Utter Frustration

I guess anyone who works in medicine has times of utter frustration, but I am really feeling it right now. Out in our corner of the rainforest, the phrase life and death takes on new meaning. It is very common for someone to be healthy and happy one day and near death the next. In the last month, we have seen three deaths in the camp and many serious sicknesses.
Ndae is one of our patients who is seriously ill. She has leprosy and has been taking the treatment for a little over a month. Part of the risk of treatment is that one’s body may begin to react to the destruction of bacteria. That is what has happened with Ndae, and the reaction is severe. She developed painful swellings in her joints and mucous membranes. We treated her with steroids only to find out a few days later that her throat hurt so bad that she stopped eating and taking her meds. We saw first hand what the textbooks talk about when they say not to abruptly discontinue high dose steroids. Ndae became swollen all over her body, her skin thickened and began to flake off, and her eyes, which were not affected by the reaction at first, became grossly swollen and inflamed. The most frustrating part is that we had informed her of the risks of discontinuing the medication. Today Ndae’s swelling had decreased, after introducing steroid treatment again, but she developed some more complications. Her eyes, already inflamed, have now become infected. She will likely loose her sight. She has aspirated fluid into her lungs and is now fighting pneumonia. And due to the high dose steroids, she has developed psychosis.
To make matters even worse, there are stories of sorcery floating around the camp. We are doing all we can for her medically, but that is clearly not enough. We need a miracle.