The challenge of low resource healthcare includes not just lack of assets alone, but also the spectrum of diseases that are especially common in such settings. Today is illustrative: parents came for consultation with this five-month-old whose eyes are yellow as a ripe banana and who’s abdomen is large as a watermelon. This quick ultrasound shows an oversized liver, consistent with hepatitis, with no tumor or unusual fluid.
What could be causing this baby’s hepatitis and liver failure? This is where lack of assets is particularly felt. Our basic laboratory reveals elevated liver enzymes consistent with hepatitis. But more precise tests to identify the cause of this hepatitis, such as hepatitis viruses A or B or even C, are not available here. I felt a twinge of medical isolation.
Viral hepatitis is also strikingly common in similar low-income communities throughout the world. Five to Fifteen percent of such populations are infected. Why? Because poverty causes few to be vaccinated, people to live with greater exposure to one another, and disease to go recognized until its late stages. This all makes the few healthcare personnel like myself feel grossly outnumber.
As I explained my findings, the parents began to sob. I explained our limited treatment options, and then offered to pray for their child. At this invitation, the mother and father countenance improved. “Yes, doctor!” they responded. “God can do what is impossible for man alone.”