Day 173, There are enough things to battle with here when it comes to patient care but cultural beliefs and practices are some of the most frustrating. I have a mother on the paediatric ward who is refusing to cooperate for her child’s care because of her beliefs, essentially equating to a death sentence for the 1yr old.
The child is a tiny little thing, bright yellow eyes, about half her target weight, and a massive abdomen owing to her liver failure. She developed problems a few months into life and was initially investigated. When the biopsy results were received, mother never returned for follow up and 6 months on we are left with a malnourished, jaundiced child with probable advanced liver damage.
I have been able to discuss the case with the specialists in Durban and they have agreed that the child needs to be reviewed immediately if we are to have any hope of preventing irreparable damage. Diligently I made all the appropriate arrangements only to find out that the mother would like to take the baby home and give it muti (traditional medicines).
The family structure here is such that the elders are often very dominant, and there is a great belief in the power of muti. For adults, they can choose what form of treatment they would like, but children have no choice. The mother is supposedly being pressured by the gogo (grandmother) and they would like the child to receive traditional medicine in the form of scarification or oral concoctions.
There is no regulation for these medicines and all too often we see babies coming in, particularly those who have had a bout of gastroenteritis, in terminal kidney and liver failure. The medicines can be cocktails of literally anything, from detergents, to battery acid to diesel. Far too many of our babies die because of the administration of these medications.
However, being respectful of the cultural norms we are often left with trying to advise parents of the dangers but having to deal with the consequences. It is a difficult professional dilemma to resolve, as incorporating cultural beliefs is key in the good practice of medicine, but so is the tenet of doing no harm and speaking out when harm is done.
What inevitably happens is parents are advised of the ills, but then we have to continue to try and mop up the catastrophes that are left for us, knowing that every death sadly won’t be the last.
I have come to the conclusion that no one else reads the comments, so here goes.... Pooooooo!
ReplyDeletethanks for that
ReplyDelete