美国国家公共电台 NPR American With No Medical Training Ran Center For Malnourished Ugandan Kids. 105 Died

 

AUDIE CORNISH, HOST:

One-hundred-and-five children died at an unlicensed treatment center for malnourished kids in Uganda. It happened between 2010 and 2015. Now the American missionary³ who founded and ran the center is being sued over those deaths. NPR's Nurith Aizenman has the story of Renee Bach.

NURITH AIZENMAN, BYLINE⁴: When Renee Bach was 18, she left her home in Virginia for the Ugandan city of Jinja to volunteer at a missionary-run orphanage⁵. A year later, Bach made a life-changing decision. She would move to Jinja full-time⁶, start her own charity. She says it felt like a calling from God.

RENEE BACH: It's kind of hard to even describe in words. Like, there was something that I was supposed to do, and I wasn't sure what that was.

AIZENMAN: But a few months in, she thought she'd hit on it after coming across several children with severe acute malnutrition⁷ - impossibly thin arms, ribs⁸ poking⁹ out, sunken eyes. They were in a hospital, but Bach says the nutrition coordinator¹⁰ there told her that medically, these kids have been stabilized¹¹. They just needed to be fed back to health.

Soon, Bach was raising funds to set up a center that would offer malnourished children and their moms a free place to stay while they recuperated¹², complete with the special foods and medicines they'd need and lessons for the moms on nutrition and the Bible.

(SOUNDBITE OF MUSIC)

AIZENMAN: That's a promo video. Bach set up shop in a large house...

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED PERSON #1: And you can help a child.

AIZENMAN: ...Came up with a name.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED PERSON #1: Help now at servinghischildren.org.

AIZENMAN: Jackie Kramlich was one of many young Americans drawn¹³ to volunteer at Serving His Children.

JACKIE KRAMLICH: I went in with a lot of admiration¹⁴.

AIZENMAN: It was the summer of 2011. Bach had hired three Ugandan nurses. She'd stocked up on oxygen tanks, IV catheters, monitoring equipment. More than a dozen kids at a time were being cared for. But Kramlich, who'd just become a registered nurse, was taken aback to find that a lot of these kids weren't just severely¹⁵ malnourished. They had complicated illnesses.

KRAMLICH: Pneumonia¹⁶, intestinal¹⁷ parasites¹⁸, tuberculosis¹⁹ - many were in stage 4 HIV.

AIZENMAN: Almost every week, a child would die. Also, it seemed to Jackie Kramlich that Bach, now 22 years old, was handling a lot of their medical care herself. It all came to a head over a baby girl named Patricia. Bach kept a blog about her experiences, including the day Patricia's parents brought her to the center wrapped up in a blanket. This blog has come to haunt Bach. She's since taken it down, which is why NPR is having someone else read what Bach wrote.

UNIDENTIFIED PERSON #2: Under the blanket lay a small but very, very swollen²⁰, pale baby girl. Her breaths were frighteningly slow. I hooked the baby up to oxygen and got to work - took her temperature, started an IV, checked her blood sugar, tested for malaria²¹ and looked at her HB count. I was attempting to diagnose the many problems that could potentially be at hand. Got it - Malaria, positive. HB, 3.2 - a big problem, most likely fatal. She needed a blood transfusion²² and fast.

AIZENMAN: But after a blood transfusion was started, Bach wrote, Patricia seemed to take a turn.

UNIDENTIFIED PERSON #2: Her neck and face started swelling²³ a lot. Her breathing went from bad to worse. Her throat was beginning to close.

AIZENMAN: That's about the moment Bach called Kramlich on the phone to ask if Kramlich could swing by the center.

KRAMLICH: So I walk in, and there's this child - swollen, wheezing²⁴, blood's running. And she goes, you know, I think she might be having a reaction. But I don't know because Google says that if they're having a reaction that they'll have a rash, and I don't see a rash.

AIZENMAN: Bach says she would sometimes run the tubing into a child for a blood transfusion, insert IV's, and sometimes...

BACH: Without a medical professional standing²⁵ right next to me, yes.

AIZENMAN: But, she says, always...

BACH: Under the request and the direction of a medical professional.

AIZENMAN: As for her blog posts...

