Elizabeth makes for our first case on the "RURAL DOCTOR".
She is 25, an orphan whose parents passed away some 5years ago leaving her with four younger ones who depend on her for their livelihood as a newborn would his mother's breast.
Two weeks back, she was brought to the facility from one of the rural areas in Kaduna state with complains of difficulty in breathing, cough, dizziness and abdominal pain. Exam showed she was pale, fast breathing, generalized lymph node swelling, high fever persistently; had a massive spleen of about 20cm from the left costal border
The thing is this, she had had 2 pints of blood over the period of 1 week which worked tremendously in assuaging her clinical symptoms. But unfortunately only yesterday, she became pale again, the spleen must have being, amongst other things, pooling the blood(sequestration).
As a rural clinic, there is just about how much we can do here and it beats me crazy. I feel paralyzed. Referring Lizzy to the city centre where she could get help would only be tantamount to sentencing her to death because she has no dime to even feed with talk more of paying for her outstanding bills. Daily her siblings would surround their only help, after God, helpless as to how to offer their support.
She would force a smile as though to reassure them that all will soon be fine. Yes, all the pain will soon be fine for her but not for them, as if no help gets to her in good time, it would only be a matter of time before her time is up.
Lizzy would need some financial assistance for some blood work up and imaging to help pin a diagnosis down in the city centre. She would need nothing less than N100,000($250) for investigations asides treatment proper. The sort of money that she has never ever seen before and probably will never see. For the average private teaching hospital in Kaduna, hematological work up will cost in the range of N6000($15), chemical tests N15000 ($38), microbiology N4000($10), imaging including abdominal CT and Xray N45,000($116), two weeks hospital stay will cost N14,000($35). These are approximated sums that should suffice in helping to make a definitive diagnosis of her underlying illness.
Shall we help her continue being the bread winner for the family or just assume we have done our best and move on...she inclusive?
Make no mistake about this, poverty as a social determinant of health, is the leading cause of differential exposure, vulnerability, access to health care services and outcome.
I am your rural man, bringing you close to the realities of the world in the rural areas.
Bank name: Guaranty trust bank
Acct num: 0026169074
Name: Okeme Arome
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