinny lady from a village way out in the Maluti mountains) was absolutely overwhelmed with her surroundings, the fact that her son was in bad shape, and the 'lekoa' (white) doctor who was treating him with eveything available, which is not much in this corner of the world. The pediatrician asked me if there were anymore advanced medical facilities in Lesotho where the kid could be treated. I said the only referral center was Queen Elizabeth II Hospital in the capital city of Maseru or in Bloemfontein, South Africa. Thus began the epic saga of transferring the poor kid.

The medical superintendent and most of the top admin staff were off in Bloemfontein at yet another church/medical related conference and so I text messaged the superintendent and asked him to contact the pediatrician ASAP. The super gave the doc permission but said that nothing could be done until the next morning even though the kid was in very bad shape. The pediatrician managed to keep the kid stable overnight but unfortunately he [the doc] was going to Maseru early in the morning for training at the new Baylor Pediatric HIV/AIDS clinic. He asked me to arrange the transfer the next morning and make sure the kid had his am meds, and then instructed the medical student from the UK (I guess he did not trust the other junior docs from the Democratic Republic of the Congo anymore) on how to care for the kid and other pediatric patients. After running around all the following morning to the business office, pediatric ward, social welfare office, receptionist, and maintenance office to sort out bill payment (the mother of the child was destitute and came to the hospital with 5 Rand and the clothes on her back), arrange an ambulance and a nurse to go with ambulance, social welfare (to pay for the bill and refer the mother to the social welfare office at QE II hospital), give the mother some money so she could feed herself in Maseru (the lady had never been to the capital city before and she look shell shocked that morning), and make sure there was a medical discharge note and the kid had his morning meds, I finally managed to get the kid transferred by noon!!! So much for an emergency transfer. What a bunch of rigmarole for what should be a straightforward operation, and to think that the receptionist and the business office wouldn't allow the kid to leave until the bill or some payment method was settled. Huh?! I finally had to say that if the kid died it would be on their heads!! Grrr... can you imagine if this was your kid?? So much for being an anthropologist....time to go to med school or become a Marine Sergeant!