Working here at St. Francis hospital in Mutolere, Uganda has been quite the challange. The pediatric ward will have from 20-40 children as inpatients on any given day. Most of these children will have Malaria, intestinal parasites,lower respiratory tract infections, or acute gastroenteritis. Mixed in with most of the stable patients will be a few critically ill children in shock from severe dehydration, cerebral malaria or in near respiratory failure from advanced pneumonia. There are evenings when I leave the ward and wonder if that child will be alive the following morning or will I find an empty crib.
Besides a number of severely ill children there are also some difficult diagnostic cases like trying to sort out a child presenting with severe biventricular heart failure and me being the only echo tech. I find myself reading the clinical presentation chapters in the pediaric textbooks alot more closely, and making difficult diagnoses based on the histories and physical exams. As our laboratory and xray departments are very limited I have to rely on my bedside diagnosis. That gets to be a little scary when someones life depends on it.
There are some patients for whom diagnoses can be made but no treatment is available. I remember talking to this young 18 year old woman on the female ward who had been developing heart failure from what sounded like rheumatic heart disease. She certainly needed heart valve surgery but her family did not have the resources to take her to the capital to get further evaluation. She sat in bed silently crying, understanding what the future held for her.
For all of our limitations, many of the children get better and go home. One small child who presented with an intestinal obstruction from an intussuseption was able to have surgery by the obstetrition (no general surgeon was available). A few days after surgery when it looked like the child would live his mother smiled and said it was like he was ressurected.
What I am drawn to and at times wish I could run away from while working overseas is that all of the layers that insulate us back in the United States from poverty and all the suffering it brings, are stripped away. Here one looks at pain on a daily basis. You are pushed to your limit physically, mentally, and spiritually. The refining fire of life is hot here but one thing is certain, you will not be able to deny that you had a chance to become more of a human being during your stay.
To find out who you are and become someone better because of your willingness to serve others through the grace of God. For this I am most greatful.
Please keep Dr. Coda and his family in your prayers as they continue to serve. You may wish to sign a prayer card on our web site: https://www.missiondoctors.org/prayercard.html