BACH: I was just writing to tell a story to my friends and family. And the mistake that I made was I very much wrote in first-person, which, looking back, sounded very prideful as if I was, you know, doing all of those things myself. But the reality was is that there was medical professionals present doing those things.

AIZENMAN: In the case of Patricia, Bach remembers a staff nurse doing the blood transfusion. And when Patricia seemed to have a reaction, she says, this nurse phoned a private doctor who recommended rushing the girl to a hospital. Bach then did just that, and Patricia lived. But for Kramlich, this was too close a call.

KRAMLICH: I was just beside myself, furious.

AIZENMAN: Soon after, she quit and sent a letter of concern to the charity's board of directors back in the U.S. because under international guidelines and Ugandan law, if a severely malnourished child has the kind of extra complications Bach's center was taking on, this child must be treated in, ideally, a hospital but, at the very least, a high-level health facility that's been specially²⁶ approved by Ugandan authorities. At this point, Bach's nutrition center didn't have any kind of health license¹ or even a doctor on staff.

Saul Guerrero specializes in childhood severe acute malnutrition at UNICEF. He says malnourished kids with these extra complications are so fragile, if you don't know what you're doing, it's actually safer to do nothing.

SAUL GUERRERO: Their metabolism²⁷ is not working. Their immune system is not working. So once you initiate²⁸ any kind of treatment, that will have, very often, knock-on effect.

AIZENMAN: Just putting them on an IV can trigger a heart attack.

GUERRERO: The chances that child will die are very, very high.

AIZENMAN: In 2011, 20% of the children Bach says she took in died. The next year, the death rate was 18%. By 2013, Bach had hired two doctors, and the death rate was down to 10% But Guerrero from UNICEF says even that's high by international standards.

Bach says she took in these complicated cases...

BACH: Not because we felt like it was fine...

AIZENMAN: ...But because there didn't seem to be a better place for them.

BACH: I can tell you time and time again taking kids to hospital after hospital and them being, like, sorry, we don't really deal with malnutrition. Like, the best bet is to take them back to your nutrition center.

AIZENMAN: Dr. Hanifa Bachou is a Ugandan expert on malnutrition. When I reach her on her cell phone, she says she doesn't accept Bach's explanation.

HANIFA BACHOU: I don't accept that.

AIZENMAN: Bachou is working with the government to set up inpatient care for severely malnourished children across the country. And she says by that point, Jinja's regional referral hospital had a fully-fledged malnutrition unit to care for complicated cases. But even if there was a need for more inpatient facilities, Bach's critics say it was not appropriate for her to try to provide it.

LAWRENCE GOSTIN: Just think of the arrogance²⁹.

AIZENMAN: Lawrence Gostin heads a center for global health law at Georgetown University. He sees Bach's actions as a particularly extreme result of an attitude a lot of Americans bring to poor nations, from college kids to credentialed doctors.

GOSTIN: The American cultural narrative³⁰ is that these countries are basket cases.

AIZENMAN: So, he says, Americans assume whatever their own qualifications, they're sure to be of help.

Ultimately, in February of 2015, Jackie Kramlich filed a report with Ugandan police. A month later, Jinja's district health officer shut Bach's center down. By then, Bach had gotten the place licensed² as a health clinic. But in his report, the officer noted³¹ that the license had expired, and he'd found at the center, quote, "very sick children who need referral to higher centers."

PRIMAH KWAGALA: It is what shocked most of us.

AIZENMAN: Primah Kwagala is a Ugandan civil rights attorney.

KWAGALA: We couldn't imagine a human being without skill taking in people that were almost on their death beds.

AIZENMAN: A few years later, Bach opened a new center in partnership³² with a government health center and with Bach no longer involved in medical care. But early this year, Kwagala, the Ugandan attorney, filed a civil lawsuit³³ on behalf of the mothers of two of the children who died. She says she wants Bach held to account. These families, Kwagala says, deserve justice.

Nurith Aizenman, NPR News.

