One Earth, Two Different Worlds

I have had the privilege of spending some time on the pediatric wards this past week.  I almost forgot how much I love it.  The peds wards are full of children with very interesting medical issues, especially when caring for them in a resource-limited setting.  One day on the wards presented complicated cases of pulmonary embolism, newly diagnosed congenital heart disease, malaria, rheumatic fever, meningitis, lymphoma, and the list continues.  With the acuity on the wards so striking, I found myself thinking about differences between here and the children's hospital at home.  I wonder what it would be like if a patient and family from both places were transported to the other hospital for care.  The vast difference between the two hospitals would make for a shocking experience for either patient.

On the wards here, there are no individual rooms.  Instead there is one large room divided into six pods, each with six beds.  There are two patients to each bed, which means two children with one parent each sharing the bed.  On the adult wards, there are usually two patients to the bed sleeping head to foot/foot to head, and occasionally three with one person in a chair next to the bed, all taking turns laying down.  Visitors are allowed at two one-hour periods over lunch and dinner.  Because the wards are so busy and understaffed, it may be up to the parents to give the medicines and therapies.  During their hospitalization, families are often not involved in their child's medical care; something that frustrates me most.  Involving families on rounds, updating them, or breaking bad news is a skill set not used much here, and probably arguably some places at home.  As can be anywhere, medical costs are hard for families; however, here patients can't leave the hospital until their bill is paid and continue to accrue costs until they leave.  Frequently, there will be other family members in the village and in town trying to raise money to pay the bill.  How would I do if I had to be admitted to the wards here? 


Adult female wards with two per bed



Peds wards...1 bed, 2 patients, 2 parents


How would one of our Riley families manage?  No video games.  No TV.  No McDonald's.  I couldn't help but think about the new Simon Family Tower.  While I am happy Riley Children's Hospital expanded, I was disappointed by the excess during my tour of the new facility.  Huge single-patient rooms with two beds and two flat-screen TVs (one for parents and one for child), an entertainment system (including a Wii), refrigerator, and wireless internet.  It was a similar feeling when I returned from Zambia and took a tour of the new Colts stadium.  Don't get me wrong, I'm not against nice things; I love football; and I want the children of Indiana to receive wonderful care in a comfortable environment; but when is it too much?  Is it the most responsible use of money?  I can't imagine what one of the Kenyan patients would do in such a room, bigger than their own home.  Typical toys for a Kenyan child include a stick and bicycle rim; maybe they can make a game to simulate it on the Wii.

During rounds, I couldn't help but wish things were different, more equal.  Wanting myself and the rest of the Western world to appreciate what we have without a sense of entitlement.  Maybe even give out of more than just our excess, not just when it's easy and safe to do so.  Certainly, no one is guiltier than me.  Wanting the Kenyans and others living in the developing world to have better health care, an abundance of food, and clean water.  A book I recently read, Outlive Your Life, makes a statement about bringing our world together:

"1.75 billion people are desperately poor, 1 billion are hungry, millions are trafficked in slavery, and pandemic diseases are gouging entire nations.  Each year nearly 2 million children are exploited in the global commercial sex trade.  And in the five minutes it took you to read these pages, almost ninety children died of preventable diseases.  More than half of all Africans do not have access to modern health facilities.  As a result, 10 million of them die each year from diarrhea, acute respiratory illness, malaria, and measles.  Many of these deaths could be prevented by one shot.  Yet in the midst of the wreckage, here we stand...you, me, and our one-of-a-kind lifetimes and once-in-history opportunity.  We can travel around the world in twenty-four hours or send a message in a millisecond.  We have the most sophisticated research and medicines at the tips of our fingers.  We have ample resources.  A mere 2 percent of the world's grain harvest would be enough, if shared, to erase the problems of hunger and malnutrition around the world.  There is enough food on the planet to offer every person twenty-five hundred calories of sustenance a day.  We have enough food to feed the hungry.  We have enough bedrooms to house the orphans..."  So, what are we doing?

Yes, it is oversimplified, but it emphasizes that the problem is not the supply, but instead the distribution.  May we take the opportunity to make a difference in a hurting world, recognizing needs and giving in a way that is beyond our excess.