Mzungu Memoirs

Our First Emergency Room Visit…in Uganda

As the mother of a very active boy, I expect I will have my fair share of emergency room visits throughout Caleb’s childhood.  I just never figured on the first one being while we are here in Uganda.  Actually, if you want to get technical about it, I guess we’ve made a couple of visits to the Urgent Care before, but I pretty much knew what was wrong on those trips and they were made because we were either away from home and our normal doctor or between doctors.

This trip was different.  I really didn’t know what was wrong and I really didn’t expect to end up in what is essentially an emergency room here in Uganda.  For six hours plus.

It started out simple enough.  Caleb had become sick to his stomach since about suppertime one evening and by early afternoon the next day, when he was unable to keep even water down, I was starting to get rather concerned.  Robert came home from the office early to take us downtown to The Surgery, a clinic run by a British doctor that seems to cater to mzungus.  It was quite the feat getting a sick child there on a boda boda.

We got to The Surgery about 4:15, and ended up waiting for about an hour.  When it was finally our turn, we got to see a lady mzungu doctor but she wasn’t British or American.  I think she may have been German or something, but it really didn’t matter.  She seemed pretty good, and seemed rather concerned that Caleb had been throwing up for almost 24 hours.  And she got even more concerned when I told her that he had thrown up half a dozen times within the first two hours.

The doctor examined Caleb pretty thoroughly.  Then she gave us a cup for a urine sample and directed us to the toilet and then up to the nurse’s station.  At the nurse’s station, Caleb got his finger pricked for some blood tests, including a test for malaria which is a fairly common practice here.  Then we were taken to a small room with a bed, a little table and two plastic chairs.

Not too long after, the nurse came back with a shot of anti-vomiting medicine to give Caleb.  At first, she said that she wanted to give him the shot in his rear end, but then she gave him the choice of the rear end, thigh or shoulder.  Caleb chose the shoulder, presumably because that is where he has been getting shots recently, so that is what he knows.  Of course, we had to get ready to take the shot first.  He got into my lap (I was sitting on the bed with him), and we took his shoes off so he could wiggle his toes (a great distraction technique).  Then it was time for the shot.  Caleb was very proud of himself: he didn’t even cry.

Then we had to wait half an hour for the medicine to take effect before he could start drinking anything.

About 6:00, the doctor came in to check on us as she was getting off her shift.  She said that Caleb was very dehydrated and that we needed to get him re-hydrated before they would let us go home.  She really wanted to get some juice in him for the sugar.  Unfortunately, Caleb doesn’t really drink anything except milk and water.  Robert suggested a lollipop as it was the fasted way he could think of to get sugar in the boy.  I don’t think it was quite the form of sugar the doctor was meaning, but she was agreeable to the idea.  So when the nurse came back, we asked for a lollipop in addition to the water she had brought.  It is the first time I have ever heard of a lollipop being administered for medicinal reasons.  Unfortunately, the sugar in the lollipop didn’t seem to work.  After finishing the lollipop and about half of the bottle of water, Caleb was asked to pee again and there was no improvement.

The nurse was still pushing the juice idea, but Caleb wouldn’t have any of it.  We asked if there was any milk.  Unfortunately, the only milk they had was warm, and they would have to add sugar to it.  Then we came up with the idea of running to the closest store to buy some chocolate milk, which would have a higher sugar content than white milk.  When we asked the nurse, she said that she was going to suggest that idea as well.  So off Robert went to find Caleb some cold chocolate milk.  And again, I was surprised they were suggesting milk for medicinal reasons as I have always be under the impression that it is better to avoid dairy for upset stomachs.

While Caleb was working on finishing the milk (250 ml or about 8 oz. of it, more than he had ever had in one sitting before), a second doctor came in to talk to us.  This one was Ugandan, but I had seen him around the clinic before.  He reiterated what the first doctor had said about the necessity of getting Caleb re-hydrated before we went home.  He also said that they would give us a syrup form of the anti-vomit medicine in case we needed it.

The nurse came back to check on us, but she wouldn’t let Caleb pee again until he finished either the water or the milk.  So we worked on the milk some more.  Unfortunately, it didn’t work either, so we were on to the next step in trying to get Caleb re-hydrated.  We were also on our second round of nurses and third doctor due to the shift change at 9:00.  We had now been at The Surgery for almost 5 hours.

The next idea was to have Caleb drink the sugar water that would normally be used for an IV drip.  The idea being that if he drank it, he wouldn’t have to have the IV.  Unfortunately, he didn’t like the taste of the water and refused to drink it.  We tried to scare him into drinking it by showing him the size of the needle he would be stuck with if he did the IV, but that didn’t work.  Surprisingly, he opted for the IV.

Actually, he did amazingly well getting the IV put in.  Between the Daddy distraction factor and how smooth the nurse was, I don’t think Caleb even felt it.  Once the IV was in, we were all able to sit back and relax a little while the IV did its thing.  In fact Caleb even fell asleep.  Unfortunately, that meant that we had to wake him up to get him to pee again.  In the process of doing so, we pulled the IV supply line out from the needle and then we managed to pull the IV out of Caleb’s hand.  It was quite the sight with me holding my thumb over the IV line in one hand to keep it from squirting everywhere and Caleb’s arm that was now dripping blood all over the bed in the other while Robert ran to get the nurse.  I don’t think the nurses were very happy with us after that.

By this point of course, Caleb was awake and rather upset.  It took some coaxing and calming down to get him to pee.  Once we did get him to pee, we had to wait for what seemed like an eternity (you have to remember it was approaching midnight by now) for the results.  Finally, the doctor came back in and said that while the results were not quite where they would like them to be, there was sign of improvement so they were going to let us go home.  Yeah!  So, after almost 8 hours, we gathered up our stuff, paid the bill, which was only 165,000 UGX (about $69) and hightailed it out of there, making a beeline for home and bed.  The doctor did make me promise that I would continue to work on re-hydrating Caleb with the electrolyte drink mix she gave me.

Caleb seems to have made a full recovery (despite the fact that I didn’t get much of that electrolyte stuff in him, although he does seem to tolerate it better than the IV fluid they tried to have him drink) and is back to his normal active 5-year-old self.  All in all, it really wasn’t that bad an experience.  I have to give credit to all the doctors and nurses at The Surgery.  They were great and had a way with Caleb despite his “stubbornness.”  I’m not terribly eager to make another trip back there, but I know if we need to we will be well taken care of.

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