An X-ray Dustpan

Today, as I sat in the entrance to the Mokhotlong Government Hospital waiting to meet with the District Medical Officer about some TTL business, I watched as a cleaning woman swept the floor with two items: the common bundle of thatch people in Lesotho use for a broom, and a child's chest X-ray for a dustpan.

The X-ray sheet must have been discarded at some point, or left behind in a place that gave the woman the impression that it could be refitted as a cleaning tool. Still, I have experienced too many instances at the hospital of lost or misplaced X-rays delaying the treatment of a child for the sight to register anything in me but vexation.

Nthabiseng, for one, is back in the safe-home now after having spent a good amount of time in the hospital. When we first took her there two weeks ago for her trouble breathing, the doctor who saw her suggested the problem might be either TB or that she had swallowed a foreign object, and scheduled a chest X-ray for the following day.

But in all my follow ups, I was unable to determine just what the doctor had observed when looking at the X-ray, or even where the X-ray was. Was there TB? Was there a foreign object? Apparently there was neither, as we would have heard about it if there was. But there was no X-ray to be found, either.

From looking through her bukana, or health booklet, I learned Nthabiseng was diagnosed instead as having "AZT-induced PCP," or a form of pneumonia commonly found in malnourished children and people with weak immune systems, and which had been induced in Nthabiseng by her new regimen of antiretroviral HIV medication.

Today, back at TTL, she is still wheezing a bit, but seems better and will hopefully conquer her illness -- just as Retsepile seems to have conquered his.

Since having received the correct diagnosis of TB, and starting the proper medications for it, the tiny, emaciated little boy who not long ago was too weak to sit up, and who was so ill the doctor said he "probably won't make it," is now gaining weight rapidly and turning into the happy little boy he's always had the potential to be. It's been a heartwarming transformation to watch.

Nthabiseng and Retsepile are two of only five babies in the safe-home now, as the other, younger Nthabiseng -- who had been here since birth -- and rambunctious little Kokonyana both went home last week.

The other three remaining babies are: Khutliso, who is recovering well and is no longer vomiting his prescribed daily intake of plumpy nut; the younger Retsepile, now a chunky little girl; and Kabelo, whose arrival I recently wrote about.

We haven't lost any children for some time here, which means our low numbers in the safe-home are indicative only of a string of TTL successes -- a great reality to consider.

It's a reality, for one reason or another, that stands in contrast in my mind with the sight of an X-ray being used as a dustpan at the hospital. We are swimming upstream here, but we are winning.