Could Omongole's life have been saved?

Recently New Vision broke a story about spoilt blood with maggots, that was found in Mbale Hospital. Blood is a rare  ‘commodity’, and for this treasure to go to waste, is absurd. Many have hustled to access even a pint of blood for transfusion during emergencies. Carol Ariba shares her experience

I watched in shock as my nephew’s mother held his lifeless body and painfully whispered, “Bye Chiko, mummy loves you.”  Without so much as a glance at his tiny body, she stormed out of the room — her baby was dead! 

She moved up and down like a zombie and she sat down on the grass, kicked off her shoes and started to rock her body, while shaking her head as if to refute a discussion only she could hear. Then suddenly she started to scream, “No, no, nooo, not my baby. Tell me, what did I do wrong? Chiko my baby, forgive mummy!”

She picked up his tiny pair of shorts, painfully stared at them and made a promise to them, “You will always be mummy’s first born.”

What exactly happened?
My brother’s son Joshua Omongole, whom we all called Chiko, was only two years old when he died in April last year. It may be well over a year, but the pain of his death stays freshly baked in our hearts. And the memory of the events that caused his death grows more infuriating by the day.

See, Joshua was quite the sickly baby, often battling malaria, a cold or infection. It was, therefore, not news when my mother called to say that he was down with malaria. His mother had taken him to the family clinic, where he was treated for malaria.

He recovered and asked to be with his grandmother, a wish he was granted. However, at 2:00am that night, mom awoke to her grandson’s raving temperature that no damp towel could quell.

Scared, she called his mother, as she rushed him to the family clinic, but because his condition was complicated, he was referred to Mulago Hospital.

His mother arrived just in time to take him to the national referral hospital. On the way there, he convulsed, bit his tongue and it started to bleed. Eventually she arrived to an even bleaker situation with parents waiting for medical attention for their little ones.

One of the mothers revealed that there were no doctors. Alarmed, she dashed out of the hospital and rushed to a hospital in Nsambya, where she found a doctor and a few nurses.

The doctor said Omongole was dehydrated and needed to be put on a water and glucose drip. After several failed attempts at finding a vein, his leg was operated to trace the vein internally.

No sooner had they put up the drip of water than they noticed that he also needed blood as a result of the heavy tongue bleeding. This was worsened by the fact that at that time, his body had barely recovered from the malaria.

So the doctor picked up the phone and asked the person on the receiving end to organise an AB blood pack for him.
By 7:00am, there was no sign of blood, so the doctor sent a chit to the same effect, but there no response.

Shortly, we noticed that Omongole was having trouble breathing, so an oxygen machine was prepped to help him breath.
“This boy needs blood, what is the hold up?” I heard the doctors and nurses who had gathered whisper amongst each other.

They sent a nurse with another chit at about 8:30am, but nearly an hour later, there was still no sign of blood.

So I walked to the doctors and asked if there was anything we could do. They said if we could get blood, and get it fast, it would help. It was coming to 10:00am; I called a family friend who works with the blood bank up-country. He referred me to a colleague at the blood bank in Nakasero.

When I got there, my friend’s colleague said that get blood, we needed to present a formal request from the medical facility where the transfusion was to be done. So I asked if the hospital van had dropped by for any blood that morning and they said it had not.

Shortly, it arrived at the blood bank and the driver walked in with a container to collect the blood.

I ran to him, in tears, wondering if Omongole’s order was on his list. He checked the list and then looked back at me as if I was insane and said “no”. He refuted having received any chit from the doctor.

I screamed, cursed until I had no strength left and sat down on the floor, weary with a tear-stained face. “AB…that is his blood group, please get me AB, he is only two years old!” I begged. “I will pay, we shall pay, what can we do to get this blood?” I bargained.

Finally, everyone in the blood bank got concerned and they said they could spare an extra pack of blood for Omongole.

As we left in the hospital van, I only hoped that it was not too late. Before Omongole received any blood, the staff at the clinic insisted that we pay a certain amount of money before the blood could be transfused, which my brother did.

At about 1:00pm, the transfusion started. Omongole seemed stable, or so we thought, at least from the look of things. But a few minutes later, a doctor came in and discontinued the oxygen supply and that was it — that marked the end of the road for my two-year-old nephew.

Could it have gone differently if the blood had come sooner?

 
What do the experts say about Omongole’s death?

Dr. Lawrence Mugisha of Cure Medical Centre, says it is possible that baby Omongole could have died from a blood shortage-related condition.

“It could have resulted from a heart failure or oxygen shortage in the body, caused by a blood shortage,” he says, adding that if a health facility requests for blood from the blood bank, the blood should be delivered in at least 15 minutes in times of emergency.

“That is the reason why hospital blood banks work night and day. It is for emergencies like this!”

According to Dr. John Ekure of the Kumi Orthopaedics’ Hospital, Omongole could not have died from the tongue bite, but probably severe malaria, which had directly affected the blood levels in his body.

He says that if a haemoglobin test (the protein in red blood cells that transports oxygen throughout the body) is carried out and found between five and seven, then the child is in danger.

“For children below 10 years, blood shortage can be severe and more dangerous than in adults. Hospital laboratories should, therefore, always be equipped,” he says.

Martha Ajilong, a blood donor recruiter at the blood bank, says they have a demarcated role when it comes to blood. “We organise blood transfusions and then take that blood for intense screening. After that, we group and preserve it for the blood units in the different health facilities to collect,” she says.

Ajilong adds that blood is free and should never be paid for at any health facilities. However, she warns against individuals going to the blood bank to collect blood because the process of preserving and transporting blood is delicate.