Rain

Patients wait outside the hospital ward- Zemio, Central African Republic 2011

The rainy season we think, has started finally. It is not like you imagine.
The earth is thirsty and greedy when it rains, initially there are torrents
of water rushing along the roads and gushing down the hills. But soon after
the deluge the earth becomes quiet and damp. Most of the water has been
swallowed below. Then the sun comes out.
A father has travelled 400 km to our hospital with his young daughter. She
has a huge tumor on the right side of her face, distorting the jaw and the
cheek. Eating and swallowing is difficult.
We think we know what it is, a type of lymphoma that is known to occur in
children in this part of the world. It has a suspected relationship with
repeated infections of falciparum malaria, the type of malaria we see in 96%
of the patients who are diagnosed here in the Central African Republic.
There is nothing much we can do right now for her, except send an email to
the capital medical team to see if there may be a chance of a chance to
treat her. You note how I word that sentence, I think the odds are not good.
The medical care in the capital, Bangui, is not much better than it is here.
I don't know what will happen to her. Frankly her future without state of
the art chemotherapy is dim. Another possibly dim future in a vindictive
land that is always thirsty for change.
But all is not so hopeless that you drown in perpetual frustration here.
Every day I tour the ward and see children pulled back from the brink. Most
of the sick children who arrive here with malaria, will stabilize and then
after a couple of days of treatment they will smile again, and you know that
a small battle is won. And almost every day children smile. As we tour the
small hospital we touch and hold hands. We try to impart what we can to
friends and relatives of the ill. We laugh, occasionally with a barely
submerged sadness. We try to accept the fact that we cannot change
everything and we continue in our own crazy, rural, isolated African
medical-centre in the rainy season way... to seek the courage and the wisdom
to change the things we can.

More later
John B Fiddler ANP