By Vanessa Kellenberger, Volunteer from Switzerland
Recently a desperate mother visited TLC at the River Clinic. The tiny seven-day old baby she carried with her suffered from fever and pneumonia. The baby was clearly critically ill and Dr. Emily, Dr. Bill and Dr. Kimsan concluded that a hospital would be the only chance to save the baby’s life. Despite their best efforts to convince the mother that this was the right thing to do, the mother refused. But there is a happy ending.
What the TLC doctors diagnosed
The mother, Heang, had delivered her son a few days before, after what she said was a normal pregnancy. The baby looked extremely small, and only weighed 4lbs. It seemed more likely that it had been born prematurely. Being born early in one of these villages is bad enough, but it was clear that this baby was also very sick. The tiny boy had a serious respiratory infection and was working very hard to breathe. He was so tired from all of this effort that he barely responded to the doctors assessments. The mother didn’t look much healthier herself. She complained of a terrible headache and her blood pressure was very high. She likely had pre-eclampsia, which could have killed her.
What we did
The only thing we could do at the moment was to give paracetamol for the tiny baby, and try to convince the family that it needed to be treated in a hospital. Normally, a visit to the hospital is unaffordable for the people who live on the lake or river. Making things worse, hospitals that provide free health care are very far away, requiring private transportation, often a boat or a motorbike. In these situations TLC will pay the journey for the families in need. Heang and her husband live six kilometers downstream in the opposite direction of the provincial hospital. We all crossed our fingers and hoped that they would take the baby there.
What happened after the visit at TLC River Clinic?
When we returned to the River Clinic one week later, the mother didn’t bring the baby back to us for a follow-up visit, as requested. TLC’s doctors, including Dr. Jameel (a neonatologist from the USA) were very concerned and went to the family’s house in the evening. As they arrived, they realized that Heang had not gone to the hospital. Even more concerning, the baby’s condition had worsened, but against the odds, he was still alive. So TLC once again discussed the importance of further treatment.
The presence of all these visitors to an otherwise remote homestead did not go unnoticed by other villagers. Soon there was a crowd gathered listening to the pleas of TLC’s staff and to the excuses of the mother and father. Sometimes, peer pressure can be a good thing. The family finally agreed and left for the hospital, but not before Dr. Jameel started the baby on an antibiotic. The family arrived there and hospital staff in Kompong Thom told them there will be no hope as the baby was too small and too sick. It appeared to have stopped breathing. So Heang and her husband took the bumpy road back to their village, bringing home what they believed to be a dead baby.
The Happy End
When they arrived back home they realized that the baby was, in fact, breathing! As soon as they noticed, they came to the River Clinic. It was early in the morning when they reached us. We were so happy to see the baby alive, but it still was not out of danger. The antibiotics were working, and the tiny boy was beginning to look more comfortable. He was severely malnourished, dehydrated, and needed support that could only be provided in a hospital. This time, the family readily agreed to our suggestions. We ultimately the mother and her baby to the Angkor Hospital for Children in Siem Reap. He stayed there for 3 days and received the treatments he needed before being discharged home looking much better. What a strong baby!
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