Burns

Yesterday the batsignal went off. One of the buildings at the Lagos University  Teaching Hospital was on fire. The fire at the Directly Observed Therapy unit or teatment of the dreaded tuberculosis was controlled and files and documents salvaged from the prompt response of other vigilantes.

http://thenetng.com/2012/08/31/luth-fire-leaves-patients-and-staff-devastated/?utm_source=dlvr.it&utm_medium=twitter

This morning I got the signal again some lunatic near Gotham City succeeded in reducing the population by three. Also the same time three died a stampede in Kenya. That is nothing compared to the 1.4 billion at risk of dying at the hands of agent Cholera. We are so used to  agents malaria and HIV that we do not talk of it  news.
  At the time my pager went off I called the attendant at Gotham Village General Hospital. She answered at the first chime of her polyphonic ring tone,
 "Doctor we have an emmergency. Hot water burns and it is a small child!"she cried with urgency.
"What have you done?"
"Nothing, it just happened. We are waiting for you."
"Get lots of water and poor on the wound"

I hurriedly put on my clothes and bolted out. There was no Batsmobile. I remembered two years ago someone made away with my Pontiac Transport and Detective Burns of the IMPD had no clue about it. So I got into my Leggedese Benz and made it in ten minutes. That did not stop this lady from calling me again while I was at the entrance of the facility. The gate and some sections of the walls had gone AWOL.
   I met my attendant still in her nightie pouring water on the wound with another first aid amateur fanning the injury with a piece of hard paper. I quickly assessed the damage. Second degree burns, 20% body surface area, 18 months old female. I started trying to remember Parkland's formula for estimating the fluid requiremejnts. Then it hit me. There was no nurse on duty, neither was there any Lactated Ringer's nor normal saline! It wasn't practical to admit his child and it was not possible to convince these poor folks to take care of this case successfully on their own. Giving them a referral to another centre will be a death sentence.
I prayed for a miracle. I figured our greatest problems where fluid loss and infection. I sent for honey and eggs and polythene bag and guaze. the attendant had sent for procaine pennicilin and petroleum jelly. There was no rectal diazepam so this child received 5mg of tablet diazepam after grinding to form  suspension. this was repeated twenty minutes later. Oral Rehydration Therapy was the only plan for fluid eplacement. The child was wrapped in plastic and held firm with gauze. A slit was made in the groin area for number one and number two.
    I spent time lecturing both parents and their Pastor who came to sympathise with them on the salient points in caring for this child. I touched on issues like birth control but this sounded Greek to them.

   Accidents will occur in the best-
regulated families; and families not regulated by that pervading ifluence which sanctifies while it enhances them I would say, in short, by the influence of Woman, in the lofty character of Wife, they may be expected with confidence and must be borne with philosophy.

So said Mr. Micawber elaborating on an anonymous prover in Charles Dickens David Copperfield. You need to go back to the time of Dickens to appreciate this saying. Accidents are the reason for having insurance companies. In the abscence of that we have only God to look up to. That is why the pastor part of the conversation. He has to be educated about the direness of the situation.

  What is the level of awareness for accident preparedness?
Some women get pregnant without realising that although this is a physiologic (normal) process complications can and do occur. In a health system that has patients pay out of pocket it is wise to curtail the family size. Women should save money before getting pregnant. That is the meaning of family planning.
  In the index case, the farmer(subsistence level) and his petty trader (once in five days) wife had two boys and two girls and the lady still has a lot of eggs waiting to be fertilised each month at a particular time. They don't know it.
"Doctor, children come from God" The pastor solemnly reminded me.