Delemma

In a poor country, anything unfortunate can happen. We had a 15% burn adult patient died today due to septicaemia. His condition is not that bad and had skin graft done already. But he deteriorated quickly in one day and died despite our effort to save him. Similarly, I was invited to the Pap West Hospital today to see a baby with severe malnutrition and with some skin infection in the face and buttocks. There is dead skin above the right side of the mouth involving half the nose and it is spreading to the eye area. If the dead skin is not removed, it can spread all the way to the meninges and the brain then he will be doomed. But taking away the skin, it will be very ugly cosmetically including half of his nose loss. We seldom see people doing so bad with such minor infection in our place. But here with malnutrition, malaria and sometimes infective diarrhoea, their body defence can be very low. So we have to do a lot of “dirty jobs” to save their life first so that they can at least have their future and can not afford to think of the impact of their diseases and our interventions that may affect them in the future.