Change Something

I have been at the Pediatric Academic Societies' meetings in Vancouver the last few days, where thousands of pediatricians from around the world are presenting research and learning and talking about all sorts of issues in how we provide the very best medical care for children. (Vancouver is, by the way, a really great city!)

Sitting in the PAS meeting's opening session in that great city, I couldn't help but remember one of my recent patients in Kenya. David was a 3-year-old who had had fevers and diarrhea for too many days. When I went to see him on the pediatric ward of the hospital, he was sick and pale and dehydrated. He was struggling to remain conscious because of how sick he was.

His mother sat in the hospital bed with him, a hand resting gently on his shoulder, her bright red and yellow fabric leso still wrapped partly around him and partly around her own shoulders. I think she was keeping him conscious with the physical connection between the two of them.

Heaven knows we were not able to do too much else to keep him conscious. Our intravenous fluids and antibiotics and the one remaining oxygen connection on the ward were all too little, too late.

With big sad eyes, David's mother watched him die.  My eyes were sad, too, when the resident came to find me to tell me that the little boy had died. I wanted to DO SOMETHING, but there was not more that we could do at this time and in this place, for this little boy.

I thought of David because he was the name I put on the statistics I was hearing from the podium when Dr. Chris Elias, Director of Global Development for the Gates Foundation, talked about the current state of under-5 mortality.  When Dr. Elias recites our grim global statistic - that 6.6 million children under the age of 5 will die this year - that statistic has a face for me. This time, it was David's face.

mother baby marketplace eldoret

My statistics have a face. My statistics have mothers. My statistics still make me cry with the waste and shame and injustice of a child dying before his 5th birthday. (This is how a person who really doesn't like math remains motivated in a career with lots and lots of numbers.)

I also thought about David when Dr. Lewis First outlined his principles for how we could revolutionize the field of Pediatrics by becoming not just excellent pediatricians, but "leadiatricians." Dr. First is a legendarily funny, engaging, and excellent pediatrician who may single-handedly have improved the health of children in Vermont and inspired countless new pediatricians. Dr. First urged everyone to embrace this motto: "Change something for the better each and every day in what we do for children!"

And, really, that's why I am a pediatrician doing global health research. I want to make things better for children like David. I want to do something that will make it better for the world's children each and every day.

We know why so many children like David die. Complications at birth, pneumonia, and diarrhea (like my little boy) are what kill most of them. Not having enough food plays a huge part in this. Malnutrition contributes to at least ½ of these deaths.

We know how to prevent these conditions. We know how to treat them.

David could have been saved if his family had a better way to get clean water. He could have been saved with earlier antibiotics and fluids. We could stop these 6 million kids from dying by getting them simple things like oral rehydration therapy, antibiotics, and vaccines. If we could get them enough food or if we could get their mothers skilled care during pregnancy and childbirth, we could do even better.

Change something for the better each and every day in what we do for children. We can, each and every one of us, do this. 

Posted at 10:36

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