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On Being a Doctor |

Looking for Betty

Jaime E. Ollé-Goig, MD, MPH
[+] Article, Author, and Disclosure Information

From St. Francis Hospital, Buluba, Uganda.

Requests for Single Reprints: Jaime E. Ollé-Goig, MD, MPH, Carretera de las Aguas 181, 08017 Barcelona, Spain; e-mail, olleuganda@yahoo.com.

Ann Intern Med. 2005;143(10):755. doi:10.7326/0003-4819-143-10-200511150-00016
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Mothers line the corridor of the pediatric ward of our rural hospital in Uganda, holding up their babies and waiting for the physician to begin their visit. The lowering of hospitalization fees has had a major impact on our already overburdened daily work. As I try to find a passage through the crowd, I notice a woman holding a young girl who is obviously very sick. A few questions and a brief physical examination make me think that the girl—her niece, Betty—suffers from meningitis. The lumbar puncture reveals cloudy spinal fluid, and the laboratory results suggest tuberculosis. I start her immediately on antituberculosis medications through a nasogastric tube and streptomycin injections. Three days later, her temperature has dropped and the patient has begun to talk in a lively manner. On the morning of the fifth day, Betty is no longer in her bed. The nurses think that she was probably taken away during the previous night. I note the village where she came from, and after a 2-hour drive, we reach a clearing in the forest. As we arrive, some women and dozens of children come out of several mud huts and surround us. All are barefoot, most of the children are naked, and the women are dressed in rags. I have no doubt that an almost identical scene could have taken place hundreds of years ago, greeting explorers such as Speke, Grant, and Burton as they wandered through this region searching for the source of that mighty river, the Nile.





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