1 license   

n.执照，许可证，特许；v.许可，特许

参考例句：

• The foreign guest has a license on the person.这个外国客人随身携带执照。
• The driver was arrested for having false license plates on his car.司机由于使用假车牌而被捕。

2 licensed   

adj.得到许可的v.许可，颁发执照(license的过去式和过去分词)

参考例句：

• The new drug has not yet been licensed in the US. 这种新药尚未在美国获得许可。
• Is that gun licensed? 那支枪有持枪执照吗？

3 missionary   

adj.教会的，传教(士)的；n.传教士

参考例句：

• She taught in a missionary school for a couple of years.她在一所教会学校教了两年书。
• I hope every member understands the value of missionary work. 我希望教友都了解传教工作的价值。

4 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

5 orphanage   

n.孤儿院

参考例句：

• They dispensed new clothes to the children in the orphanage.他们把新衣服发给孤儿院的小孩们。
• They gave the proceeds of the sale to the orphanage.他们把销售的收入给了这家孤儿院。

6 full-time   

adj.满工作日的或工作周的，全时间的

参考例句：

• A full-time job may be too much for her.全天工作她恐怕吃不消。
• I don't know how she copes with looking after her family and doing a full-time job.既要照顾家庭又要全天工作，我不知道她是如何对付的。

7 malnutrition   

n.营养不良

参考例句：

• In Africa, there are a lot of children suffering from severe malnutrition.在非洲有大批严重营养不良的孩子。
• It is a classic case of malnutrition. 这是营养不良的典型病例。

8 ribs   

n.肋骨( rib的名词复数 )；（船或屋顶等的）肋拱；肋骨状的东西；（织物的）凸条花纹

参考例句：

• He suffered cracked ribs and bruising. 他断了肋骨还有挫伤。
• Make a small incision below the ribs. 在肋骨下方切开一个小口。

9 poking   

n. 刺，戳，袋 vt. 拨开，刺，戳 vi. 戳，刺，捅，搜索，伸出，行动散慢

参考例句：

• He was poking at the rubbish with his stick. 他正用手杖拨动垃圾。
• He spent his weekends poking around dusty old bookshops. 他周末都泡在布满尘埃的旧书店里。

10 coordinator   

n.协调人

参考例句：

• The UN Office for the Coordination of Humanitarian Affairs, headed by the Emergency Relief Coordinator, coordinates all UN emergency relief. 联合国人道主义事务协调厅在紧急救济协调员领导下，负责协调联合国的所有紧急救济工作。
• How am I supposed to find the client-relations coordinator? 我怎么才能找到客户关系协调员的办公室？

11 stabilized   

v.（使）稳定， （使）稳固( stabilize的过去式和过去分词 )

参考例句：

• The patient's condition stabilized. 患者的病情稳定下来。
• His blood pressure has stabilized. 他的血压已经稳定下来了。 来自《现代英汉综合大词典》

12 recuperated   

v.恢复（健康、体力等），复原( recuperate的过去式和过去分词 )

参考例句：

• For a while she recuperated there. 她曾在那儿休养了一个时期。 来自辞典例句
• Can chronic rhinitis cause giddy tinnitus? What method can be recuperated! 慢性鼻炎会引起头晕耳鸣吗？有什么方法可以调理！ 来自互联网

13 drawn   

v.拖，拉，拔出；adj.憔悴的，紧张的

参考例句：

• All the characters in the story are drawn from life.故事中的所有人物都取材于生活。
• Her gaze was drawn irresistibly to the scene outside.她的目光禁不住被外面的风景所吸引。

14 admiration   

n.钦佩，赞美，羡慕

参考例句：

• He was lost in admiration of the beauty of the scene.他对风景之美赞不绝口。
• We have a great admiration for the gold medalists.我们对金牌获得者极为敬佩。

15 severely   

adv.严格地；严厉地；非常恶劣地

参考例句：

• He was severely criticized and removed from his post.他受到了严厉的批评并且被撤了职。
• He is severely put down for his careless work.他因工作上的粗心大意而受到了严厉的批评。

16 pneumonia   

n.肺炎

参考例句：

• Cage was struck with pneumonia in her youth.凯奇年轻时得过肺炎。
• Pneumonia carried him off last week.肺炎上星期夺去了他的生命。

17 intestinal   

adj.肠的；肠壁；肠道细菌

参考例句：

• A few other conditions are in high intestinal obstruction. 其它少数情况是高位肠梗阻。 来自辞典例句
• This complication has occasionally occurred following the use of intestinal antiseptics. 这种并发症偶而发生在使用肠道抗菌剂上。 来自辞典例句

