While I was a medical student at a government hospital in Mombasa, I was struck by how much of a patient’s care was dictated by their profiling. Each patient had a chart – their medical record – which was a college ruled notebook with some information on the front. Their name, gender, age, tribe, religion, language and how they would be paying for their care/how much they could pay. Often, money dictated their care.
For example, I remember a man about 30 years old who had HIV that hadn’t been fully treated, who came in feverish, confused, weak, and vomiting. The team could tell he likely had an infection that had spread to his brain, but in HIV this can be caused by different sources that need to be treated differently (bacteria with antibiotics, a virus is treated with one type of medications, fungal infections with another). So, the dilemma became: since he cannot afford to be given all the medications until we know which one is working, how do we make an educated guess on which was most likely? And if we guess wrong, will he survive long enough for us to switch his medication to what will work? We made our best guess based on his blood work and history and started an antibiotic. The next day, he was no better. The third day, he wouldn’t wake up for us but became less and less responsive. We were worried we had bet on the wrong drug, so we switched him to an antiviral medication.
The fourth day, I was walking through the long, cement hall of beds towards his at the very end, when I saw a crow fly in from the window and land on the head of his bed. It sat there until the nurse shooed it onto the porch. It hovered on the porch for the rest of the morning, as if it was waiting for something. The man died that day. I don’t know if it’s because he never had a bacterial infection in the first place and being too poor to afford both medications is what cost him his life, or if he would’ve died either way because it took him so long to come for medical care. I don’t know. But that image of the crow hovering over his frail, sleeping body stuck with me, the way it seemed poverty hovered over his medical care. It’s hard to work against these difficulties. It’s hard to try to treat people who don’t have the resources to do what is needed for them to improve. It’s unfair, frustrating, sad. . .
I think there are two positive responses to this. One, trying to be part of the solution. And two; remembering that “our struggle is not against flesh and blood, but against the rulers, against the authorities, against the powers of this dark world and against the spiritual forces of evil “(Ephesians 6:12). Remembering that the ultimate solution to suffering is found in God helps us to be strong while we fight these battles, because the war has already been won. Be strong, friend.