18-Month-Old Bahati’s Struggle
to Survive Severe Malaria
Chris Bird, a former Reuters and Guardian reporter, put down his notepad and left more than 10 years of news reporting to study medicine with the intention of returning to the front lines where he can be hands-on saving lives and alleviating the kind of suffering he once wrote about.
As the sun went down and the ridges of the
Mitumba mountains turned a smoke blue, a line of
mothers sat quietly on a wooden bench in front of
the nurses’ station in the pediatric tent. The children
lying prostrate in their laps were new admissions, too
weak to protest against the nurses, who wore miner’s
headlamps to help search for a vein to place a drip.
These children have “severe malaria,” […] an
infection with one type of malaria parasite, Plasmodium
falciparum. After the parasite has invaded via the drilllike
proboscis of a blood-hungry female Anopheles
mosquito, the falciparum parasite replicates fast and,
like a microscopic wrecking ball, smashes red blood
cells and leaves children breathless with severe
anemia and sticks to blood vessels in the brain,
causing seizures, coma, and death.
Time is everything — delay treatment and the
parasites multiply unchecked and the child reaches a
point of no return. Lejuif — the nurse on duty — and
I started with the sickest looking child, 18-month-old
Bahati. His feet were cold, signalling he was in shock.
He didn’t respond when we rubbed him vigorously on
his chest — he was in a coma — and his chest heaved
up and down. He had severe respiratory distress. His
hemoglobin, the measure of how much oxygen his
red blood cells could carry, was very low. He needed
an immediate blood transfusion.
We rushed him under a crowd of stars between
the tent and the single story building containing our
intensive care unit (ICU). The unit has an oxygen
concentrator, which we used to help him breathe while
we placed a drip, gave anti-malarials, and arranged
for a transfusion.
Families have to donate blood if a child needs
a transfusion. Bahati’s mother had walked from the
gold mining town of Misisi, 15 kilometers down a dirt
road, and her partner had not accompanied her. As
she was pregnant, she could not donate. There was
no suitable blood in the hospital freezer. Wilondja,
another of the nurses, went back to the pediatric tent
and persuaded another of the parents to give blood.
We also started antibiotics as we had no means of
ruling out meningitis or another blood infection. […]
Political will and funding to buy bed nets,
insecticide spray, and medications that both cure
malaria and stop onward transmission of the disease
have saved many children’s lives in Sub-Saharan
Africa. There is now hope for a vaccine.
Experience in the Kimbi-Lulenge health district
would seem to bear out evidence from the World
Health Organization’s latest World Malaria Report
(2011) that the Democratic Republic of Congo (DRC)
is defying the trend and cases are actually rising.
MSF treated 15 percent more malaria cases in South
Kivu in the first two months of 2012, compared to
2011. […]
Bahati had a stormy course and remained in a
coma, with periodic seizures, for two days. His name
in Swahili means “luck,” and with the care of the
nursing staff in the makeshift ICU, he pulled through.
But thousands of children in the DRC will die from
malaria this year, a disease that is both preventable
and curable.
Available in: <http://doctorswithoutborders.org/news/article. cfm?id=5936&cat=fi eld-blogs>. Retrieved on: 27 April 2012. Adapted.
Dr. Chris Bird
