© Erwin GUILLERGAN
Hello! I would like relate my story in Amharic (just to brag – hahahaha!) but of course, no one could understand it. I have been here for 3 months now and I feel quite confident in speaking the language. In fact, when I go on rounds, I ask the nurse not to interpret for me. Anyways, it so much fun to look at the faces of the patients when I speak Amharic.
It had been a rough week for us – my national staff doctor has been away for the Somali explo and one of my nurses is sick. The number of patients we were taking care of was more than what the clinic can handle. On top of this, the cholera treatment center has been receiving more than 60 patients per day. Thank God I have another ex-pat helping me with CTC or else I would go crazy!
I know you probably are asking if I still get very interesting cases. Yes, I do. Kala Azar is quite an easy disease to treat if the patient comes early. However, when the parasite has devoured much of the patient, the course would be a short slide down hill. Worst, if the patient is co-infected with HIV.
The other day, I was informed by the nurse on duty at 2:00 am of a patient in status epilepticus. A migrant worker was admitted earlier that day because of severe emaciation, fever, spleenomegaly and epistaxis.
The patient was still having focal seizures when I arrived. A young male probably aged 20-22 years, BMI of less than 15%, lies on the bed. He was clinching his fist very tightly. His random blood sugar was very low, making me think that one of the probable causes of his seizures would be hypoglycemia. But then, he also has diarrhea, so it could be anything. After giving Phenobarbital, hydration and pushing glucose intravenously, the patient calmed down.
© Erwin GUILLERGAN
When he relaxed his hand, we found 800 birr (about 100 US dollars)! I told the nurse to keep the money so no one would take it from the patient while he is asleep. The next day, he was up but severely weak. I asked him why he is so thin when he had money to spend for food. Why is he wearing a torn shirt when he could buy himself decent clothes?
He gave me a wry smile and answered softly: "It is for my family".
I tried holding back my tears, because a lot of us would do everything for our family, or for the persons we valued. I have heard of countless of stories of people leaving their comfort zones to earn money somewhere else. A lot of Filipinos have sacrificed themselves so their families would have a scrap of luxury back home.
But what is the actual value of money in a place like Ethiopia? 800 birr would feed his family for the next three months. He would be able to buy seeds for the next planting season. He would be able to get on a bus and go home. 800 birr is probably worth two cows, or four goats, or three sheep. 800 birr is big money.
After two days of ups and down in the patient's condition, he died.
I asked the staff as to who shall I send the money the patient owns, but all I got was a shrug from every member of the staff. We don't know where he came from – all we have was a name.
What is really the value of money? For this young man, it was his life.
Every year for four to five months, thousands of migrant workers go these parts of Ethiopia to work in the farms. The population in Abdurafi which is about 50,000 during summer would go up as high as 180,000 during the planting season. Of these, hundreds of young men die from hunger and malnutrition, HIV/AIDS and Kala Azar, and other diseases. The sad reality is that for money, a lot of these people would be willing to risk life and limbs.
On the other side of the world, a lot of my friends have asked me why I am in this kind of work. I, along with thousands of volunteers risk also our life and limbs for a lot of different reasons. I used to respond with a very generic answer: "I want to make a difference". Recently, I have changed my answer to: "I can make a difference". Money has been an issue with a lot of my friends. Of course, I fully understand them. We were in school for almost 10 years of our lives and so, to "waste" it by not earning enough, is absolutely crazy. However, it is not always about the money. Sure, it is nice to have ready cash to spend on things you wanted, but at the end of the day, you ask: "Am I satisfied"? "Have I done my part and helped people"? How much more money do I want"?
So you see my friends, we all have different valuation of things. I don't question our quest for better financial status. The value of what we work for depends on whose perspective it falls into. A young man, barely out of his adolescence would at anytime give his life for a hundred dollars for his family. What would we give in exchange for what we do?
I hope have not touched any raw nerves. My work in this isolated place has taught me a lot of things. I am learning everyday – even though it is the hard way. I also hope that I have opened up some views, and made you all realized how important life is.
Keep in touch and please do give any response to this letter. Miss you all!
Filipino doctor Erwin GUILLERGAN joined MSF in 2006. From May 2006, he worked in Ethiopia to provide Kala Azar treatment.