Sunday, June 19, 2011


So many patients on the female medical ward have ascites. Tiny, wasted women with giant, distended bellies lie in the beds awaiting treatment. Sometimes we can treat the cause – we have plenty of medications for heart failure and tuberculosis. Those with hepatic failure or malignancy can only be treated symptomatically, such as with an ascitic drain.
My friend did an ascitic tap on one woman with malignant ascites. The woman was keen to go home, but knew she needed her belly drained first. As my friend prepared the equipment, I brought in the screens – the woman immediately jumped up on the bed and drew her shirt up over her giant belly.

My friend inserted the cannula into the woman’s tense belly and attached a giving set, running the tube into a large metal bowl. Immediately, clear yellow fluid began draining into the bowl, flowing at quite a rapid rate. The woman stared, fascinated, as the bowl began to fill with fluid from her own belly. She began talking to us questioningly, but none of us know much of the local language yet. Was she in pain? Did she want us to stop? She didn’t look too upset.

Eventually we managed to call over a nurse to interpret for us. He smiled before relaying the message, “she wants to know if she’s allowed to touch the fluid. She wants to feel it”.

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