When breathing is difficult

Today an 18-year old girl brought her 5 month old baby into the clinic, complaining he had a cough.

Probably one in every three of the patients we see has some kind of simple respiratory infection, so we were expecting the usual.

But as soon as she unswaddled the baby that was nestling in layers of cloths on her back, it was clear that this was different.

The baby was tiny, weighing only 4kg, and pale. As he struggled for breath, his minute belly was sucked in, his fragile ribs pumping in and out frighteningly quickly, his little nostrils flaring out trying to grasp at the elusive air he so desperately needed.

Fergus and I glanced tentatively at each other, both knowing that this baby was very sick, and wondering how we were going to get this across to the mother without unecessarily frightening her. My own respiratory rate quickened; this was our first emergency, and we did not know what to expect.

As the lead doctor at the clinic came in to examine the fragile boy and explain to the timid mother that she needed to take him to the hospital immediately, a pitiful helplessness settled firmly in my stomach. As we examined him more carefully, it became clear the baby had something quite drastically wrong with him - he bore a number of the tell-tale signs of a genetic disorder, probably Down´s syndrome, and it was likely that he had a congenital heart disease that was making him so breathless.

The helplessness turned to hot anger and shame at my inability to change the course of fate for this new family. Through wells of tears held in downturned, sorrowful eyes, the young girl said that someone had told her there was something wrong with the baby when he was born, but nothing was ever done about it. She hurriedly slung him onto her back, little grunts coming from within the bundles of material, and walked out of the clinic. Whether she ever took her son to the hospital, whether she had the means to, I will never know. What I did know with unsettling clarity was that he would not survive much longer.

We carried on with the busy clinic, slightly distractedly. As the day wore on, the anger and shame I had felt gradually melted away, as I considered that sometimes this life is unfair and soemtimes we have to learn to accept that there is nothing we can do about it. What we can do is to be there to support people in times of need, and that emotional support is desperately lacking in Guatemalan healthcare. Not a single comforting hand was offered to the young girl by the local doctors today, and if it had been I´m sure she would have been surprised and unsure how to react.

But I firmly believe that no matter what culture or background we come from, what we do have is a shared humanity and a need for solace from the reassuring actions of others, so that we have the confidence and willpower to carry on.