The Cry of a Starving Infant

Ishmeil and his mother finally left the ETC.  This is a victory and joyous occasion that everyone has been waiting for as we have had few Ebola-free discharges and especially discharges for someone as young as four years old.  I was at St. John so could not share in the celebration but I am glad to have been a participant in his care. I had a feeling that Mariatu would die and she did.  Asiatu is doing well and her child has been tested negative for Ebola. 

Triaging had been brisk all morning.  A 25 year-old mother brought along her one-month old baby all wrapped up wearing a colorful winter hat.  When she slowly unfolded the wrapper from the baby, we were speechless looking at a baby who was starving; face aged and wrinkled, skeletal arms and legs and skin stretched thinly over her prominent and delicate rib cage.  This was her second child and she said she was not producing sufficient milk. The young mother did not look particularly malnourished. The crying baby was eager to suckle when she put her to her breast.

In the afternoon I went to the Pediatric Ward in search of the infant.  Since my last visit, the ward had quickly filled up, a very good sign for the hospital.  A woman lying next to her boy called me by my name but I drew a blank when I looked at her.  She told me her name which I had not heard of before and explained that she works at the ETC but she has not worked with me.  I am very humbled by the fact that the people in the ETC seem to take an interest in the visitors and I hope I have also reciprocated by my genuine desire in getting to know them. 

I found the tiny baby with two nurses hovering over her busily placing an IV in her arm and they were so skillful, they succeeded.  As a nurse took the baby to be weighed, she cried loudly and we could see that there was a big defect in the soft palate; the baby had a cleft soft palate which might have cause her to have trouble breast feeding and resulting in malnutrition and starvation. She was only 1.8 kg.

Next they placed a naso-gastric tube for feeding.  In the meantime they handed mom a cup for her to express breast milk.  I asked if they had infant formula if the mom was not able to produce enough milk.  One of them told me that the hospital had no milk and did not know when they would receive a shipment.  They also had no idea if the feeding centers in Makeni or Port Loko were open but even that would entail discharging the baby from St. John and the mother had to find her way to the center.  I could only envision the death of the child with all this logistical nightmare that a poor mother had to navigate by herself.  I called the ETC if they had infant formula milk and very fortunately they had a small supply, perhaps enough for a day.  In the late afternoon, I delivered that to the patient’s bedside.  A nurse was patiently giving a syringeful of breast milk through the naso-gastric tube.

Tomorrow I shall check on the infant again.  If the infant formula has run out I will go to Lunsar Pharmacy and buy a supply for her.