Roseline Biago, an ICU nurse at MSF’s hospital, has worked alongside her colleagues treating many patients with cerebral malaria. Typically, they arrive unconscious, convulsing, with a persistent high fever. In Paul’s case, he became highly combative, fighting off the staff. For his mother Lydia, this was a particularly confronting sight.
Nurse Victoria Pewee could see how worried Lydia was. So Victoria encouraged Lydia to get involved in the treatment plan, telling her: “Come and report anything abnormal you observe, so that we can be able to take an intervention right away. Maybe if the patient has diarrhoea or a fever—though we are checking all the time—or the child is vomiting, you will be able to tell us. Because sometimes, at that point, you are there.”
Lydia’s hope, and confidence, was bolstered. “Each time I asked a question they were willing to answer me, to make me understand.”
Still unconscious in ICU, unresponsive to anything but intense stimuli such as a pinch of his fingertip, Paul’s intake was limited to intravenous fluids to avoid dehydration and low sugar levels, as anything more could have destabilised his condition. His convulsions were lessening however. As his level of consciousness improved, the paediatric consultant, Dr Tim Pont, advised Paul could now start feeding through a naso-gastric tube.
The neurological effects of the malaria meant that Paul stayed combative for several days. Lydia recalls how he slapped a nurse aide, and kicked a doctor.