Casting a Wide Net

When I arrived at the front of St. John Hospital this morning, I did not see any patients waiting and yet after I changed into scrubs, the patients continued to parade through triaging.  All of them we cleared to be seen at the out-patient department including a very thin man who had been coughing for about a month with many of the hall-marks of tuberculosis.

Then walked in an ill-looking man who had a whopping of a fever, complained of malaise and anorexia.  He has been traveling from Makeni to Freetown driving goods and staying overnight in Freetown.  Just about a week ago he started to have diarrhea and he stopped his trips to Freetown and returned to Makeni where he sought the help of a traditional faith healer.  He was not feeling any better so he came here accompanied by his brother who wore a black t-shirt with multi-neon-colored words printed on the front” My Money Grows Like Grass”.  There was no psychosocial team to explain to the patient about the ETC which was where we sent him after waiting for the ambulance to be dispatched via the government for at least an hour.  Oftentimes the line at the command center was turned off and the captain either did not answer calls or failed to return calls when promised to do so.  Knowing the tardiness, I made sure he received his lunch and water.

Between twelve and one o’clock, all of a sudden the patients were all triaged.  We had three patients who walked in, including one being brought in by a taxi.  He was discharged from the ETC two weeks ago with two negative tests for Ebola.  He was feeling well the first week then poorly the second.  The only symptoms we could get from him were weakness and poor appetite.  He did not look dehydrated to me.  We decided to send him to be seen at St. John.  While he was being triaged, he was given an energy bar which he devoured eagerly without even unwrapping it; the flame of hunger consumed him.  He did have an appetite; perhaps he was just weak with hunger.

Looking over the book for triaging, there have been very few suspected cases being sent to the ETC and the ones that were sent usually turned out to be negative.

Our lunch from the ETC never materialized.  We were promised a one thirty delivery, then two-thirty, then three thirty but still no lunch.  The WASH shift is on duty till seven in the evening.  They would have to wait to eat at dinner time, a long time to be hungry.