29 May 2006
Baby Rebecca
Jason Lohr
It is late afternoon. The African sun is setting and it is beginning to feel cool after a moderately warm day. I am called down to casualty (the ER) to see a patient with malaria.
When I arrive, I notice a small baby lying on an examination table, deep asleep, but making slightly audible moans. It doesn't look like a baby with the usual malaria and anemia so after I see my patient with malaria I walk to the baby's side. Her name is Rebecca.
I feel for the child's fontanelle (soft spot) and I am unable to find it. "Could the fontanelle have closed by this age?" I think to myself. I ask how old the baby is. Ten months, the mother says. A ten-month-old would still have an open fontanelle, so I feel again. As my fingers run across the front of his scalp I feel something very hard, but with slight force I can compress it. I then realize that this is the fontanelle but it is under so much pressure that it is actually bulging out and feels as hard as the skull bone.
This baby must have an infection of the brain. Most likely meningitis. I call my fellow doctors to see the baby. We do a lumbar puncture and the fluid comes out murky, a classic finding for bacterial meningitis. As we discuss with the mother the need for antibiotics, she tells us that her husband has left her and the baby, and has gone to find money to pay for the treatment.
It is normally hospital policy to provide treatment only after payment. This policy has developed because too often the patients and their families will refuse to pay after treatment is given. The antibiotic the baby needs is expensive, the equivalent of $20 dollars for a single day of therapy. We make the decision to use our patient fund to help with the first few days of antibiotics.
That was five days ago. Since that time, baby Rebecca has improved. Her fever is gone, but she is still unconscious. Please keep her and her family in your prayers. We thank the donors who gave to our patient fund last December. It is because of our donors that this baby girl has another chance at life.
Jason
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