It was a tough day at the clinic today. Wednesday is the usual day for the malnutrition clinic at Bwafwano (which has miraculously continued to have some attendance in spite of not having food), so the MCH clinic had a decent turnout-- about 17 kids came in to be seen, several of which will be started on the feeding program once we get everyone trained next week.
There was a big interruption toward the end of clinic, when Mr. Chello came looking for Rebecca and me. A child that was seen by him yesterday for diarrhea and dehydration was brought back again by her mother, looking somewhat more sick than yesterday. She was given ORS (Oral Rehydration Solution), and the girl was apparently still sitting in the waiting room when the mother noticed she was no longer breathing. She brought the child to Mr. Chello, who came to find us. The baby was pulseless, so we started CPR. From the beginning, we knew our chances of success weren't great, but we continued for 15-20 minutes while a taxi was called (there are no ambulances here, and Bwafwano's trucks were elsewhere). Rebecca continued in the car on the way to UTH, where the baby was pronounced DOA.
Meanwhile, I continued with the clinic. One child was found to be HIV+, and one other we referred to the Chipata clinic for a chest x-ray for a strong suspicion of TB. In our most difficult case, an HIV+ mother brought in her twin children, both of whom will need supplementation. The tough part is this: her first child, by her first husband (who died), is HIV+. The twins are HIV-. She is HIV+, but only found out a week ago. As of yet, she has been afraid to tell her husband for fear that he will divorce her. However, she is still breastfeeding her twins, who are both 11 months old now, which for those of you who don't know is a risk for transmitting HIV to those two. Her reasons for continuing this are twofold: one, if she stops now, her husband will become suspicious, and two, she says they don't have enough food to feed the twins in any other way. She claims that she will bring her husband for testing tomorrow, but it remains to be seen. Right now, I am mostly worried about her twins.
Zambia's Flag
Map of Zambia