Chiko

Thursday I took the day off from Bottom, the morning I enjoyed by myself, mostly reading in bed and then in the afternoon I decided to visit Chiko. Chikumbutso is the motherless baby girl of Nathan who lives in a village 50km outside of Lilongwe. About a month ago Nathan, her father, and his sister-in-law arrived at Bottom with a listless extremely dehydrated little Chiko. They said she had been having diarrhea for the past 24 hours and already her fontanel and eyes were impressively sunken. We took her to Kamuzu Central right away and after a week of IV fluids she returned to her beautiful bright self. I believed that Nathan would call if they needed milk or if anything were wrong with Chiko but Thursday I felt as though a small voice inside was telling me to go see her.

When I arrived at the house the sister-in-law handed me Chiko and weight the little bundle disturbed me a bit. The aunt said she had malaria. I tucked an electric thermometer under her arm and it shut off once it read 103 degrees Fahrenheit. I also noticed that some spots around her mouth were hypo-pigmented and then was stunned to see more spots spreading from her neck down over her chest. (Later, with the translating help of Sister Namaleu, the aunt told us the spots were vesicles and then sores and were now healing.) I told everyone that we should go the hospital immediately. So the aunt packed up and the three of us headed back to Lilongwe.

The clinical officer started treating her for sepsis immediately, ordered a malaria test, and a full blood count (FBC). The following day I returned to visit her with Sister Namaleu. Her temperature still climbed above 101 and none of the lab results were in the chart, even though blood was drawn early the previous afternoon. Sister Namaleu and I went to the lab to chase down the results; we found that Chiko’s blood was negative for malaria parasites but her hemoglobin was 7.6 (anemic) and her platelets 50 (low). On our way back to the ward we cornered the chief pediatrician who told us that he would not yet consider transfusing her but would repeat the FBC Monday.

I just returned from the hospital where I met Chiko with her pink knitted hat strapped to her aunt's back. She was smiling and cooing and looking much better. The aunt says her antibiotic injections will finish tomorrow. I'll make sure that she gets another FBC to see if there is any change and if it's no worse she'll be heading home on Tuesday.