What impresses me the most every morning when I start my day in the hospital, divided between Neonatal Intensive Care and Paediatrics, is numbers: 208 are the children hospitalized now in Paediatrics, 61 the available beds, 1.353 children under five years of age affected by malaria admitted in hospital in the last three months.
1.8 is the lowest hemoglobin value I’ve ever seen in my life, so low that it would be foolish to think it could be compatible with life. This is the hemoglobin value of the first child I saw dying of malaria in Kalongo.
Since the beginning of June, the malaria epidemic in Uganda has left no way out and it mainly affects children who most often arrive to the hospital dying, hoping to find a cure. And what is the cure for malaria? Artesunate is the indicated drug in complicated malaria forms; otherwise in severe anemia forms, what is the cure? Blood. But this is a problem all across Africa. For Kalongo, the nearest blood bank is located in Gulu, which is about four hours away by car. Yet many times blood is not even there.
What should we do then? We start screening parents, to see if they are compatible, but many times they cannot donate because they have already donated to the other child, or are pregnant moms, or dads with a blood transmissible disease (HIV, hepatitis B). In other cases they are simply not compatible.
What can you do if you are the doctor taking care of the child with 1.8 hemoglobin to let him live?
Try asking other family members, but they often live too far away and would not arrive on time. So if you are compatible, and you haven’t already donated in the last three months, you donate yourself. Yesterday, however, I managed to find a midwifery student, who donated for another child who had 2.8 hemoglobin, and this child made it!
If not much can be done without blood for all these cases of very serious anemia, on the other hand for cases with hemoglobin values above 5 gm / dl the main cure remains the medicine, Artesunate. We must safeguard the lives of these children.
We cannot and must not give up. We can and must go on.
Antonella Tuscano, resident in Paediatrics from Idea Onlus partner of Ambrosoli Foundation