      |
Letter from Stewart Condon, Aceh
We see many different patients, but most of them have one thing in common - they are poor, and it is these people that the health system has overlooked in recent years. Although medicine is free through the puskesmas (community health centres), supply can be problematic and diagnosis often difficult. Many people improve, but sometimes the patients have larger problems. One in particular comes to mind. She is eleven years old, and she quite obviously has a larger problem. Her mother brought her to the clinic as she wanted to see if the bule (foreigner) doctor could help where the others hadn’t been able to. She has seen general doctors at the puskesmas in the past, and has also had a specialist opinion from a paediatrician in Sigli three years ago. She is breathing fast, and you can see her little heart’s beat on the surface of her chest. She has been like this for a long time, and closer examination reveals a very loud heart murmur and signs of cardiac failure. This is common with congenital heart disease or after damage from rheumatic heart disease. Either way, she needs medicine on a daily basis and will probably need surgery. There is some hope, as we have heard that an Indonesian cardiac surgeon travels to Banda Aceh every month to do exactly what she needs- valve surgery! However, the family have no money, either for travel or for the medical expenses. The other consideration is the time spent away from the rice fields is time not spent earning, and this is perhaps the biggest cost of all. Many patients here don’t spend the adequate time in hospital for treatment because of this - quite a reversal from the bed blocks and discharge planners of home! With the help of MSF, though, we can try to give this girl the medication she
needs and send her to the surgeon that will cure her. Over the next few weeks
we will see her again, and make plans for investigations such as chest x-rays
(which require a full day excursion to town) and specialist reviews. With some
luck and good planning and logistics she will slowly improve over the next few
weeks.
|
|
|
||
|
||||
The
mission in Aceh is quite different to many others that Médecins Sans Frontières
(MSF) has around the world. We came here in emergency circumstances, after the
tsunami, and helped with the medical work that needed to happen. Almost all of
the different operational sections of the organisation were working in Aceh after
December 26th. MSF worked in Banda Aceh immediately after the event, and then
moved to assist in Meulaboh hospital, also severely affected by the destruction.
The Sigli mission [on the northeast coast of Sumatra] has been working since February,
and now has expanded to include a surgical program. There is a psychological program,
a small hospital outside of Sigli has been started with MSF assistance, and recently
a mobile clinic to two other sub-districts has started. I am the doctor and team
leader of the mobile clinics.