I recently spent some time with a doctor friend who works in a Malawian government hospital. She described one ward round of 3 hours seeing 56 patients sharing 32 beds; three quarters of the patients had HIV.
‘The first call was to the diarrhoea side room, a sobering array of wasted bodies and sunken eyes. The floor was wet with poorly mopped spills from bed pans. The first bay was reserved for patients with meningitis, strokes, or paraplegia. I crawled half under a bed with the house officer to show him the sensory level of a man with paraplegia. Urine seeped from the mattress on to our knees. Relatives were leaning in through the windows, anxious, listening, watching, commenting. One called across, asking me to treat his cough. I told him where to find the clinic. As we passed the nurse on her drug round, a man from the other half of the ward pulled at my coat sleeve: “Help me”. The nurse told him that someone would see him later. The second bay was pneumonia, tuberculosis, jaundice. Another patient was tapping my shoulder and demanding that I help with his stomach pains. We hastened through several cases of chronic cough in the last bay and were done.’
‘I issued a closing pep talk and turned to leave. Passing the noisy relatives, I felt an insistent tug on my coat hem. Not again! I whipped round, suddenly angry and impatient to get out. It was one of the patients on the floor in the second bay. Could he not see how hard we had worked? I didn’t bother to conceal my irritation and said, “I have already heard your problem. What do you want now?” He looked up at me earnestly. “Nothing, doctor. You look tired. I think you can share my beans.” He pushed his watery hospital meal on its plastic plate across the concrete floor towards me. I had seen the face of Christ.’
Revd Dr Sam Wells