PENNY WISE, POUND FOOLISH

So many times, we have either heard of, or used the popular idiom; "penny wise, pound foolish". We have also heard of, and used this one too - "a stitch in time, saves nine". They mean basically the same thing - do the right thing now and avoid future complications. So much goes on in our daily living, and also in the hospital (where I spend most of my time), requiring us to constantly make decisions. Sometimes, we make the right ones, sometimes, we make the wrong ones. Other times, we just make the foolish ones.

A day doesn't go by, that I don't see at least 10 patients (especially in the pediatrics clinic) who have been to the patent medicine dealers, or some other form of healer for health counsel before showing up at the hospital for the doctors' advice. On many occasions, it is too late for the advice they seek.

Let me give you a typical example of some of the experiences I've had. A woman calls up a doctor she knows. She had gotten the number on a day her child was very sick, and she was scared and desperate. She didn't want to go home and be stranded should something that she couldn't handle come up during the course of treatment. 2 months later, the child develops a fever. She calls up the doctor and narrates the present condition of the child. The doctor politely tells her that she was not in town at the moment , but that she should take the child to the nearest hospital for early diagnosis and treatment. Guess what? She replies 'okay' then takes the child to a chemist, where some medications including the injectable forms were adminster to the child by the attending personnel. She didn't know the name of the medications.

2 days goes by, and she calls the doctor again to complain that the fever was not abating and that the child was now vomiting. One simple question by the doctor gave her up. She was asked "madam what did the doctor at the hospital tell you was wrong with your child?" She confessed that she had actually gone to the chemist and not the hospital. She was adviced to make sure she goes immediately to the hospital for expert care. She agreed to do so. Another call the next day revealed that she had opted for a maternity instead and was still there as at the time she was making the call. The nurse did a PCV test and gave more injections. The poor child was still burning up.

After much talk by the doctor. She presented at the hospital without much funds required to treat the child. She had used whatever little she had to undergo sub-standard treatment at  the other places she had been to. A donation had to be done among staf and other patient relatives present to save the child's life. This is a good example compared to others that are brought in gasping or already dead.

I began to ponder at the possible causes of such a behaviour among people and I have come up with these few reasons.

• Ignorance: a lot of people simply do not have the information they require to make sound decisions. Many causes and outcome of diseases are still based on spiritual beliefs and hearsay. The problem with hearsay is that the information been shared is never accurate.  It is usually reported from the person's own perspective after adding sugar and spice and the tale spins on. A typical example is when a patient tells you that they have had antimalarials, then you ask for the specific one and they reply amoxyl.
• Spirituality and beliefs : Nigeria is a country in which many people including myself belief that there are principalities and powers. However, turning to a spiritual healer everytime there is a minor health disturbance and labelling it "an attack" may not be very helpful. Imagine a child has malaria and develops a distended abdomen because of the enlargement of the liver and spleen and instead of coming to the hospital,  the child is taken to one "baba" who cuts the abdomen into different designs in the name of letting out the "bad blood" that is causing the distension. They usually applied herbs mixed with dirt to the wound, so that by the time I'm seeing  such a child, I'm no longer treating just malaria but sepsis too. The annoying part, the parents usually want you to perform a miracle.
• Wrong advice from friends and family members: charity, they say begins at home, well, so does learning and trust. We tend to believe and trust people we've known over a period of time than a doctor (with all his knowledge) that we just met. It is a normal reaction than doesn't yield the best result sometimes. A grandmother who tells you to put pepper and oil into the eyes of a8a convulsing child, is telling you what she knows/thinks and with love but it might just help to blind the child.
• Poverty: I believe this is another very important factor that is easy to explain. If you don't have a dime, and you don't a good lending record, then you can't get the proper help most times. Simply because the hospital will ask for money first. They have learnt to do so because of the bad experiences they've had. 

My recommendation, poverty alleviation and public enlightenment. Never easy jobs to take on. So my advice, seek the best when looking for solutions to any problem you might have.

Cheers.....