I walked into a wall of human warmth. The stench of spit-up, human refuse and sweat filled the air. I almost vomited. I swallowed hard and entered.
Though I had already properly interviewed 20 patients, winter wasn’t the “season” for acute gastroenteritis, and I wandered into Children’s A Ward to see what else I could find. I found myself in a small, side laboratory that catered to the children’s ward. Its rudimentary setup consisted of a single microscope, sulfur, methanol and other testing chemicals. Children’s stool, urine and blood samples were brought in to be tested. Across the hall were a pharmacy tech room, several side chambers for more stable patients, a Higher Disease Unit and a neonatal and pediatric Intensive Care Unit.
The lack of privacy and structure was evident even to an untrained eye. Mothers openly breastfed, and patients’ siblings ran around half-naked and often unsupervised. For the duration of their stay, patients lived in close quarters, their families occupying all parts of the hospital. Families ate, prayed and slept where their children lay ill, and I often wondered whether patients could get sick from all the chaos around them.
Two-month-old Wajeeha was on an intravenous saline and dextrose solution because she was unable to keep down the Oral Rehydration Solution (ORS) that was necessary to rehydrate her. Her mother fed her often, but every few minutes Wajeeha threw up and the stench of diarrhea filled the air. Many mothers were unable to afford diapers, and instead swaddled their babies in cloth diapers that were unable to contain defecation. This increased the contact with the refuse most likely caused by rotavirus, which was spread via fecal to oral transmission. Even when they washed their hands, they used the same hand to turn off the tap that was turned on with a previously dirty hand, possibly reinfecting themselves. That is, if they even washed their hands.
Due to the culture of scrimping, I knew that even if disposable diapers were made available, they would be used multiple times to their maximum capacity, and in turn could harm the child. But what if a washable, plastic sealed diaper was made available to these mothers? Would the spread of fecal-to-oral disease greatly decrease? I began to truly realize the importance of educating these mothers.