Africa Vision 8

Africa Vision 8

N’Djamena, November 22, 2007

Medical reality.

Bebetou is our first place to visit. There are several roads leading through the forest. You get bumped and mauled and this is the best season to travel. I am told that elephants roam freely and that at some places where we drive during the rainy season the road is submerged in a lake. Between June and October due to heavy rain you need several hours, if you arrive at all and a Toyota 4x4 pick up to arrive. Now the 50 kilometer from Doba take only two hours.

This village is relatively well off. Two thousand people live here and there is a Catholic mission post, a protestant health post, a government health post and it is the main village of this locality. Yet even here the government health post does not do all vaccination. The cold chain is in place. Staff members are trained and available. Yet when the nurse goes to the regional capital Doba to pick up vaccines they are not made available. As a consequence diseases like measles still are rampant and tens to hundreds of children can still die of this vaccine preventable disease. And every so often there is an outbreak of measles. Two thousand seven and children die of malaria, malnutrition, tonsillitis and chest infections.

What happened?

Why are basic services not even delivered to the people in the rural areas?
True there are great obstacles; distance, access over trails, lack of personnel, funds, resources. The magnitude of the disease load (malaria is rampant), cultural practices (children eat last, for a multitude of reasons), traditional healing practices (when a child is feverish, the tonsils are removed by a local healer by finger. This practice often leads to bleeding and death). The nurse in this health center told me he had 30 ampoules of Quinine. This enough for the full treatment of maximum three patients suffering from severe malaria.

But I also said this center is well off. The diocese has a vehicle and in case of emergency the hospital is about one hour drive away. Many villages lie in more isolated places. Picture the chances of a child there. Often health posts are health post only in name. When a woman delivers and in it turns into an obstructed labor there is a high likelihood she will die in childbirth.

As for the tropical medical doctor it is a great area to work in. Malaria, leprosy, schistosomiasis (mansoni and haematobium), cutaneous leishmaniasis, oncerchosis (river blindness), tuberculosis, HIV, typhoid fever, meningitis. The list is near endless. My plans for the next two months will be to work in the hospital at Bebedja part time, teach at university part time in N’Djamena. Traveling up and down from north to south and back.

Bebedja is a mission hospital and has taken over in the region as being the only functional hospital for a big region. The public hospital in the regional capital has shut its doors. Here there are about 85 beds. There is an operation theatre, maternity, HIV voluntary counseling and testing center, treatment of HIV, out patient department and inpatient department and a laboratory. Several sisters work in the hospital as do 3 doctors and many other health staff. It is a great opportunity to get to learn more about the local language, diseases, problems and solutions. I am happy to be going back south soon.

Peace and love,

Ashis

Aspiring jungle boy