One more. No doubt. I see her enter the door supported by her mother, her closed eyes covered by a yellowish discharge and a cough that runs from her mouth. I approach, with his permission I gently lift the shirt looking for a rash on his trunk, I put my hand to his skin to feel it and feel his body burn.
Fever, conjunctivitis, cough, and rash. We do not need anything else to confirm that it is one more case of measles. She is Frehiwot. She is the twelfth girl who appears with the same symptoms since we started the day and it is only eleven in the morning. Yesterday more than twenty children with these symptoms. Figures that have remained that way for the past few weeks.
The rural hospital of Gambo in which we find ourselves, located in the south of the country, in the Oromia region; it is collapsed and overflowed. Emergency care has more than doubled, and children admitted more than triple, which forces us to enter two children per bed and in some cases to triple them and improvise stretchers in the corridors, to call it somehow. Our income capacity is 45 children and we are having more than 120 admitted children.
However, in the middle of the darkness there is a light that shines, and that is the commitment of the health personnel with whom I learn every day and who I admire, transmitting calm and serenity and a sense of control. I want to take advantage of these lines to dedicate my applause and sincere appreciation to the great work they are doing. They are the invisible and underrated heroes of this silenced epidemic.
We have reorganized the hospital to accommodate this increase in measles cases. In a ward, girls and boys with respiratory complications, the vast majority pneumonia along with the supply of oxygen cylinders they need. In those who present complications such as dehydration and require IV serums. And in another the most serious cases that require intensive care from medical and nursing personnel. Like the one in Meseret.
Meseret is bedridden, connected through a tube to an oxygen cylinder that supplies her with the gas of life through cannulas through her nostrils. The little girl takes a deep breath, mobilizing all the muscles in her body as if each breath was the last. Each deep inspiration is a battle won, a breath of air that turns into energy for the next inspiration. The battle does not stop. Death lurks stealing the air, closing the airways.
We must prioritize children and adults who need it most. As soon as they improve, we withdraw them for the benefit of those who have worsened. We are experiencing a silent epidemic
The young Meseret entered four days ago with a serious measles complicated with respiratory involvement. Fight death with every breath, finding yourself more and more exhausted in a game without rest or downtime. In each breath, the ribs are drawn into the chest, a sign of the effort at the limit of the muscles to open the rib cage as much as possible and to expand the lungs to the maximum, squeezing each breath. He squeezes his lungs by tattooing the edge of each rib on his black skin. One, two, one, two, one, two … The intercostal, subcostal muscles are wearing thin. With all his strength he stretches his neck towards infinity, trying to inhale as much oxygen as possible, squeezing the horizon. But it is of little use.
Precious air, life-giving air, gold in gaseous form, oxygen; it is a scarce resource in rural hospitals like Gambo. I wish I could offer Meseret all the respiratory support it needs. But all we have are few oxygen cylinders and we don’t have a respirator.
Right now there are seventeen children who require oxygen therapy but we do not have seventeen cylinders, a situation that forces us to optimize resources. In this situation, we have no choice but to calculate all those who need oxygen and prioritize among those who are more serious and have the possibility of survival. One of them is Biftu, who continues to fight for air by squeezing his muscles and lungs with each breath.
It is a very dramatic situation, it is a humanitarian emergency that nobody talks about.
We must prioritize children and adults who need it most. As soon as they improve, we withdraw them for the benefit of those who have worsened. We are experiencing a silent epidemic, which does not appear in the media.
And I want to invite you to stop. To look up from our four walls and look up past our navel. Because in the meantime, life goes on, begins and ends in other places, such as in Ethiopia, where girls like Meseret or Biftu struggle to breathe, because of a virus called measles that could have been avoided with a vaccine, and treated optimally. if sufficient health and oxygen resources are available.
We are not facing an unknown disease that we do not know how to avoid, nor with a high mortality among older people. We are dealing with a well-known disease, which mainly affects girls and boys, and for which there is a very effective vaccine prevention. We are facing the silenced epidemic of measles.
Malnutrition, pneumonia, dehydration, measles, tuberculosis, malaria, HIV … continue to be the murderers of girls and boys under 5 years of age in rural Ethiopia and in many other countries on the forgotten and silenced continent.
According to data from the World Health Organization, childhood pneumonia is today the largest infectious killer of children, claiming 800,000 lives a year, which is equivalent to one life every 39 seconds. Ethiopia is on the list of the five countries in the world with the highest mortality from pneumonia in children under 5 years of age. Let’s also not forget the chilling figure from Unicef that tells us that every 5 seconds a child dies of malnutrition in the world.
To all this, the pandemic begins to haunt Ethiopia where confirmed cases begin to increase and containment measures are being developed to prevent a tragedy in a country where more than two thirds of the population does not have access to drinking water. But this is another story that will be told another time …
Iñaki Alegría She is a pediatrician and coordinates the maternal and child health program at the Gambo Hospital, Oromia, Ethiopia.
The section On the Front Line is a space in Planeta Futuro in which members of NGOs or institutions that work in the field narrate their personal and professional experiences in relation to the impact of their activity. They are always written in the first person and the responsibility for the content lies with the authors.
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