…And that’s how I found myself pushing intravenous narcotics in a jeep on the side of the road.
Oh wait, perhaps I should start at the beginning.
The beginning is a small, open cook fire; a feature that every home in this region has. In the cold winter months, most people spend more time in the kitchen, and huddle a little bit closer to the fire. Sometimes too close. This week alone, we have had 5 children in our inpatient department (IPD) with severe burns, one of whom passed away.
The little girl who this story is about was more fortunate, though she has a long and painful recovery ahead of her. When her clothes caught fire, she suffered 2nd degree deep burns from her mid-abdomen to mid-thighs. Her family brought her to the nearest healthcare facility, which could not treat her injuries. Her mother then carried her for two days to reach the hospital.
The little girl’s name is Dila, and even with daily dressing changes, antibiotics, fluids, and observation, it was clear that her wounds needed advanced treatment. Barring infection her burns may eventually heal on their own, but even so, the resulting scar tissue would cause severe contracture, limiting her mobility and posing lifelong challenges.
This is where Watsi, a fantastic organization that allows people to directly donate to an individual patient’s treatment, enters the picture. Dila’s family had no way of paying for advanced treatment, much less the multiple days of travel required to travel to a major city that they had never seen. In less than a day following the posting of her profile on the Watsi site, 13 donors from around the world changed Dila’s destiny. They provided her with the means to seek treatment; a fighting chance to grow up and live a normal life. Thus began our journey together.
As Dila was having her dressings changed, Ryan and I were packing our bags in preparation for our departure from Achham. Having received word that Dila’s profile was complete, her mother carried her, freshly bandaged, to our waiting jeep. The doctor handed me a syringe of morphine and asked if I knew how to push meds. I do now. Though 25% of her body is covered in severe burns, the only sounds Dila made throughout our winding, bumpy, 12-hour jeep ride were a few slight whimpers when we hit extra large ruts in the road. She only cried when I came near to give her medications; afraid that I might be trying to change her dressings. The rest of the time she lay there in complete, stoic silence.
The next day, we made our way to the airport, where Dila and her mother had to board a different plane than ours, as they had received last-minute tickets. Neither of them had even flown before, and I spent a moment reflecting on the injustice of a small girl being too badly injured to be able to look out the window on the world from above. The important thing though, was making sure that she was comfortable during the flight, and that she and her mother did not feel lost in the Kathmandu airport when they arrived. I fumbled with my limited Nepali phrases, all semblance of grammatical correctness lost, but managed to convey a few simple messages. After giving her one last dose of pain medicine, and hoping that she would sleep soundly through the flight, I stood on the runway and watched their plane set off, carrying them at hundreds of miles per hour toward a strange, new place. A place where Dila’s future has more options than infection versus contracture. A place where the technology exists to treat her injuries. A place of hope.
Dila underwent the first of multiple skin graft surgeries two days ago. Her condition is stable, and she still lies quietly in a hospital bed, waiting to see what comes next.
Jesse Brady is Director of Research and Advocacy at Nyaya Health, our Medical Partner in Achham, Nepal. Jesse manages various healthcare implementation research initiatives at Nyaya, but also has a passion for patient accompaniment and storytelling.
Cofounder at Watsi