“Relief from pain and suffering is a human right.” –WHO 1990
The words above were printed out and taped onto a wall in the pediatric oncology ward at Queen Elizabeth Central Hospital.
The day I read it, we had just left a meeting attended by QECH doctors, where they had convened to discuss the preceding week’s maternal mortality cases. Each case was thoroughly explained, from when the patient was admitted, the condition of the patient throughout her stay, the birth proceedings, and the time/cause of death. Case after case, we listened as doctors explained what resources—medicines, machines, tools, blood, extra nurses, an open operating theatre—may have saved the patients’ lives.
In pediatric oncology, where the poster was, we were looking at the only electronic body scale in the pediatric oncology unit. Karen and Tanya had been asked by the nurses to come by, as the machine wasn’t charging correctly. We found the machine hooked up to the incorrect power plug—the jack and the plug were two different shapes—despite the fact that the nurses said they had been using that particular plug with the scale for a long time. The scale was many years old; most likely, the correct cord had been lost or broken months ago, and the nurses had improvised a solution in the interim. Unfortunately, their solution wasn’t going to last, and the scale was probably going to soon cease functioning.
After we left the ward, I spent time shadowing doctors, where I noticed example after example of “making do” when resource limitations didn’t allow for ideal care. For instance, I listened as doctors discussed the problem of newborn hypothermia immediately after birth. When the mother experiences health complications and the baby cannot be rested on her chest, the baby often grows dangerously cold without the skin-to-skin contact. Limited resources prevent the use of expensive incubators or warming blankets, so the alternative solution decided upon was the use of plastic shopping bags, which would be wrapped around the child for insulation. Though not ideal, the solution was the most current funds would allow. While in pediatrics, I saw a baby who was being treated for jaundice with phototherapy. Typically, a thick headband is used to shield the baby’s eyes from the intense light. Unfortunately, none were available. Instead, an adult sized mouth and nose mask had been carefully fastened around the baby’s eyes, attempting to substitute for the more appropriate eye mask.
Seeing the poster, “relief from pain and suffering is a human right,” between hearing the maternal mortality cases, seeing vital machines disappear from use, and shadowing in the wards, hit me hard, as most of the problems stemmed only from the lack of available resources. Patients fill every ward in the hospital—labor, burn, oncology, special needs pediatric, neonatal—their eyes glancing up as you walk by; family members wait nearby, walking through the hallways with bundles of food for loved ones tucked under their arms or bending over buckets of soapy water outside tending to the patient’s laundry. Busy, hardworking doctors meet with patient after patient; bustling nurses bounce between filled cots; medical students cluster around every morning during rounds.
Despite all of this effort and thought, patient care continues to suffer due to lack of resources—no amount of good will, hard work, or long shifts can take the place of needed materials. Syringes run out, life-saving medicine isn’t obtainable, tools break, and diagnostic equipment is too expensive: low resource takes on a new meaning when you observe it firsthand. Despite the right all humans have to be relieved of their physical pain, such relief often requires funds to procure, and money and access is extremely limited here. This depressing and unfair fact is a reality faced by so many we interact with every day. Doctors don’t have the medicine they need to properly treat patients; the hospital can’t buy the materials nor machines it needs to improve survival rates; the repair department can’t fix machines because they can’t buy replacement parts; engineers can’t build the devices they have created in their minds because there is no money to fund their project; patients from rural areas can’t receive treatment because they can’t afford or don’t have access to transportation.
The problem is massive, overwhelming, complex, and working against it is at times discouraging. The actions needed to move forwards, to encourage growth and progress, often feel equally massive, overwhelming, and complex.
However being here, I’ve begun to notice how this beast of a problem is oftentimes not diminished by large actions on the part of powerful governments and corporations. Large-scale action exists too, of course, and often does a lot of good (while other times doing a lot bad). As an individual, though, it’s difficult to relate to the changes that huge donations, programs, or interventions effect to combat the absence of resources. Instead, by looking at the small ways that the patients’ lives are improved by the relatively small innovations of a few, I begin to see how progress can be made. Granted, progress is slow, often difficult, and is made in small steps, but it is through these small feasible actions that I see ways we can help to solve a problem that otherwise seems too huge—even impossible—to tackle.