Our head nurse had to find the mother and deliver the news: her 8-month-old daughter had died. We had known for two days that this would be the eventual outcome – she had been gasping for air since arriving to the hospital, and we don’t have ventilators, and her tuberculosis and malnutrition were much too advanced. When she eventually stopped breathing, I was in my ward, the Emergency Zone: a parent came up to me urgently and pointed to the ICU, so I went quickly to the unit and led the resuscitation. She had no pulse, her abdomen was distended, and within a few minutes blood came out of her nose. She could not be saved.
I looked around to see if the mother had come into the ICU during the code, but she had not. Our head nurse went and found her, and when they came into the room, the nurse delivered the news. The mother’s tears quickly became sobs as she leaned over her baby in utter despair. The people in the hallway and the Emergency Zone looked our way and paused for a moment, realizing that yet another child had passed. Of the 250 children hospitalized in Kamuzu Central Hospital each day, 3-4 children die each day, so everyone is accustomed to these moments when the ultimate tragedy occurs. I sit here, crying as I write this, unable to fathom how these parents get through each day.
Looking from 20,000 feet, global child health is moving in the right direction, and Malawi is on course to meet its U.N. Millennium Development Goals for reduction in child mortality. But this fact is of little comfort to the 10 million children who die worldwide each year, almost all from basic diseases that are easily treated or prevented, like with our patient yesterday. With all these preventable deaths, it’s easy to understand why so many international organizations focus their resources on preventing and treating infections and malnutrition. With BRANCH, we’re taking the next step and asking “As survival rates continue to improve, how can we ensure that each child grows up in a safe, stable, nurturing home?" This question is vital to the 6.8 million children of Malawi and the billions worldwide.
This first week at Kamuzu Central Hospital has already done much to inform my work in BRANCH about the day-to-day challenges that the medical, legal and social service agencies face in their work to help children. I look forward to the next 7 weeks and to continuing to learn from my Malawian colleagues about how they want to grow their work to improve the lives of children.