Today I read this article
written by the mother of an American boy with a brain tumour.
It made me realise just how
different our cultural attitude towards childhood illness is in the West than
here in Ghana. I’ve been working at the hospital here for almost 8 weeks and
over that time I suppose I’ve become desensitised to the differences. But
reading this article really reminded me of how different things are back home.
Back home parents will fight with every fibre of their being to prolong their
child’s life by 5 minutes. Here… it’s very different.
In my first week here I had
a patient with a ventricular septal defect (VSD) – a whole in the heart, so
blood goes the wrong way. Although now, as a baby, she is relatively healthy, eventually
the girl will develop heart failure (and probably die) if this isn’t repaired. One
of the volunteers here had some money raised from home that he was willing use
to pay for the girl to have surgery to fix it in Accra (the capital). It would
cost somewhere in the region of $2000. Everything charitable here is done
through the hospital’s chaplains, so we went to speak to them about the girl.
They pointed out the importance of the family taking ownership of the girl’s
treatment and suggested that they ought to pay for transport and accommodation.
Although this was nothing in comparison to the cost of the surgery, it would
make them take some responsibility and stop it being a hand out. We spoke to
the mother about it who found it difficult to comprehend as her child is
currently relatively well, but was still keen for the surgery (she couldn’t
even read her own daughter’s name, so it’s hard to know how much explanation
got through by the translator). The chaplains drove to the village to speak to
the girl’s father who hadn’t come to see her in the hospital. They explained
the situation and the proposal for the surgery, including his involvement of
paying transport and accommodation. The father refused to pay. Instead, he said
“I have another wife who has already produced another child, I have other older
children from this wife, why should I pay? If this child dies, I will have
another one.”
At the time I found this
heart breaking. How could he love his child so little that he wouldn’t even pay
a small amount of money to save her life?
But I think there is a huge
self-preservation element to it. Although this has been the most extreme example to date,
I think generally people here expect some of their children to die and so
prepare themselves for it mentally. I’ve been with many parents as they watched
us attempt, unsuccessfully, to resuscitated their dying children and they just
don’t react the same way as Western parents do. When we performed a C-section
and one of the twins was born dead and handed to me, I asked where shall I put
it, and all the Ghanaian staff answered “in the bin”. I couldn’t do it and in
the end one of the doctors put it (probably in another bin) in the other room,
but at least it wouldn’t spend the rest of the surgery at my feet… The majority
of stillbirths don’t get buried here or have any kind of funeral. There’s a
concept of a ‘good death’, which would be an old man who has lived a long and
successful life and died peacefully, where as a baby born dead is classed as a
‘bad death’ and is therefore not worth the same respect.
In the end, the father of
the VSD baby agreed to allow the baby to have the surgery if all of the costs
were covered, so she will have the repair… but it’s sad to think how little he
values his child.
To be fair, not all parents
have been like that here. The hospital (possibly country?) has had a massive
shortage of anti-snake venom (ASV) for about a month now. Previously ASV would
be covered by the Ghanaian health insurance, but since the shortage families
have had to buy it from the black market. Where before patients would normally
only need 1 or 2 viles, with the black market stuff they were needing 6 or 7.
There’s some question as to whether this is due to it not being refrigerated
during transport or if it was even ASV at all. Each vile from the black market
costs 160 cedis – more than a month’s wages. Many parents would buy vile after
vile of the stuff for their (older) children, bankrupting themselves, so they
obviously did care a lot for them. Now the pharmacist has bought in a large
quantity and is selling it privately for 100 cedis a vile – still a lot of
money, but at least this stuff is actually working.
Sorry this is becoming a
bit of a depressing blog! I’ll have to come up with some more penis stories… I
have seen another patient who almost got his cut off in January when his shirt
got caught in some machinery. He had scar tissue circling all the way round,
but luckily apart from some chronic pain, he had regained normal function. Not quite as scandalous as the last one!
I love this photo of Liz's - all the kiddies get weighed like this before they're seen in clinic
Hey, I liked your post. Maybe, since poverty is so bad and money is so scarce, allocation of resources is another reason why he wouldn't be happy to pay for his kid? Maybe the financial investment in one kid that he would have to do would not be worth the negative effects on the rest of the family due to reduction in their finances. For example, if they are £10 above starving, even paying just £10 could mean the whole family/the skinniest ones might die. So unless the benefit is greater than the cost then it wouldn't seem worth it. Just a thought X
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