My medical school ( Patan Academy of Health Sciences), has a system of assigning 3rd
year medical student on night call once a week with the motto of providing good exposure to clinical scenarios and
practice protocol. It has already been 5 months of my clinical journey. During this timeline , I haven’t encountered such a pathetic case yet. I don’t know whether I was lucky enough not to face such disaster or lagging behind from being aware of bitter reality of
our society. At that night, I was staying at Emergency Room with one of my colleague
talking about history taking and presentation that we were going to have tomorrow, at morning handover. Though patient flow at PH is generally high and the environment
of ER seems quite hectic, today the condition was somehow different. Probably
because, it was heavily raining outside affecting the transport as well. I was wishing to finish my work soon so that I
can enjoy the sleep in such a nice rainy night. There were just few bed
occupied in ER. Doctors & nurses were on relaxed
mood , talking and laughing with each other. Meanwhile, a middle aged
man, with raged shirt and muddy cotton paint entered the ER carrying a baby on
his arm. Following him, two middle aged women with tears on their eyes entered
inside. That man with small voice turn around the doctors and uttered “
Doctor…” I don’t know what he was trying to say, but he was unable to complete
the phrase. Group of some doctors who were at middle of their discussion, turned around and asked, “ What happened to the baby?” . That old man was silent
with frightened look. It was like pause for few seconds and then a girl standing
by his side uttered few words. “Doctor saap, pneumonia”.The doctor
requested them to keep baby on one of the vacant bed and whispered with
colleagues in a joking manner, “ See, they came with diagnosis, easy for us” . Then
he walked towards the bed. We also smiled at his joke and kept on doing own
work. After few seconds (probably a minute), doctor requested a nurse to bring
bag and mask , asked for help with colleagues. Suddenly, the environment of ward became different. We too, along with others ran towards the bed.
There was a cute, small baby boy sleeping without response on bed. Doctors
started giving basic life support( Bag
and mask ventilation) to the baby. Nurse was preparing some medications,
opened the vein from hand and administered the drug. Doctors kept on trying.
Baby had cold extremities,he was neither crying nor respiring. After
each interval of BSL, doctors were taking ECG. I was praying for ECG not to
come flat. But each time, despite lots of exercise , unfortunately ECG finding was same.
Finally, doctors came to the conclusion that he was already DEAD/on
arrival. They stopped all the procedures
and return back to doctors zone. During the procedure, I noticed that middle
aged man who was his father and a lady(Mother) were far away from the baby(Probably at a distance of 6 feet). They didn’t even dare to see the scene. Mother was crying
silently and father was giving the same blank look.A girl who had come
with them, was quiet close and observing all these. Later I came to know that she was
their neighbour. Eventually, doctors broke the bad news with baby’s family.
Mother was on tears and father was murmuring, “babu, chhora why u left us?”
holding the dead baby on his arms. One of the intern doctor started making note
and legal documents which has mentioned “Death probably due to cardiopulmonary
arrest”. During that period, I also tried to dig out the history
from note and that neighbour lady. While I was asking something, she was cross
questioning me, “Do they have to pay hospital charge or not?, time and again.
From her I came to know that they were from Badikhel, probably 5 km of distance
from the hospital and he was the only child they have. On further enquiry, I came to know that baby
was apparently well 4 days back when he developed the symptoms of high grade fever with chills, rigor and cough.
He had decreased appetite since then and used to cry all the time. This morning
parents went for work leaving the baby alone in the home. When they came from
the work at 4 pm the baby was silent. He was neither moving the body parts nor
breathing. Then they brought him to the hospital by local bus at about 7 pm.
Here,
from this story, I'm not just trying to express my sentiments on his death.
Yeah, though it is tragic, its normal physiology of life. Some die early and some
later. But, its really tragic and shocking to know that people are dying even
from simple preventable and curable disease like pneumonia in the community
just because of poor economy, even in the place like Kathmandu , CAPITAL CITY
OF NEPAL, the same place where hundreds of people spend bucks just on
gamble every night, where thousands of people spend thousands of money for
prostitute, alcohol, luxury and fun.
They
were from poor economic background. The couple used to work at itta-vatti on daily salary basis. That was the only income source they had. Baby was ill from last 4 days. They decided to wait for few days if
he improves on his own, probably because of financial issues. As usual, this
morning also both of them went on work leaving the baby alone in the home. This
was the similar story since last 5/6 months. There was no other caretaker at
home. Nor they have ability to leave the job and take care of him daily. Mother
fed the child in morning and went for work. When they came back baby was still, not crying and not responding.
Don’t know, from when that poor baby was struggling to live. After that, they
called for help and the same girl who was with them at ER came and they brought
him to hospital. The most shocking news was they brought that baby on local bus
from Badikhel which took about an hour, just to cover 5 km of distance. We can
just imagine, even a person from low economic class tries to call for ambulance
or any other private vehicle, at least in such emergency situation. But, what a
reality?, they couldn't afford that. Probably that was the same reason,
that neighbour girl was asking time and again.
At
the lap of capital city, feels bad to know that its money which plays a key role on cure of sick people. Such a polarity on economy of society, such an inequity.
Is it a crime to born in a poor family? Of course not. But the fact is, in the
society like ours, such humans are just like innocent prisoners caged with
poverty and deprivation. What about the parents who have to live whole of their life with guilt of being economically
deprived. Do they have no right to have child?? to dream big?? to live happy
life?? If yes, who is responsible for those factors that come conjointly with
the birth of baby i.e. added responsibility, of care, of money and of growing environment. Its not that poverty is deeply rooted at Karnali or Mahakali only. The public health activitis seems quite satisfied that
the nation is going to meet Million Development Goal. But in other hand though
we are in line of infant and child mortality reduction, what's the effect on
those who are still losing their child, their hope. Even if the mortality
decreases to less than 1%, those who are among that “less that 1% “ , for
them its same like 100%. What is the compensation for them? It’s time to think. It’s time to unite and
fight against inequity, such a huge social stigma.
So, from this story, my commitment to go to rural Nepal and serve poor population has got more power. I am proud to be the part of such medical college which is dedicated to sustained improvement of health of people specially those who are poor and living in rural areas...
So, from this story, my commitment to go to rural Nepal and serve poor population has got more power. I am proud to be the part of such medical college which is dedicated to sustained improvement of health of people specially those who are poor and living in rural areas...
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