Nameless

A friend of mine wrote a blog about his experiences in a developing country health care setting and chose to change the names of the people and places. I think this was a good idea.

It was my original intent to attempt to share these experiences as objectively as possible so the stories would be about this place and its people and not me. I can't seem get out of the way. I also want people to know about BMC and the work that The Touch Foundation is doing in Tanzania. I can only hope that those who see through my eyes will forgive any inaccuracies or misconceptions that may result.

The life expectancy at birth in Tanzania is 46. A perfect storm of HIV, tuberculosis, child and maternal mortality and increasing unintentional injuries from road traffic accidents combine to account for this shortened life expectancy.

There are also cases like the 23 year old who presented to casualty complaining of chest tightness. His blood pressure was 205/120 and he could not lie down on the stretcher. He had crackly noise in all his lung fields but looked comfortable as he calmly shared his symptoms with me. He also had markedly pale eyelid linings. He said his stool color had been black for 2 days. Again the ICU was full and to clear the casualty stretcher, the young man was admitted to a ward. In the meantime, I followed him to x ray after I was told a portable film was not possible. I saw the fluffy white markings in his lungs that indicated fluid was spilling into his air spaces. I walked his tubes of blood to the lab and waited for the result which was a hemoglobin of 4.4(less than 33% of what it should be).Unlucky for him, his blood type was O negative and the hospital once again had no units of the rare(for Mwanza)blood type. I rode with him up the elevator and explained to the resident and charge nurse that he should not be here and to please take him to ICU when a bed cleared. Later that day I saw him sitting on an ICU stretcher eating rice and meat. We smiled at each other and waved a greeting. I relaxed and went home. This morning I went to ICU and discovered that this young man had died at midnight.

You know if it was ethically acceptable I would choose for you to know the names of each of these patients described in my postings. I think it adds to the sadness that they are the only nameless participants in the stories I share.