28/06/2013
Here where I am the love of money outweighs good health. Dr's in this part of the world commonly put money before health. Not all of the time, there are many good committed doctors here but far too many times a patients health is second to the patients wallet.
Too many times have I watched people die slow miserable deaths, literally drowning in their own body fluids from the inside. Here is the Readers Digest version of one mans account.
I found a man about a year ago who was about 40 kg over his dry weight. ( Dry weight is the approximate weight of a human body that is not overly saturated with fluid. ) He looked like Jabba the Hut. He had run out of money to pay the fees at Korle Bu Teaching Hosptial, the premier hospital here in Accra, so they sacked him from the clinic and left him to die. He had not dialyzed in 3 weeks, I could not believe he was even alive. His name was Kwame, a Ghanian who had spent the last 20 years in the USA. He left the US for a visit to Ghana with his residence status in question and he was unable to return!! He was from Atlanta, GA
We went to his house at the request of his friends, he was so full of fluid that he could not rotate his neck more than a few degrees. His hands were swollen to the point he could not move them and his ankles and feet looked like one giant mass of flesh. His testicles were the size of basket balls and he could not utter more than a few words at a time without gasping for breath.
We drove him in our s**tty little car to our clinic and dialyzed him for 8 hours straight. We easily removed about 15 kg from him. At the end of his treatment he was talking normally and could breath, but the swelling in his extremities had not gone down much. He still looked like Jabba. As he was leaving I threatened him and told him if he put one drink to his lips I would cramp the s**t out of him the next time he came in.
He came in 2 days later, looking better but still massively swollen and bloated and still unable to perambulate. We put him on one of the trusty ole Fresenius 2008H and dialyzed the f**k out of him again! 15 Kg removed in 7 hours, no cramping and no hypotensive episodes. Allahu Akbar/God is great!! We were making progress. So 30 kg off and about 10 more to go. He went home with the swelling markedly reduced and he was actually laughing and joking with me. If your stuck in a room with me for about 8 hours you WILL laugh at least once!!
2 days later Kwame WALKED into our clinic. He had not gained one single kilo. He was helping us help him. We removed about 6 kilos in 4 hours. He was now pretty much dry and he was not dying!! He came to the clinic every Monday, Wednesday, and Friday for about the next two weeks. He was doing well and was actually starting to act like a typical dialysis patient, complaining!
One Monday he did not show up, I called him. I heard a raspy voice on the other end saying, Alex, Alex, Alex, I'm sick. I have Malaria. I rushed to the house to find him lying in his bed fevered shaking and in serious trouble. Again we stuffed him in to our god blessed Mitsubishi Lancer and drove like fools to Mercy Hospital. He had Malaria of +4 very severe.
He died a few days later. His body was so stressed from his ordeal of the past few weeks that the mosquito borne illness killed him quickly.
