‘There was no way we would send Vishal home to die’

Dr Ashita Singh writes,

‘Vishal was carried in to Chinchpada’s casualty department in his parents’ arms. A young man in his early twenties, he was desperately thin, semi-conscious and very agitated.

His mother explained that he’d had a cough for a couple of months, and a fever for a few weeks. Then he’d started complaining of a worsening headache and had now developed altered consciousness.

Immediately, we knew the three most likely diagnoses for Vishal’s condition: tuberculosis, tuberculosis or tuberculosis.

The disease is so rampant in our impoverished communities that it is a spot diagnosis we often make as soon as a patient arrives.

Within five minutes of meeting Vishal, we knew he probably had disseminated tuberculosis, affecting multiple organs including his lungs and brain. He had not been washed for days and all his bones were visible. On examination we discovered that his oxygen saturation was borderline, and he had neck-stiffness, meaning meningitis.

We quickly prepared to send his blood tests and get a chest X-ray to start his treatment as soon as possible. I watched as our nurses efficiently and lovingly cared for him – deftly inserting his tube, taking off his dirty clothes, sponging him clean and dressing him in a clean hospital gown. All the time they spoke so kindly to him and his anxious parents.

What a gift that such a faithful team of godly people provide this high quality care to the most vulnerable people, affirming their dignity and value! I reminded them to keep their masks in place and prayed silently that the Lord would protect them from infection.

Critically ill, he needed supplementary oxygen and close monitoring in a high dependency unit, but that would endanger our other patients. The best we could do was to stabilise him and shift him to the ‘TB room’. This is the last of our single rooms, far from adequate for his needs and not really isolated enough to prevent the spread of tuberculosis to staff and other patients.

We have often been troubled by the question: is it ethical for us to put our staff at this increased risk? Four staff members have been treated for TB recently because of the lack of adequate isolation facilities. While we doctors are at risk, nursing staff spend more time with patients and so are even more vulnerable.

But the only alternative was to send him home to die, and we were not about to do that. God-willing, things will improve, and for now the only right option seems to be to accept the risk and do our best to save each precious life. After all, isn’t that what cruciform love is all about?

Vishal’s parents looked exhausted in their torn clothes, and were almost as thin as their son. Clearly, they were not used to nutritious food, and had not slept for days. When we asked why they had taken so long to bring him, they told us how they had taken him to the witch doctor after multiple bottles of ‘saline’ from the government hospital had made no difference. When he got worse, the witch doctor referred him to Chinchpada, reassuring them that they would be welcomed even though they had no money.

Vishal gradually improved. We hope and pray that he will make a full recovery over the next six months of his treatment.

We also hope – with all our hearts – that we will be able to build an isolation unit in the months ahead, so we can optimally and safely cater to the needs of others like Vishal who deserve better.’

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