An oily smile

‘’Good morning mama, how is baby today?” which normally would be in affirmative when the child is still ill.
‘’Did u pick the results from the cancer institute?” To imply the hemoglobin electrophoresis results. “Did baby get blood yesterday?” These questions became a routine, I would ask of every patient in the daily morning ward rounds and that went on for the three months I was at the hemato-oncology ward during my paediatric rotation of internship. The paediatric hematology ward at Mulago hospital could informally be referred to as the sickle cell ward by scores of patients, given that the condition formed the bulk of the cases admitted to the ward. The ward operates in tandem with the ever busy daily sickle cell clinic in an opposite block in the hospital.
The treatment protocols and guidelines are rather followed to the dot, with the strict bespectacled professor who heads the ward, a fervent educator and stickler for detail ensuring all children received the best of care the available resources at our disposal would offer. He humorously would wish we break a leg in finding blood for transfusion of the children.
Every time we carried about with our work, a challenge was bound to arise; inadequate supplies of blood products! We needed it in plenty; in sufficient amounts. It though never appeared to be the case, we were bound to have outages or short supply regardless of the fact that the national blood bank was a few minutes away from the hospital. When we had a child referred in with a sickle cell stroke, severe anemia or severe painful crisis; the struggle starts. The ward would fill to the brim just because we could not aptly manage the children, stabilize their conditions and hence discharge them promptly, we continued seeing children with agonising pain, simply because we could not readily access the blood products.
As we were lounging about after our morning rounds and as we deliberated upon the cases we had on the ward, I was called upon to review a 6 year old girl with sickle cell disease, brought in unconscious after having spent two days, in the paediatric ICU; she had experienced her fourth successive stroke in a space of two years. As a result, the little girl had been kept out of school, was not thriving well and had lost speech prior to admission. She as well was brought in with severe anemia. And basing on their physical appearance, her parents looked somewhat affluent; a sight pretty uncommon on the ward. To an unsuspecting mind, you cannot help but think the condition only affected the poor; only that you were proved wrong if you knew how sufferers get sickle cell disease.
I started the child on treatment, picked blood samples for investigations, grouping and cross matching and started supportive management. I rushed to the blood bank, and all I could get was a blank stare from the laboratory staff, there was no blood! I had to wait till late in the afternoon when I managed to secure some packed cells. I could not help but notice the sigh of relief on her parents’ face when I finally hang up the unit of blood on a drip stand. I knew the father realised that help had finally come!
The child was rather restless, and twice her intravenous cannula had gotten off. The ‘’precious’’ blood freely flowed on her crisp white sheets. Her father ran back to me, explaining how the cannula had gotten off. A little stunned given the struggle I went through to secure access blood for transfusion, after a series of trials, I managed to establish another intravenous line and successfully transfused her. The team had to keep her on transfusions every time we could and measured how much her hemoglobin had risen daily.
On occasions when I told the mother her child needed a transfusion, and I came back thereafter from the blood bank, without her child’s but for other children, I would painstakingly explain to her that her child’s blood type had run out. To her, blood was all she needed, oblivious to the fact that it had to be typed and cross-matched. Such was the despair you would see on every parents’ face on the ward.
We nonetheless managed to hyper transfuse her, till her hemoglobin level was well about 10 g/dl and kept her on treatment and physiotherapy, to hasten recovery. Her parents had resigned to the fact that she could not recover from this stroke.
One sunny morning, as I was about to start my morning rounds, I was met with a sheepish but beaming smile from the child’s mother, the girl had started to develop eye contact and had begun to move her weak limb. A fortnight after the child’s discharge from the hospital, the girl could mumble a few words; I could not help but gloat in my new found self-exaltation. The girl could talk with her mother, though could not understand why every one of us was paying her an uncanny attention and were all elated to see her in the hospital once again. I had seen children come in very ill, after a blood transfusion or more ,the next day they would be prancing about on the ward, but in this very case, it was indeed miraculous; from being unconscious to finally talking and smiling. Regardless of the challenges we faced every day in managing her condition; with the oily gloss on her lips, she had a melting smile once again.

Key Entry Rules

  1. You must be someone with Sickle Cell Disease or have some strong connection with SCD through kinship, friendship or caring responsibility.
  2. Your story – which must be true and should include some aspect of the importance of blood in the narrative – must be between 200–2,000 words.
  3. We expect most entries to come from Africa, but where you live is less important than the story you have to share.
  4. Stories must be submitted by the contest deadline of 30 September 2016.
  5. Photographs and other media can be included and are very much encouraged.
  6. First, second and third place winners will be awarded a monetary prize of $500/$350/$250 respectively. There will also be two special $125 prizes for standout young contestant (under 16) and standout health care professional, if not represented among the overall winners.

Story Criteria

Contest Rules

Past Winners