18 parasites   

寄生物( parasite的名词复数 )； 靠他人为生的人； 诸虫

参考例句：

• These symptoms may be referable to virus infection rather than parasites. 这些症状也许是由病毒感染引起的，而与寄生虫无关。
• Kangaroos harbor a vast range of parasites. 袋鼠身上有各种各样的寄生虫。

19 tuberculosis   

n.结核病，肺结核

参考例句：

• People used to go to special health spring to recover from tuberculosis.人们常去温泉疗养胜地治疗肺结核。
• Tuberculosis is a curable disease.肺结核是一种可治愈的病。

20 swollen   

adj.肿大的，水涨的；v.使变大，肿胀

参考例句：

• Her legs had got swollen from standing up all day.因为整天站着，她的双腿已经肿了。
• A mosquito had bitten her and her arm had swollen up.蚊子叮了她，她的手臂肿起来了。

21 malaria   

n.疟疾

参考例句：

• He had frequent attacks of malaria.他常患疟疾。
• Malaria is a kind of serious malady.疟疾是一种严重的疾病。

22 transfusion   

n.输血，输液

参考例句：

• She soon came to her senses after a blood transfusion.输血后不久她就苏醒了。
• The doctor kept him alive by a blood transfusion.医生靠输血使他仍然活着。

23 swelling   

n.肿胀

参考例句：

• Use ice to reduce the swelling. 用冰敷消肿。
• There is a marked swelling of the lymph nodes. 淋巴结处有明显的肿块。

24 wheezing   

v.喘息，发出呼哧呼哧的喘息声( wheeze的现在分词 )；哮鸣

参考例句：

• He was coughing and wheezing all night. 他整夜又咳嗽又喘。
• A barrel-organ was wheezing out an old tune. 一架手摇风琴正在呼哧呼哧地奏着一首古老的曲子。 来自《现代汉英综合大词典》

25 standing   

n.持续，地位；adj.永久的，不动的，直立的，不流动的

参考例句：

• After the earthquake only a few houses were left standing.地震过后只有几幢房屋还立着。
• They're standing out against any change in the law.他们坚决反对对法律做任何修改。

26 specially   

adv.特定地；特殊地；明确地

参考例句：

• They are specially packaged so that they stack easily.它们经过特别包装以便于堆放。
• The machine was designed specially for demolishing old buildings.这种机器是专为拆毁旧楼房而设计的。

27 metabolism   

n.新陈代谢

参考例句：

• After years of dieting,Carol's metabolism was completely out of whack.经过数年的节食，卡罗尔的新陈代谢完全紊乱了。
• All living matter undergoes a process of metabolism.生物都有新陈代谢。

28 initiate   

vt.开始，创始，发动；启蒙，使入门；引入

参考例句：

• A language teacher should initiate pupils into the elements of grammar.语言老师应该把基本语法教给学生。
• They wanted to initiate a discussion on economics.他们想启动一次经济学讨论。

29 arrogance   

n.傲慢，自大

参考例句：

• His arrogance comes out in every speech he makes.他每次讲话都表现得骄傲自大。
• Arrogance arrested his progress.骄傲阻碍了他的进步。

30 narrative   

n.叙述，故事；adj.叙事的，故事体的

参考例句：

• He was a writer of great narrative power.他是一位颇有记述能力的作家。
• Neither author was very strong on narrative.两个作者都不是很善于讲故事。

31 noted   

adj.著名的，知名的

参考例句：

• The local hotel is noted for its good table.当地的那家酒店以餐食精美而著称。
• Jim is noted for arriving late for work.吉姆上班迟到出了名。

32 partnership   

n.合作关系，伙伴关系

参考例句：

• The company has gone into partnership with Swiss Bank Corporation.这家公司已经和瑞士银行公司建立合作关系。
• Martin has taken him into general partnership in his company.马丁已让他成为公司的普通合伙人。

33 lawsuit   

n.诉讼，控诉

参考例句：

• They threatened him with a lawsuit.他们以诉讼威逼他。
• He was perpetually involving himself in this long lawsuit.他使自己无休止地卷入这场长时间的诉讼。