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Alima has bronchiolitis, but there is no oxygen to prevent her suffocation in the Ethiopian hospital


A Spanish pediatrician posted to a rural health center south of Addis Ababa details the lack of means to save the lives of children with respiratory diseases. There are more than 15 minors who need oxygen and only two cylinders that empty quickly

Alima takes a deep breath, as if each breath was her last.

Maybe it is.

Alima mobilizes all the muscles of her body with each breath in order to take in as much air as possible.

Each of these gestures is a battle won, a breath of oxygen to prepare for the next breath.

The battle does not stop.

Death by suffocation due to bronchiolitis lurks stealing the air, closing off the airways.

With each breath the ribs are drawn on the chest, a sign of the effort of the muscles to open the ribcage as much as possible and to be able to expand the lungs to the maximum.

Alima has only a few months to live and arrives at the rural general hospital in Gambo exhausted.

Her bronchial tubes are clogged and she is increasingly exhausted.

She squeezes her lungs out by tattooing the ridge of each rib into her black skin.

The intercostal and subcostal muscles are exhausted.

With all his might he extends his neck towards infinity, trying to inhale as much oxygen as possible.

After a long journey, she finally arrives at the hospital, but she is not the only one.

Like her, small bodies are crowded together, breathing to the limit in the collapsed waiting room of a hospital where, when it seems that there is no room for anyone else, four suddenly enter.

They need oxygen, like everyone else, although in rural hospitals, like the one in Gambo, Ethiopia, it is a rare commodity.

The rural hospital of Gambo has more than 15 children who need oxygen and only two concentrators and cylinders that are emptying quickly

I remember in my days as a pediatric resident at the Granollers hospital in Barcelona how by turning a little wheel the oxygen came out by liters from a pipe in the wall.

I had normalized it, I didn't value it.

Now, after being in this hospital in the south of Addis Ababa, the country's capital, what I saw during those years in Spain seems to me to be a true miracle.

At the Gambo health center, and most of the country's hospitals, oxygen cylinders are needed that weigh more than stones, and the problem is that when they are emptied we have to transport them hundreds of kilometers to be able to refill them.

I thought that in the pediatric emergency room I would find children with tuberculosis, AIDS, malaria, tropical diseases, but I have found that the most frequent are bronchiolitis, bronchitis and other respiratory infections.

So I've learned to value medical oxygen, which here doesn't come out of the walls by turning a screw.

Two workers from the rural hospital in Gambo (Ethiopia) carry an oxygen cylinder. Iñaki Alegría

In these moments of bronchiolitis epidemic we do not have enough resources, there is a shortage of oxygen.

We have over 15 kids in need, and only two hubs and cylinders that are running out fast.

This is where the precious “Y” comes into play, so called because of its shape.

A simple piece of plastic or metal that splits an oxygen stream in two.

And these two, with two other pieces, you can turn them into four.

I wish what it did was multiply the oxygen, but no, it splits it.

It allows us to reach more children, paying the price of lowering the flow that each one receives.

Oxygen cylinder tube divided into a 'Y' shape, which allows care for two patients with bronchiolitis in the rural hospital of Gambo (Ethiopia). Iñaki Alegría

It is time to juggle calculating how many patients there are, and prioritize among those who are most serious.

It is a very dramatic situation.

It is necessary to get more concentrators to avoid having to ration the air so much.

As soon as they improve, we remove them for the benefit of those who have worsened.

Alima and other girls like her are silenced victims of the injustice of being born in rural Ethiopia.

When the power goes out, we are forced to put the fuel generator that is economic ruin.

The alternative is these cylinders, but they can only be refilled in Addis Ababa, which is very expensive.

Meanwhile, girls like Alima continue to struggle for air and, as the Chilean poet Gabriela Mistral would say: "She can't wait, her name is today."

When the power goes out, the discomfort is not that of having to light a candle, it is the impotence of not being able to light an incubator

No one in the hospital knows for sure the number of beds available in the pediatric ward.

One day there are 45, the next day, 57. The papers say that there are 45, but those of us who live from day to day know that this is not true.

There will be as many as necessary.

It is only possible thanks to the work of each of the workers: cooks, cleaners, nurses, assistants, nutritionists, midwives, maintenance technicians, doctors... forming a team of more than one hundred and fifty Ethiopian employees.

It is also the hospital of the three hundred hands.

The center offers work and training to the people of this rural population.

With effort, sacrifice and dedication, the health, education and living conditions of a population can be improved through comprehensive development.

Hospital workers are the real heroes and heroines.

Without them it would not exist.

I want to pay tribute to each one, since they are the ones who are there day after day, at the foot of the canyon throughout the entire epidemic, until the next one arrives.

We have already dealt with measles, meningitis, and bronchiolitis…

More information

The explosion of cases of bronchiolitis in babies fills pediatric ICUs and forces hospitals to prepare contingency plans

Towards the end of bronchiolitis: new drugs may make the current wave the last to hit Spanish babies

I would not like you to have to live like us, at the limit with the oxygen available, measuring and dividing each liter, as well as medication.

Here I have discovered what it is to jump for joy when the light returns.

Energy that will feed oxygen concentrators, incubators, operating room and laboratory machines, saving expensive generator fuel.

When the power goes out, the discomfort is not that of having to light a candle, it is the impotence of not being able to light an incubator or an air concentrator, it is the impotence of having lives vanish before you.

A newborn in an incubator at the rural hospital in Gambo (Ethiopia). Iñaki Alegría

Meanwhile, we will continue loading cylinders, dividing it with the pieces in 'Y' and dreaming of oxygen coming out of a pipe in the wall in an endless stream, turning a thread, as if it were tap water.

Speaking of water, I'll leave it here, that's another story that will be told another time.

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Source: elparis

All news articles on 2022-11-30

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