My niece, Livvi Swann, is working as a doctor in a paediatric ward in Malawi. Many children have HIV. Here are excerpts from her e-mails:
"The paeds unit is well set up and slightly better stocked than I anticipated, but still runs at a 1 in 20 mortality for all admissions. Better than the adult unit (who don’t keep records) which a conservative estimate is 1 in 4 people admitted die. People present incredibly late and mums really resist oxygen or NG tubes as they think they are harmful (based on the fact that only the sickest kids get them and more of these will go on to die). When we lose a patient, the morticians arrive and wrap them in a white sheet with a red cross on it. Then most of the relatives of all the other patients on the ward (sometimes hundreds) will follow behind the trolley to the morgue in a long line singing a deep song in close harmony. It's extraordinary..."
"My clinic is finished for the day and I walk past a lady in her 40’s, nonchalantly carrying a two-seater sofa on her head. Amongst my collection of patients today I have “Fraction Banda,” “Lovelessness James” and my personal favourite; “Princess Derek” For the fourth time this week, the plastic water bottle I have been carrying with me has been turned – Blue Peter style – into a spacer chamber for a salbutamol inhaler with a little lateral thinking. Back on the wards, the oxygen from the concentrator (26%) is divided between the 3 bluest babies by plastic-haired nurses with quite spectacular bottoms. Out in the district general hospital, I try and persuade a mum that her new baby with 7 fingers and toes is beautiful, to little avail. "
I asked what equipment might help. This was Livvi's reply:-
Thanks so much for the offer of stuff. Equipment-wise, three things come to mind. 1. Simple battery operated oxygen saturation monitors (we have 4 which are extremely temperamental!) 2. Handheld simple otoscope 3. Transdermal bilirubinometer!! If you would like to help, please donate. The otoscopes are £20 to £150, the sats monitors roughly £150