2am “Oncall, oncall for ICU – we have one child yes, they are convulsions…” I jolt into wakefulness and am out of my bed and running over to the hospital as fast as I can go telling the nurses to prepare IV diazepam down the radio as I go. This could be anything, but always think worst case scenario… I arrive on the ward and yes, this is actual convulsions, a four-year-old with cerebral malaria.
Being able to go to the hospital at night requires a proverbial blade, its attachment and a handle. Practically speaking we need drivers, cars, petrol, guards and radio operators to make it happen. We need nurses on duty, who first discover something is wrong. We need logisticians who ensure there are generators to give light to the hospital at night. We need non-medical team members to also order key medications that I or other medics might prescribe at night. We need a coordination team in the capital to reach an agreement with the Ministry of Health that we can work here in Amtiman. And we need donors and supporters who generously give to make all of this possible.
Late at night we need a doctor. But we need a lot more too.
It’s just after midnight in Rutshuru. Tomorrow morning Dr. F, the French anesthetist who arrived here with me, and I leave for Goma. Unfortunately the schedule worked out with me on-call at the hospital and I missed tonight’s farewell party. This morning we had a fairly typical day in the OR, doing 12 procedures between 8am and 1pm including performing a skin graft, placing a traction pin in a patient with a fractured femur, draining a few abscesses, debriding a few wounds plus a handful of dressing changes including two children under the age of three with 2nd degree scald burns over roughly 30% of their bodies plus an eight-month-old who had her foot amputated for an infection two days earlier. I also admitted a 16 year old girl from the ER with chronic osteomyelitis [bone infection] who will need a fairly large operation in the next week or so to remove infected dead bone from her tibia. Chronic osteomyelitis in children is rare in the US but fairly common here in the DRC.