Orphanage visit

I visited the orphanage near my hospital who always sends kids to our paediatrics ward. We were supposed to check the kids and babies that the staff are concerned about. There were no MO free to accompany us to the free on that day, so it was only me and two other HOs. We saw 6 kids - 2 with scabies, 1 failure to thrive probably suckling and swallowing incoordination, 2 with URTI, 1 with some skin problem probably viral. It was good fun.

The last child had global developmental delay. There was a bony swelling on the left side of the head prominent enough to be noticed at first glance. History taking was a big problem as the staff doesn't know how did this child end up here. Notes and documentations were split between the admin office and the nurses office. For this child they didn't even have a date of birth, so we were unsure his exact age. I was discussing with my friends if we ought to refer this child to our child development clinic. They were not keen, saying that we ought to just leave it. I was disappointed. I thought if this boy belonged to a parents, there would have been someone concerned for him regarding all these and be brought to the attention of a doctor. For unfortunate kids like him, it is up to us to protect their best interest. The centre itself was unorganized and the staff had too many children on their plate. As doctors, if we cannot act as advocate to the few children that we see, what were we there for?

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