American Morning

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September 14th, 2010
11:23 AM ET

REPORTER NOTEBOOK: In Pakistan, a life can be saved in 15 minutes

By Kaj Larsen, Correspondent

Editor's note: Kaj is covering the aftermath of the flooding in Pakistan. Watch his reports on AMERICAN MORNING at 6:00AM Eastern.

We awoke at 0515. Breakfast at 0700. Conducted interviews from 0800 to 0900. Our caravan rolled out to a remote area of southern Punjab at 0930. By 1100 we had set up a remote clinic.

By 1115, our team had saved a life.

Now I use that phrase pretty liberally. It was really Dr. Eduardo Dolhun, the lead physician on Team Rubicon, who saved a life.

I’m currently embedded with Team Rubicon in Pakistan, where I have the privilege of working alongside them while covering the flood disaster for American Morning. It allowed me to see the effects of the natural disaster through a humanitarian lens.

When we arrived at the impromptu clinic, we began to set up our equipment and see the first patients. Almost immediately, a crowd formed. Americans in this part of the world attract a ton of attention, and the people of this area, which had been severely impacted by the floods, were in dire need of medical attention. Even as we made our way to the staging area for delivering medicine, we crossed rivers and washed out homes, and saw hundreds of people living in tents and makeshift shelters along the side of the road. Bottom line, the need was great.

The military members of Team Rubicon fanned out and tried to organize the crowd while Dolhun and another Rubicon paramedic examined patients. I noticed that all of the patients were men. I had seen this before in rural Afghanistan. In highly conservative rural Muslim societies, often women would wait to be treated until the men were gone.

While the rest of the team held security, I surveyed the area. Under the shade of a tree, I found about 50 women and children sitting, waiting to be seen. In the extreme heat and humidity, many of the children were lying around or sleeping, but earlier in the day Dolhun had briefed us to be especially attentive to babies that were “floppy.” At the time, I thought to myself that floppy didn’t sound like a proper medical term. Aren’t all babies kind of floppy? Sure enough, among the dozens of children, one woman was holding her listless baby who appeared exactly how the doctor described—a little “floppy.” His eyes were rolled back in his head, and when I shook him or played with his arm there was no response.

I grabbed another Rubicon member who brought a translator over to the child. We were told that the baby had been vomiting for days and would not drink or eat anything. At that point we grabbed Dolhun.

He assessed the baby, and said that the child required fluids but suggested we try a little ORS solution first. ORS, or Oral Rehydration Solution, is one of those simple life saving tools that is extremely important in Pakistan, where the incidence of gastrointestinal disease is extremely high.

Dolhun is a passionate evangelist of ORS. On all three flights I have been on with him, I’ve seen him explain to strangers why ORS was one of the most important medical inventions of the 20th century. He says it may have saved as many as 2.9 million lives. He’s so passionate about ORS that he invented his own ORS solution that tastes better than standard ORS. If you met him, you could very easily conjure an image of the mad scientist pipetting away on some solution in his lab in the middle of the night.

So here is Dolhun, a physician from San Francisco, administering ORS to an infant in the flood-affected areas of rural Pakistan. And this is where the timing gets interesting.

Dolhun estimated that it usually takes several hours to get a response from a dehydrated patient after treatment. But within minutes, we saw some improvement in the child (which was good, because the doctor was close to administering fluids intravenously).

Within 15 minutes, the baby was suckling on the ORS solution, alert and oriented. After 30 minutes, he was playing.

It was an extraordinary, dramatic and rapid turnaround. Dolhun said that considering the baby’s severe dehydration, it was possible the baby wouldn’t have survived the night without intervention. Dolhun went on to treat other patients; I took over administering ORS to the baby for a few minutes, then had the mother take over after that.

Disaster medicine is an exercise in triage. You don’t always get to see the outcomes of medical interventions. But here was a case where this child was at death’s door, and within 30 minutes had a chance at survival. That one child made the entire journey worth it.

I’m naturally pretty skeptical. I was initially suspicious of Dolhun’s ORS evangelism. It sounded too simple. But I became a convert when I watched that child come back from near death. I pity the next person who sits next to me on a flight. They may just get an earful about the health benefits of a little something called ORS.

Watch the rest of this report here:


Filed under: American Morning • Pakistan
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