Tuesday, September 11, 2012

Dana's Story and RH Bill


 
     Dana is  4 years old and weighs 8.5 kilos on admission (that's about the weight of a 7-8months old infant and sometimes 6-months old breastfed infants). She is the youngest of 5 children. She was born at home, a hilot helped her mom deliver her. Her mommy couldn't recall all the immunization given to her or if she was given any.

     Her mommy hadn't noticed when Dana started to stop walking ,talking or growing. But those are not their problems.


     A week earlier, Dana was admitted at the provincial hospital because  Dana has been having diarrhea , continuous high fever and cough. While she was there, she was given medicines and blood transfusion and was sent home after one week of hospital stay.

     A day later, Dana was brought in cradled by her mom at the emergency room . And being unable to express herself elaborately, Dana's mother simply said that her daughter did not get better after the 7 days confinement from the previous hospital.
    
     Dana was severely dehydrated, severely malnourished, and extremely sick (to the point of blood and brain infection! )
    
     I told her mom that Dana could die anytime.
    
      But unlike usual parents who would breakdown and cry, or there are those, who would swear and scream. Dana's mommy did not show any of those extreme emotions. There was just silence , perhaps they are signs of emptiness, misery and indifference. But then again, she brought her here just the same with the hope of getting better.

     Dana is important.

     Dana was given intravenous fluids and medicines. A tube was also inserted through her nose to reach her stomach for feeding. Her feeding started with 35g milk, 20ml oil, 100g sugar and one liter water given in small feedings. She was also given zinc syrup, multivitamins, magnesium sulfate.We tried asking for vitamin A at the health center but failed and I  thought of giving Dana copper as mineral supplement but  was also unsuccessful ( I can only think of the electrical wire as the only accessible source of copper here. So perhaps when she get well enough for discharge, she can chew the copper wire at the social welfare office where I plan to refer her back.)

     Dana was fairly difficult to manage during her first 72 hours of hospital stay, she was between living and dying. She had medical problems on top of other medical problem.

     Gradually Dana improved. And on the 7th day, Dana can be left sitting on her own and can eat by herself. (Although a normal 4 year old can read, write and do a lot of stuff, I was happy Dana can feed herself already!!)

     On this day also, Dana's mother approached me and asked me what Dana was sick of ,her dad wants to know.  And I said..."What??!!!" I almost fell out of my wits. I have been explaining everyday Dana's day to day progress ,and day to day plan. Anyway, the only solution is to let Dana's mom memorize a segment of Dana's diagnosis: Pneumonia, severe; TB and Malnutrition. (The entire final diagnosis would be too much to memorize for Dana's mother. And I think severe pneumonia has a worse implications than septicemia or meningitis in terms of relating it to other relatives , or even in tsismis sa may tindahan )

     The plan was to complete medications and build her up to the last hospital day. That would be more or less 14 days.

     On day of discharge, two page discharge instruction written in large fonts and translated to the local dialect was explained to Dana's mother over and over.Then, Dana's mommy was reminded of family planning repeatedly . She was reminded of family planning repeatedly. Repeatedly.

     Will Dana recover completely? Will there be enough food for Dana when she gets home? Will Dana be able to go to school? Will there be more siblings after her?

         

 
This is Dana's mother on her 7th day at the hospital.




 
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