Per chance

He was sitting outside the casualty ward office. We exchanged some polite swahili greetings. He asked in English if I was a Father, not the first time I'd been asked the same question. "Not in the way you ask, " I replied.
So we talked for a little while. He was there to get steroids injected into overactive scar tissue on his chest wall suffered in an unspecified injury. He said the injections were helping.
He is in Mwanza on scholarship to university studying sociology. This education is to help him in his work in the community with refugees from Burundi, Rwanda and the DRC.
Turns out I reminded him of an Englishman who worked an office near his home village. When I shared that I was actually from the U.S, he said he'd visited Orlando.
He said how real some of the creations in Disneyworld seemed. This after inviting me to the park near his village where work is conducted with chimpanzees.
He was in Orlando to attend some kind of global conference of young people that do refugee work. His intention is to work for Peace.
Today he gave me some hope.

Why

A small roach scampered from beneath the laryngoscope blade as I lifted it from the box to place on its handle. It was symbolic of the futility of my efforts to follow.
A 6month old baby had stopped breathing. This following a 5 day illness during which he was treated at a dispensary and brought today to our hospital weakened from his struggle.
Why did this baby die?
Was it because his Mother was poor?
Was it because he was born in one place, not another?
Was something misdiagnosed or inadequately treated early in his illness?
Was it because he had an overwhelming pneumonia with poor defenses to disease?
Was it because I couldn't get a tube in his trachea?
We talk about the burden of disease. What about the burden of sadness?

Big Splash

Growing up my brothers and I would compete to see who could make the biggest splash jumping into the pool. I never won.
As mentioned in my last posting, I succeeded in getting nothing accomplished in my first three months in Mwanza. Making a difference, making a measurable difference...is that what it is all about? A big splash makes a difference but once the ripples die away, the pool, perhaps short a small volume of water remains the same.
This visit I brought two vital sign monitors purchased with the generous donation of funds from my home church, Davidson College Presbyterian Church. We've put the monitors to immediate use at the triage station and in the wards of the casualty department.
Today another woman with white eyelids and abdominal pain was rolled in on a stretcher. The new monitor revealed her blood pressure to be 85/49 and her heart rate was 140. She was cool to the touch and her abdomen was tender. In a previous posting I shared a similar case that turned out to be an ectopic pregnancy. Today was a virtually identical experience as I squeezed in the only unit of O positive blood in the hospital and waited for her to get to theatre. After she was gone I walked around the ward with a nurse from Kenya on her first day in casualty and we used the new monitor to take the women patient's vital signs.
A woman who moaned quietly as the drama of the first patient unfolded shared with the nurse that she might be pregnant. The machine reported her blood pressure as 105/79 and her heart rate was 107.
She got up to provide a urine sample ordered by the gynecology intern and passed out.
We repeated the same interventions for this quiet woman who also had an ectopic pregnancy.
These new monitors will accomplish nothing that could not have been accomplished without them. Nurses taking vital signs and a history on the patient's arrival is a process that requires no more than mercury manometers which are present but in short supply.
The question whose answer disturbs me is: When these monitors no longer work and the big splash(ok, small splash) and ripples have subsided, will the pool short of a small amount of water remain the same?