Guarantee

It’s particularly troubling when children and newborns die because a country is so behind countries that are developed. It is especially difficult when you know all the advantages of the developed world. During our visit to the district hospitals and the central hospital of Blantyre, I helped input registers for neonates and. Death after death I thought to myself if only they were born in the States!

Many neonates here pass due to prematurity, low birth weight, respiratory distress syndrome, and pneumonia. Mothers lack proper information, education, nutrition, and health services. Hospitals don’t have the equipment, drugs, or specialized supplies for proper treatment. Healthcare workers are overextended. Simply put, they die because they are born in Malawi.

I don’t think that I am the only one who struggles with these feelings and thoughts. I’m sure everybody from luckier backgrounds like myself does too. On our last day in Blantyre, we attended morning report of the pediatric ward in Queen Elizabeth Central Hospital. There were many American and British doctors along with many Malawian doctors discussing how to best care for a newborn with a mechanical airway obstruction due to swelling of neck tissue. They did not discuss background details of this child so I can’t really explain the diagnoses further. However, I listened in on the discussion and realized a fundamental difference between the American/British and the Malawian doctors. Essentially, one side seemed to push for further treatment and some form of temporary rudimentary life support while the other seemed skeptical of the value of such care.

The Malawian doctors had legitimate concerns. They considered not only the cost of such care for the hospital, but also, what that would mean for the family of the child. There would be financial burden among other strains for a family most likely already in poverty. They also considered the abilities of the family to actually follow through with the home care needed to keep this child alive. In short, they had intuition that the child would die even with all the treatment and care they could possibly provide. The suggested treatments and plan of action just did not seem worth the price unless there was some guarantee of it actually working. I’m afraid though that there’s really no such thing as guarantees when it comes to health care in the developing world.