Expanding Pediatrics at FAME: David's Story
David.
David and his mother.
At FAME’s Outpatient Department (OPD), we meet 4-year-old David* and his mother. David has been suffering from ear pain for the last month. He had been playing with his friends when he came home with his ear hurting.
“David came home from the playground complaining of ear pain. I didn't think much of it and put it down to tiredness or having jumped around too much, but by the following morning, his ear was swollen and he complained of increased pain. I asked him if he had any idea why his ear hurt and he said no. So I took him to a local clinic.” - David’s Mother.
The doctor at the clinic gave him some ear drops and painkillers and sent him home. However, after a week, there was no improvement, so she took him back. The doctor said there was nothing further he could do as he didn't understand what was causing the problem.
Determined to get help for her child, David’s mother decided to try another clinic slightly farther from home. This time, the doctor examined David and said he thought he had a foreign body inside his ear canal. Surprised, the mother asked David if something could be inside his ear.
“I have a small seed in my ear. My friend put it there.”
The doctor attempted to remove the seed but said it was impossible because of swelling. He asked her to return when the swelling went down and sent them home with different ear drops, tablets and an ointment.
David's ear became infected and started oozing pus in just over a week. His mother took him back to the doctor and said the medicines he gave them were not working. One look at David’s ear and the doctor said he needed to see an ear specialist urgently and recommended FAME.
“The doctor said I should bring him to FAME, an excellent hospital with qualified doctors who may be able to handle David’s situation. He said that he had referred many of his patients to FAME and they all had good things to say. So we took a bus to FAME, 50 miles from home.”
Once at FAME, they saw a doctor at OPD. The doctor struggled to inspect David’s ear because David was irritable and uncooperative, making removal difficult and risking injuries. The doctor admitted him to FAME’s inpatient ward, put him on IV antibiotics and pain medication and planned to inspect the ear under sedation.
“I wish he had told us about the seed in the ear in the beginning. We would not have wasted valuable time and his condition would not have worsened.” - David’s Mother.
The next day the FAME staff performed an otoscopy (procedure to examine the ear) under anesthesia. The ear was found to be enlarged and containing necrotic tissue.
“The infection was much worse and the ear more fragile than we thought, with no sign of the foreign object. We feared an increased risk of eardrum damage if the foreign body was close to it and knew multiple attempts at removal would lead to serious complications. We determined that this complex case warrants a referral to an ear, nose and throat (ENT) specialist in Arusha. Foreign objects in the ear, nose and throat are a common problem we often encounter in pediatric patients, though not exclusively. Most of these objects can be removed in our outpatient clinic, but prompt recognition and management are required to minimize complications. David’s case had been ongoing for over a month, making the removal of the object quite complicated. This is why we decided to exercise caution and have an ENT specialist look at it”
Cases like David’s are one of the reasons that over the next five years, FAME is committed to building a dedicated pediatric team that will be trained and equipped to handle screening, assessment and referral of more complex cases involving newborns, children and adolescents. FAME’s investment in reproductive, maternal, and child health, along with outcomes for newborns generally and in our Special Care Nursery, has established its reputation as an institution committed to the well-being of newborns and children and has built a trusting relationship with the families that we work with. In David’s case, Dr. Ken counseled David’s mother extensively about the safest option, which was referring David to an ENT. FAME’s doctors work in close collaboration with other doctors and medical centers throughout Tanzania and have a deep knowledge of the options available. Even when FAME is not the best-equipped institution for handling a case, our team takes a holistic and collaborative approach to patient-centered care, ensuring the patient feels well-cared for and receives the most appropriate treatment possible.
*While the patient’s name has been changed to protect privacy, permission was secured to share his photos and story with FAME supporters and to raise awareness of available medical care at FAME Medical.