He Ain’t Heavy

A medical doctor friend of mine spent a total of four weeks in Bangladesh treating patients in a Rohingya refugee camp. The following is his story, posted here with permission. (Click here for an overview of this refugee crisis.)

Late in the day. Last patient. I see a young man with an older man on his back. We skip the registration and get him back to an examining table. With a translator and the young man, who turns out to be his son, standing beside me, we get the story. Mhd Abdul is struggling for air as he says, “It has been five months, and I’m still spitting up blood.” (My translator tells me every Rohingya man’s first name is Muhammad, so it often gets shortened to Mhd as it is recorded.)

Mhd Abdul has tuberculosis (TB), and it sounds as though he has been taking the medicines as instructed. It even sounds like they are doing DOT therapy, directly observed therapy, as we would in the US.

“How many drugs?” I ask.

“Four,” he says.

The next thing to think about? A drug resistant form of TB. This is the most feared and hardest form of tuberculosis. And the most expensive to treat. We will have to get him back to the NGO that is following TB in the camps, but he is going to need a culture and probably some costly second or third line drugs to help him battle this. We talk this over with the son, and he seems to understand. They will go back.

A few minutes later, after starting to pack up and thinking we are done for the day, I realize the son is sitting in a chair with a registration card in his hand. I invite him back into the examining area and again, with the help of a Rohingya translator, ask what the problem is. Were I to have been more observant, I would have noticed as one of nurses did that he was very short of breath as he came in carrying his dad. Then the standard, basic three questions: “Are you having fevers at night?” “Are you losing weight?” “Are you coughing up blood?”

The answer is “yes” to the first two questions and “no” to the third. When I listen to his lungs, I don’t hear any classic sounds in the upper lungs. But then, he has no lung sounds in the lower half of either lung. He is going to have to go to the tuberculosis hospital as well since I suspect he has a kind of TB that attacks the lining of the lungs and causes the lungs to fill up with fluid. No wonder he was short of breath.

Still, with their two pieces of paper in hand, they get ready to start off for the other clinic. Dad makes it about ten steps and is too tired. So the son gets him up on his back again, and they walk off down one of the paths that snake their way through our camp on their way to the TB hospital.

“He ain’t heavy. He’s my Dad.”