Every baby wears five layers

Plenty of sick kids now that the weather is colder.  No indoor heating to speak of and the children’s ward is no exception.  Rounds can be almost comical because the mothers do not want to expose their children so that I may examine them.  The ambient temp is between 10-15 celsius but it does feel a bit nippy.  Pneumonia after pneumonia.  I am not supposed to use that term back home without xray confirmation but no one wants xrays here because of the cost or I’m not sure?…so we treat on clinical grounds alone.

I have proof that Group B strep screening of mothers at 36 weeks pregnancy does help with lowering neonatal morbidity.  If a mom with a high Group B strep count gets antibiotics in labour it lowers her babe’s chance of a pneumonia after delivery by a factor of 7.  Two babes in two weeks admitted under my duty surely have Group B strep pneumonia with high fevers, malaise, poor feeding and breathing difficulties at 11 days of age.  Those babies get better with the right antibiotics but it is scary for a short while for the moms and the caregivers to see babies so sick.

Two medical items have caught my attention repeatedly.   Frequent cases of severe anemias with hemoglobin levels below 50 (less than 40% of normal).  Very little meat in the diet OR malaria OR stomach ulcers from helicobacter pylori bacteria OR HIV/TB OR juvenile rheumatoid arthritis…  The other is everyone’s generally low body mass.  Most 40-60kg.  Not many 80kg.  Common to see 35kg.  How many people I’ve anesthetized back home are 120kg or 140kg…much more difficult to keep people safe or be technically quick with all that adipose tissue…but then again all those folks have hemoglobin levels of 150!  The older I get the aware I am that many folks abuse their body with poor food choices or excess alcohol (empty calories).  Pure as the driven snow I am not… but on that topic we are pretty spoiled with food portions and food types.  I propose to live at least a year without Dairy Queen soft serve…what is in that stuff anyway?

The kids have all had an opportunity to round with me this week.  The medical students are very kind to them, the nurses are friendly and the delirious patients do tend to point to them.   Nice fringe benefit of the atmosphere here and the girls and Zach have had their eyes opened just a notch.  I’ll go help Teresa put an extra blanket on them right now….

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