On a sad note...

When people think of Africa, they often associate it with HIV/AIDS. Throughout our trip, we have seen the devastating effects of this illness on the children in Namibia. Today, I was able to see the effects right before my eyes. We had started rounding on patients in the high care unit on 8B when one of the nurses called the team over to the isolation unit. The intern was the first to arrive and I was following her. When I arrived to the room of this young infant who was HIV + and was admitted for respiratory distress, the intern was giving chest compressions. We were told that the baby had stopped breathing. The bag mask was not in the room so the nurse went to get it. When the bag-mask arrived, the intern tried to give breaths however we noticed that the baby had vomited and likely aspirated. More vomit came out of the mouth during the attempted positive pressure ventaliation. I informed the medical officer of the situation who advised that we were not going to proceed with any resusciation as this baby has HIV with a poor prognosis. At that point, it was unlikely that anything we could have done would have saved him. The medical officer examined him and pronounced him dead. In this hospital, if a patient has HIV they are not intubated. Although this death was not surprising as I have seen this baby over the last couple of days and watched him in such distress, it is still very different how death is approached here compared to in the United States. At Geisinger, we would have called a code immediately and a flurry of people would have arrived to start the code process. This approach is very different from what I am used to and somewhat difficult to understand due to the way we practice medicine in the US. As Anna and I have stated in previous blogs, death is something that occurs frequently here therefore people become almost indifferent to it; however, the bond between a mother and a child can be seen in any culture as I watched the mother crying and grieving over the death of her young son.