Easter Weekend

I had the relative misfortune to draw the “on call spot” for Easter weekend, despite me being the one who puts out the schedule. How does that happen? Anyway, this afternoon the nurses called me about a 7-week-old, 5.3-pound girl who is in our Infant Feeding Program (IFP). The program is designed to allow them to have months of nutritional supplementation in preparation for their cleft palate repair, a defect that limits their intake and development in the first place. They are taken care of at home, but the guardian brought her in because of a fever of 102. She had been feeding less than usual (not a good sign in any infant) and had only had 2 wet diapers. Her head was out-of-proportion to her body, she had large doe like eyes, and her skin was wrinkled without much turgor. She was subdued with a mildly pronounced fontanel-not a good sign either. As we finally located the information on her in the IFP files, we discovered that she was HIV positive, her mother seriously ill, and the baby had recently been started on retroviral medications. This was going to require a major septic workup and an automatic admission on multiple IV antibiotics until her cultures were either negative, or identified the source of her infection. There are no pediatricians on the ship, and this could take a lot resources that would ultimately lead to many other patients not receiving the surgeries they needed as well as being, frankly, beyond our ability to handle. Sierra Leone had just enacted a law that allows all children under 5 years old to get free medical care, so I gave the local children’s hospital a call. I couldn’t reach the administrator on call, so rang the “Wellbodi” doctor.  I was actually surprised that the call went through, and to hear an American accent on the other end of the “line”. To my further amazement (given the unfortunate lack of trained physicians and medical resources this country has) the doctor knew the patient by name before I could tell her. She said to bring the baby to the Emergency Department and she would notify the pediatrician on call that the infant was coming. Remember that this doc was not on call, but still available by phone. I was blown away and said so to our nurse supervisor. She agreed and said that the pediatrician is a great doctor, nice person and was surprised that I hadn’t met her. Come to find out that she had grown up as a child on Mercy Ships, left to go to medical school and train as a pediatrician and now practices in Sierra Leone. I was sobbing in tears as I was telling Mary the story. How wonderful and frankly Divine to encounter a person who, having seen as a youth what a dedicated life can mean to those who have been forgotten by most of the world, then decides themselves to train for years in order to make a difference in this neglected corner of the world. I was humbled and broken.