Last night two guys named Abdissa and Benti came into the ER with multiple stab wounds. Abdissa had been speared in the head, like the spear actually went in, not some glancing blow. We were still surgeon less and in any case we don't have the capacity to handle massive skull fractures of this kind.
Priscila did her best, but it was pretty clear that Abdissa would die in Gimbie and would have some chance in Addis. Given the gravity of the situation, I decided Abdissa was worth part of our charity budget. I went to his family and told them we were willing to transport him to Addis for free.
They didn't seem excited or thankful, which was weird because patients and their families typically erupt in tearful "God Bless yous" at this point. Between my bad oromoiffa and their bad English, it was tough to figure out what the catch was. So I called Birassa, the hospital's purchaser and billing officer to translate.
The family had no interest in treating Abdissa. They came to the hospital for a court letter (MD's analysis of the cause of death) which they are planning to use to sue the pants off the spear thrower, who is a well heeled local gentlemen. Abdissa's family actually hoped that Abdissa would die quickly (they figured he would die in ER last night) so they would have an easier time in court.
Patient rights (i.e. family rights) are the name of the game in Ethiopia and we couldn't force Abdissa to stay. Birassa and I gave it our best shot. If Susan Smith's jury had heard passionate and well reasoned appeals of our caliber she would have walked with 10 days of community service. Abdissa's family did not bat an eyelid. They picked Abdissa up (incredibly, he was still alive and conscious) and took him home to die.
I don't think Priscila or I will sleep well tonight. Which is a great pity because she will be on call tomorrow and tomorrow night and I have to drive to Mugi starting early and goodness knows neither of us have been getting anything like enough sleep.
Usually we have trouble with people asking for charity when they have money to pay. It is rare indeed for free treatment to be refused. It hurts. I wonder if this is how Jesus feels when we thumb our noses at his offer of eternal life because we want revenge. How utterly stupid and cruel of us.