These are words I will never forget. They were uttered by a dejected mother as she watched us, her daughter’s medical team, desperately try to resuscitate the child.
She was right.
Because she could not afford the antibiotics to treat severe pneumonia, her daughter died when the infection overwhelmed her little body.
As a Pediatric Critical Care specialist, I am trained to help children survive their most acutely ill states. I fight death, in the literal sense. Over the last few months, while working in Rwanda and Liberia, I have all too often found myself staring helplessly at parents and family members as they watch their young children succumb to disease. Much of the western medical advances that allow us to minimize childhood mortality rates have not yet made it to these countries.
In Sub-Saharan Africa and other low resource areas, preventative strategies and primary healthcare are the focus of governments and ministries of health. The need for basic healthcare services will always be present, but tertiary healthcare systems — including critical care — are becoming more important as childhood mortality rates decline. These supplementary services must be incorporated into the fabric of existing healthcare structures.
There are some patients that keep me up at night — the ones I worry about even when medical care is optimal. Patients with severe acute malnutrition fall into this category.
It’s difficult to predict which child with severe acute malnutrition will survive and which child won’t make it. All too often, I have seen a child on the pediatric ward who seems to be doing well, only to be told the next day at morning report the child had died. …Read More
There were many skeptics who said we couldn’t create a self-sustaining pediatric cardiac surgery program in West Africa. But after eight missions to Kumasi, Ghana, our team’s goal was fulfilled.
Along the way, we faced numerous challenges.
For starters, when our initiative — called Hearts and Minds of Ghana — launched back in 2008, clinicians in Ghana had never seen open-heart surgery in children. (We were the first team to successfully conduct pediatric open-heart surgery in West Africa). In the beginning, Ghanaians asked what was going on and questioned the promises we made. They wondered, were we actually going to help? Would we come back?
Pediatric cancer is curable when diagnosed early and treated appropriately; the survival rate for all childhood cancers surpasses 80 percent in most high-income countries. Yet in mid- to low-income countries, basic elements of pediatric oncology care are often lacking and outcomes are grim, with survival rates of 40 percent or less.
“Twinning” is a model where pediatric oncology programs in high-income countries partner with cancer centers in low-income areas to share expertise, resources and technology. One such example is the partnership Dana-Farber/Boston Children’s Cancer and Blood Disorders Center formed in 2011 with the Unidad Hemato-Oncologia Pediatrica (UHOP), the pediatric oncology program at the Hospital Infantil Dr. Arturo Grullon in Santiago, Dominican Republic. …Read More