Another public health experience

Seeing that we interview kids about physical health problems as well, we get quite a few who have a number of TB symptoms.

This 15-year old boy had cared for his mother who died of TB, was having night sweats, a constant cough, coughing up blood and yellow stuff, had a fever and had lost a lot of weight from an obese 120kgs to 75kgs following his mother's death in September.

Having finally convinced him to do a TB test in December, this came back negative in January. A second sputum test with culture came back negative in January and the child was referred from the local clinic to the hospital for further investigation.

Our first appointment at the hospital TB clinic was in January. We waited 2hrs in administration to get the file and then made our way to the TB clinic from where we were sent for HIV testing and then to see the doctor. From the doctor we were sent to x-ray and returned to the doctor who was on lunch break and could not see us again until 3pm. His diagnosis was that the child does not have TB. He declared the child healthy and only at my intervention: "So why does he keep coughing up blood and loosing weight if he is healthy?" the doctor responded "Because he is fat!" Now, I might not be a medical professional but the last time I checked on the internet, coughing blood and being overweight are not typically related unless there is organ damage for which the kid should be treated.

The doctor then agreed to take another sputum sample and sent us home. 

In February we returned to collect the results for the sputum sample. Unfortunately we couldn't be seen by the doctor until after lunch because the outpatient department had been flooded 2cm by a burst pipe and it took the whole morning to clean this up. All patient services were stopped  to accommodate these works. The sputum was again negative. A different doctor sent the child for an ECG which was found to be abnormal. So we finally got an appointment with the specialist which was yesterday at 7am.

So we arrived at the hospital at 6:30 and went to admissions. If you have a hospital file already you have to tell them your file name and name and this information is taken down on a piece of paper, then sent to archives from where the files are collected. At 7:30 our name still had not been called, the admissions room was overcrowding and people were lying and sitting on the ground because they weren't enough chairs. Only two ladies were dealing with the distribution of patient files and the collection of the hospital fees. The room was filled with disgusting smells, people's limbs fouling, unwashed people, the urinary smell of uncleaned and non-functioning toilets. At 8:30 we requested to find out where the file has gone only to be rebuffed to wait our turn until it came. 

We were finally called at 10am and then the lady couldn't provide a receipt for the payment of treatment because "the printers were not working".

At the Outpatient Department we were told that the doctor had not yet started to see patients and was still doing clinic rounds - why give people an appointment for 7am when the doctor is not actually there (granted, neither is the patient because they are stuck in admissions waiting for the file). 

At 12:30 we were finally seen by the specialist who had no clue what was going on with the child. Her first question was "why is he 15 and only in grade 8? Is he retarded?". This she asked in front of this very clever boy who is planning to become a scientist when he grows up.

We were sent for an Echo, another x-ray, more blood tests and more sputum samples and found that she had gone by the time we returned at 4pm. Next appointment is on the 17th at 7:30, watch this space for I doubt we'll be any wiser about this kid's health then.