Pediatrics at St. Mary’s

Tuesday was my first day at St. Mary’s Hospital, a 200-bed Catholic hospital located in Pinetown, about 30 minutes outside Durban.  I spent the day in the pediatric ward, a small wing with a big open room and several closed off “cubes.”  I was surprised to see the largest cube was devoted to burn victims.  In the more rural areas such as Pinetown and surrounding small towns, it is common to cook outside, placing large pots over open fires.  Curious kids have easy access to these, and often spill hot porridge or boiling water on themselves.  One boy had burnt his face, and much of it was still wrapped in bandages. He was clearly feeling ok though, and zoomed around on a tricycle with the other kids.

Also surprising to me was that the most prevalent pediatric problem was malnourishment.  Coming to South Africa as opposed to other African countries, I didn’t think malnourishment would be common.  There’s no drought or famine, and food is generally plentiful, but as the pediatrician explained to me, “HIV allows for TB, which allows for malnourishment.”  Each disease further weakens the body, and without proper diets, inflicted children have trouble growing up healthily.

I spent the better part of the morning with the pediatric dietician, whose job it is to assess what supplements each infant or child receives, and to ensure they are drinking and eating well.  We first visited a 3 month old, who had severe malnourishment.  His belly was swollen (known as edema), there were lesions around his mouth, and his skin on his arms and legs was peeling.  The mother had been breastfeeding as is recommended, but was unaware that she wasn’t producing enough milk.  Lack of proper maternal education was a recurring problem – I saw children whose mothers fed them porridge three times a day, and others who didn’t know how to breastfeed properly.  The children who are severe are placed in the cubes to keep them warm, as hypothermia quickly becomes a threat when a child is malnourished.

Our last stop was the baby room, where infants ranging from 6 to 18 months were recovering from malnourishment.  I thought it might have been a happy ending – all five of the infants there had recovered well, were eating and drinking, and had entered the last stage of recovery, known as “happy baby,” when they are able to engage, laugh, and play.  It was great to see them with full bellies and giggling smiles, even if they were far behind normal development stages.  There was one girl in the corner, however, whose story broke my heart.  She had been in the hospital for six months, and no one had come back for her.  Though she had been officially discharged and the nurses tried calling for her parents, no one ever answered.  At only 9 months, she was blissfully unaware, playing with my watch, but I couldn’t help but wonder what would happen to her, and whether she would ever leave the small room with bare white walls and tattered sheets.

Later, as I was running through the Woodlands neighborhood where I live, four small children jumped down from the yard where they’d been playing and joined me for a jog.  As they asked me questions (Have you ever met Beyonce? What about Barack Obama? Do you have weights we can lift?) and laughed at my attempts to speak Zulu, I was reminded of the children in the hospital, the burn victims stuck inside, and the malnourished kids who barely got up to walk.  South Africa is sometimes called “the land of contrasts” – it’s true in more ways than one.


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