Thursday, September 14, 2006

Failed State Equals Failed Babies

Haiti is not supposed to be called a “failed state”. So I won’t call Haiti a failed state. I don’t like the description either. But Haiti failed the baby pictured above.

Yesterday, the baby’s mom brought this 16 day old baby into the clinic. The baby was very irritable, jaundiced, and had a fever of 104 F. It was critically ill.

As you may see in the picture, the left knee was very swollen, hot to touch, and very tender. The x-ray is amazing and shows the knee joint full of gas with swelling of the soft tissues around the knee. This would be the "case of the week" at an academic center in the States. But you NEVER want to be the case of the week if you are the patient. In Haiti, this baby is not even a blip on the medical radar.

The baby has a severe infection of the knee joint and adjacent tissues with a germ that produces gas. Mother stated that at 3 days of age the baby’s left knee began to swell. She took the baby to a hospital and the baby was admitted for one week. The hospital employees haven’t been paid in 5 weeks. When the IV would infiltrate, it would not be changed and the baby received only one dose of antibiotics during the entire week according to mom. The baby needed surgery very quickly to open the joint, but never received any. She took the baby home 3 days ago because of the lack of care for the baby in the hospital and the baby’s continued deterioration.

In medical terms this is called malpractice. In the developing world, this is called routine care for people that can't pay cash.

The baby has a septic joint and most likely has the bacteria in it’s bloodstream as well and is septic. The severe jaundice points to a serious infection. If the baby survives, which is unlikely, it will have a destroyed knee joint because the cartilage and bone were damaged within the first few hours after the joint became infected two weeks ago. At best, the baby will be crippled for life with a knee that will not work.

Mother tried to get the baby admitted to another hospital after she left the first hospital, but it had no open beds, and she has no money for a private hospital.

After some “finagling”, we were able to get the baby admitted yesterday to another hospital where the knee was drained immediately and antibiotics started.

The State of Haiti has failed this baby and mother. Is Haiti a failed state? You decide for yourself.

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