Sunday, March 01, 2009

Agosto and Suhartini



Leaving the centre of Bogor, I motored along the usual bumpy roads to Bogor Baru.

Having visited little Andi and tubercular Asep, who seemed in reasonable health, I decided to find out how Ciah was getting on.

Ciah was sitting on her verandah, looking pale but reasonably well recovered from her hepatitis. Maybe her lack of colour was due to the lichen and moss covered trees cutting off the sun from her shack.

"How’s Agosto?" I asked.

"He’s sick," said Ciah, standing up and beckoning me into the wood and bamboo house.

Lying on the black metal bed, which almost filled the stuffy room, was twelve-year-old Agosto. He looked fevered, withered and yellowy-green.

Two neighbours, having helped carry the boy down to the road and into the back of my van, accompanied us to the Menteng Hospital.

I wondered if we would get there in time to save him.

He closed his eyes but kept on breathing all the way through town.

We reached the emergency ward and Agosto was laid on a bed covered in stained plastic.

"How long has he been ill?" asked the young doctor.

"I think it’s about ten days," said Ciah in a tired voice.
"Cough?"

"Yes," said Ciah. Agosto seemed to be not quite aware of what was going on.

"Headache?"

"Yes."

"Stomach pain?"

"Yes."

"Constipation or diarrhoea?"

"Yes," said Ciah, sounding hesitant.

I got the feeling she was not too clear in her thinking.

The doctor looked at a rash on Agosto’s abdomen and peered down his throat. A nurse took his temperature, did a blood test and attached him to a drip.

"What do you think it is?" I asked the doctor.

"Typhoid, probably. Very common among children aged ten to fourteen. It can take several tests to be sure. Not easy to diagnose. We’ll give him antibiotics."

"Is he very seriously ill?" I said.

"It’s a pity Agosto wasn’t brought here much earlier," said the doctor frowning, "He’s very dehydrated and weak."

"Do you think he’s going to be OK?"

"We hope so. There’s always a risk of complications, especially when patients get here late."

"What kind of complications?"

"Meningitis, intestinal bleeding, pneumonia. There’s a problem if the infection gets into the bloodstream and moves to the liver."

"Why do so many kids get typhoid?" I asked.

"Patients who’ve recovered can still be carriers. The bacteria is in their faeces. So it spreads. Dirty food and dirty water."

"Kids don’t wash their hands?" I said.

"And food has to be boiled for twelve minutes to kill any bacteria in it."

"Why don’t kids get vaccinated?"

"Vaccination can cost a month’s wages and it only covers you for three years. Another problem is that some antibiotics don’t work anymore." The doctor gave a shrug and a friendly smile before heading to a desk to do some paperwork.

Agosto was wheeled through a section of garden and into the crowded third class children’s ward, a long shed-like building with big metal windows.

Sitting beside the sick children were family members who had brought with them baskets of home made snacks and bottles of tea.

In one corner of the ward, a mother and daughter guarded a little girl who was even more grey and wizened than Agosto.

"Who’s the girl in the corner bed?" I asked the nurse, as she adjusted Agosto’s drip.

"Suhartini."

"She’s not on a drip," I said.

"The parents are very poor," explained the nurse.

"Is she getting any medicine?"

"They can’t afford it," said the nurse.

"What’s wrong with Suhartini?" I asked.

"Typhoid. And there are complications."

I looked at Suhartini’s mother and older sister who were seated at the bedside. The tired looking mother wore a watch, although it may have been of little value. The older sister looked plump and wore a clean school uniform.

"I’ll pay for the medicine," I said to the nurse. "Has the mother got the prescription?"

"Yes, you can take it to the pharmacy near the entrance."

This was explained to the mother and I was accompanied to the chemist by the plump sister.

"How many days will Suhartini’s medicine last?" I asked the pharmacist.

"Three days."

"Can the doctor write out a prescription to last more than three days? I live in Jakarta and can’t get here every day."

"No," said the pharmacist. "The family must buy more medicine in three days time."

"I’ll need to give the mother some money for that," I said.

"Give me money for school," said the grinning sister. She seemed to show no trace of anxiety about her sibling, but then emotions are often difficult to detect.

Back at the children’s ward, I handed over some money to Ciah and to Suhartini’s mum.

"For medicine and food only," I said. "Not for other things."

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