Mayotte : le centre de santé MSF à Kaweni

La salle d’attente attend ses premiers patients. Demain, c’est le grand jour de l’ouverture.

par Jean, médecin.

Le centre de santé se situe à l’entrée du bidonville de Kaweni. Il est très bien agencé, avec une salle d’attente, une  pièce pour la prise des constantes (poids, taille, température, tension…), deux salles de consultation, une infirmerie, une salle d’observation, une pièce qui sert de pharmacie de stockage.

  

Le centre encore en construction

Nous sommes secondé par un « staff » composé de neuf personnes : une réceptionniste qui enregistre les patients, une personne responsable des “constantes”, deux traductrices, deux distributeurs de médicaments, un infirmier, une technicienne de surface et un visiteur à domicile. Ce visiteur qui habite le quartier fait le tour des “bangas” (petites maisons de tôles du bidonville) et repère les  pathologies évidentes, les  problèmes sociaux ou financiers, les  décès,  naissances, personnes arrivées ou expulsées et en fait part à l’équipe.  

Les consultations sont quotidiennes, débutent à 7 heures et se terminent à 15 heures. A 7 heures, a lieu un premier tri des patients selon des critères médicaux stricts et prédéterminés de 30 patients, deux autres tris ont lieu à 10 et 12 heures. 

 

 

 

 

 
 
 
 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

World AIDS day in Homa Bay - Day 3 - Love medicine

In the lead up to World AIDS Day, 2008, on December 1, photographer Brendan Bannon is in Kenya and will be providing images every day of his travels with MSF throughout the region.

Day 3 - LOVE MEDICINE

Sometimes what you need to give a patient is love. For two months little Steve was our fuel. He kept us going“, Dr Rodrigo told me.

I think  that In medicine, as in life, there are ordinary  relationships and extraordinary ones. Extraordinary ones teach us about our selves and connect us deeply to other people. They  change us as they remind us of each others humanity. It sounded to me like the relationship that was fused between young Steve, his family  and his team of doctors was  extraordinary.

Steve, at 12 years old, was facing death.

Steve, at 12 years old, was facing death.

When steve came to the hospital he was sick. His first line ARV treatment had failed. Whatever medical interventions were tried seemed to be failing as well. Steve, at 12 years old, was facing death.

Dr. Rodrigo:
“For two months he was our fuel’, said Dr.Rodrigo. “He kept us going and now the medical me doesn’t understand what happened! When I look back, I ask myself : what did we do to make him better?”

“At the time I was trying to Phase into the stage where you let him die peacefully- then we started to get closer to him. We talked to him about his dreams…
The emotional me wants to believe that love was the treatment. The medical me dstill wonders what was that got him through and made him recover.

“I remember a couple of days  being fed up with work. T

hings weren’t working and I went and saw little Steve who is dying and he would give you a smile and everything was better.

“One day Helen, Steve’s tuberculosis doctor, told me  tshe was having a tough day but after seeing little Stevie’s smile, things looked completely different, somehow better. I felt jealous for not being there.”

Eventually he started to recover. We  saw he gained  a Kilo of weight, then three and so on. Every little weight gain was like a grain of hope. Helen would come and check him very early and then she wouldn’t be able to keep the good news. It kept us going like fuel for our souls.”

In here you need to win some battles from time to time, little Stevie is one of those.

Steve was put on second line ARV treatment and, after a short while, he started correcting a nurse who delivered his medicine.

When a patient is correcting his nurse by telling her she is  not giving the right amount of drugs.

That is the sign that the patient is ready to take his medications alone !” Dr. Rodrigo said.

In the end ,the magic was Steve. He found the will to follow his treatment.”

The point of Dr. Rodrigo’s story to me  is not that love will conquer all or that on it’s own a miracle. But I do believe, because I have seen it in my own life, that when love, compassion and curiosity are shared with a patient the patient can see a world that is bigger than the disease.
And they can summon the will  to live in the world that they see.
My mother was sick for years with Multiple Sclerosis. I took her to hundreds of doctors appointments.  Most of the time the news was grim. She would be told: “you are worse off than  the last time I saw you and  it’s likely continue to get worse.” Then she was told that it was vaguely possible that the steady March of  disease could be stalled at its current stage for a short period.
There was  one doctor, Dr. Phillips, who made the time to listen to her. He asked about her work and her family. Then he would tell her that he admired her courage and that if he could  ask God for  one miracle he would ask for her  recovery.
By then she couldnt walk. So I couldnt see her quicken her step…. But  I did notice that she would push  the wheelchair out of his office herself.