dispatches from here

We see about ten patients in the two hours that the clinic is open each night, mostly with chronic conditions like hypertension and diabetes. Sometimes family members come by for med refills if the patient is unable to make it to the clinic on their own. Last week, an anxious middle-aged man came in to ask some questions about his father. His father had End Stage Renal Disease due to chronic diabetes and was now dialysis dependent, getting dialysis twice a week. About a week ago, the son noticed some redness and swelling around the catheter site, which was apparently an old indwelling central line (high infection risk, which is what was likely going on now). Feeling fatigued, he had missed his last dialysis session and now hadn’t been dialyzed for nearly a week. The son was now even more worried, as his father was tired, nauseous, vomiting, and having hallucinations. These are all classic symptoms of uremia, and the only treatment is urgent dialysis, along with antibiotic treatment for his likely catheter and possible bloodstream infection.

We discussed the urgency of the situation, and the son told us he had called the ambulance a few times but they wouldn’t come. I thought I had misunderstood, so I turned to Dr. Milad for an explanation. “They know Jaramana is where all the Iraqis are, so they usually don’t bother coming,” he explained to me. In addition, they often can’t navigate the narrow streets and alleys with the ambulance, isolating the refugees even more. The son was hesitant to go to the emergency room because of the cost, and explained that he couldn’t carry his father down the stairs alone. Dr. Milad again pressed the urgency of the case. Hesitant, worried, already expecting the worst, the son said he would get help in the morning and go the hospital. With that he thanked us and backed out of the room, slowly closing the accordion style door behind him.

Yesterday we heard that the father had passed away a few days after his son’s visit. I’m not what his underlying medical condition was, or if he ever made it to the hospital, or that even if he had it would of saved his life. But it would have at least given him a chance. Something as simple as ambulances that show up. Can you imagine the fear you would live with knowing that if something happened to you and you called for help, nobody would respond?