In addition to drugs, patients need love and good feeding

There are two hospital rotations I will always remember. No, three, if you add Butabika Hospital.

But two are vivid; and they both involve one patient. Let us call him Baby S. Baby S’s mother gave birth the day UB 40 threw their famous show in Kampala in 2008.

I recall this vividly because I got a call, barely 30 minutes into the prelude, requesting me to return to the special care unit to cover an attending doctor who had called in ill.

Baby S was one of a set of twins. They were six weeks early and their mother delivered them on the way to hospital.

When I arrived at the hospital, the mother was recovering in one of the outer ward rooms and the twins had already been incubated. I noticed that Baby S was slightly more ashen than his younger sister, but an examination and routine tests revealed nothing untoward.

I particularly recall that during the course of their 12-day stay, Baby S was not thriving as well as his sibling. We had to order specific feeds to be given through both his nasal tube and an intra-venous (IV) line.

It was hard to find those feeds in Kampala. Luckily, I had a friend flying in from Nairobi who I asked to bring the feeds.

Three of my colleagues raised money to pay for the feeds, Baby S soon recovered and was discharged on advice to be followed up regularly.

I did not see him again until he was two-and-a half. I had just returned for my masters and my first rotation was at the nutrition ward.

There was a frail and gaunt child, wearing an ‘old man’s face’, but appearing not more than nine months old.

His aunt, who was taking care of him, told me he had been admitted with pneumonia. His story started long before that.

I learnt that the boy was one of a set of twins and that for whatever reason, his mother favoured the other one. As a result, she lavished what she could on his sister. What she could lavish was nothing more than food.

Soon, Baby S became malnourished. Towards their second birthday, the mother decided she was tired of him. But how do you get rid of a baby? She decided to poison him. She gave the poor malnourished child something to eat that was supposed to kill him. It did not, but it left him with a permanent tube in his tummy through which he was fed.

This is because the poison corroded his oesophagus and partially closed it. He had been operated on in a hospital near his home, where he had the tube inserted. But he had a constant drool, his mouth was ulcerated and his teeth were stained from lack of use and a poor diet.

On the third day of my rotation, I discovered that he was Baby S. When I joined the ward, he had been in one hospital or another for nearly six months. His stay in the hospitals had actually worsened his malnutrition as many of the health workers who treated him were unfamiliar with the dietary rigours of a young child, sporting a feeding tube in his tummy.

The most meal he ever got was porridge on public holidays or when dignitaries would visit whatever hospital he was in. But Baby S remained a delightful child. I started work every day with giving him a hug. I figured love was something he had not seen too much of in his short life and it was something I could do for him. He seemed to enjoy it.

Again, I soon realised that the feeding being given by the hospital was woefully inadequate. I arranged for a friend in South Africa to ship a carton of feeds for Baby S. Despite a prolonged clearing procedure at customs, the feeds eventually arrived and were handed over to the aunt. At this time, Baby S had deteriorated and was in a critical condition.

He was given the feeds in addition to being showered with care by the health workers. Baby S was eventually nursed to health. He was discharged on the fortieth day. I recall someone making the comparison with the fast Jesus took before his ministry. We were all hopeful Baby S would fulfil his calling.

Feeding the healthy is a feat that is difficult enough for many families in Uganda. Feeding the ill is an even more daunting task considering the extra energy requirements, the patience needed and the complexity of dietary requirements.

As a result, many patients die of nothing more than starvation. I pray Baby S and other patients do not succumb to poor nutrition and never become an anonymous name again.

The writer is a paediatrician at The Children’s Clinic in Kansanga and executive director of the Uganda Paediatrics Association.