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[flagged] American with No Medical Training Ran Center for Malnourished Kids. 105 Died (npr.org)
49 points by JPLeRouzic 70 days ago | hide | past | web | favorite | 48 comments



>> She needed a blood transfusion. And fast.

The part about the blood transfusion confuses me. How common is that a small "health center" without a doctor makes transfusions? Here in Argentina the nurses only do the invasive procedures after a medical doctor has prescribe it. [1]

In particular, think it's very strange that a small "health center" has stock of blood for an immediate transfusion.[2] Did they make blood transfusion often?

[1] The nurses are usually much better finding the vein an the practical part of the procedure than the doctors.

[2] I hope they did a blood group test before the transfusion. I guess they didn't mention this to keep the article short. The test is fast and cheap but IANAMD.


She got children killed by performing random medical procedures on them. She literally had to Google symptoms because she had no clue what she was doing.


Jesus Christ... The part that makes me the most angry is that this seem to be one of those hipster adventures and all about "making the world a better place". How much narcissism can a single person have? /s


She didn’t even google the right symptoms. She googled “allergic reaction” rather than “transfusion reaction,” which is why she found herself looking for a rash.


Don't discount the googling that easily. Doctors everywhere will Google both procedures and symptoms. (and check procedures on YouTube!) The difference is though that actual doctors will know where to look for valid information, know the context where it's applicable, and know how to deal with complications.


Dunning-Krueger is a hell of a drug...


.


Is there a long held tradition as well as laws requiring 7 years of specialized education before treating RO filters? Does your RO filter have central nervous system?


1 in 9 severely malnourished children died. I am genuinely curious how that would actually compare to a hospitals efforts? I’ve no idea the odds of survival for these poor children.


That's what journalists are for - to give numbers without context. But unlike the woman in the article, they do have education on what they're doing, so they can't blame ignorance.


The article explains that the death rate went down when they hired appropriate medical staff. The stats are there to see.


Fair enough - though from my experience (not counting articles on economics), this makes this article an exception.


This

Imagine, says Kwagala, if a 20-something Ugandan woman had gone to the U.S. and set up an equivalent arrangement to treat impoverished American children.

"She would have been prosecuted. She would have been behind bars,"


#weaponizedstupidity, exported. Using the ignorance defense, no doubt


> "The American cultural narrative is that these countries are basket cases." And so, says Gostin, Americans assume that whatever their qualifications, they're sure to be of help.

I didn't grow up with this narrative at home, but I sure did and do see it a lot.


It’s upsetting to see how prevalent it is even in this thread. More than a few people are jumping in without having read the article to simply support that same narrative - better a random white lady than nothing!

For what it’s worth, for every ridiculous naive fool out to pat themselves on the back, there are people out there actually working -with- local communities to try and build up sustainable improvements to local infrastructure so people can help themselves. Project Alianza is one of my favorite programs in this space.

https://www.youtube.com/watch?v=ccJfzS13ZtA


> More than a few people are jumping in without having read the article to simply support that same narrative - better a random white lady than nothing!

There's actually only two people making this sort of argument in this thread. One person claims it outright. The other person is me.

I have read the article. I'm saying it's possible that more children would have died without her care, than with her care. That's just a fact. The article mentions that other local facilities also had death rates of up to 20%. Why would people keep visiting her if there was a better alternative?

> For what it’s worth, for every ridiculous naive fool out to pat themselves on the back, there are people out there actually working -with- local communities to try and build up sustainable improvements to local infrastructure so people can help themselves. Project Alianza is one of my favorite programs in this space.

How do you know that? What do you actually know about Uganda and who works there? Project Alianza doesn't work there.


> better a random white lady than nothing

+= God-has-a-plan-those-kids-were-meant-to-die


And unfortunately

> She says she agreed to help the children. And before long she came to feel that this was God's plan for her

Is also a typical pattern. Not a freaking clue what I'm doing here, so just use the "god wanted this" copout so I don't have to make any difficult decision.


Close to "white savior complex". https://en.m.wikipedia.org/wiki/White_savior


> The White Savior Industrial Complex is not about justice. It is about having a big emotional experience that validates privilege.


If she wouldn't have taken care of the 940 severely malnourished children, more than 105 of them would have died.


I don’t know if you read the article, but she was performing medical procedures with absolutely no training.

The care part may have been ok to good. But stuff like performing a blood transfusion on a 9 month old and then not being sure whether the baby was having a reaction because “google says there should be a rash if there is a reaction, but I see no rash” isn’t just insane, it may be torture.


No. “Random white woman” is not a medical qualification. If you are googling allergic reactions - and not even knowledgeable enough to do That (in transfusion reactions you are not looking for a rash) - you are absolutely not equipped to be giving IVs (and looking out for electrolyte problems, or water load problems), nor even to feed kids (because if you can’t handle IVs, you certainly can’t handle refeeding syndrome.)

Malnutrition isn’t that acute a condition. If a big pile of your patients are dropping dead in the first 24 hours, it’s a good hint that you’re precipitating an acute decline.


Uhm... She took medical actions instead of bringing them into the hospital and broke the law and therefore also denied many children the help they needed, quintessence is, she couldve saved many more lives.

"[...] the problem with Bach's center went beyond Bach's hands-on approach to medical procedures. Under both international health guidelines and Ugandan law, if a severely malnourished child has the kind of extra complications Bach's center was taking on — serious respiratory infections, dehydration, swelling — this child must be treated in an advanced medical facility."


The article mentions that just giving a malnourished child an IV can cause a heart attack. In fact doing nothing, in absence of expertise, is recommended.


I have very little knowledge about conditions in Uganda, so if you could back up that claim it would be helpful.


Would this be the same reaction if it was a black woman who was a caretaker? Or an uneducated Indian?


Hospital with many fully trained staff accepted patients who were terminally ill. Thousands died.


Have you read the article. This facility was supposed to provide the lowest level of care (nutritional) but instead chose to perform medical procedures designated for the highest level of care facilities. This without docters, a permit or otherwise subscribing to local law, norms or customs. The end result was a death rate only comparable to that of a highest level of care facility and a high one even for that. That's criminal and she faces charges. The US has an extradition treaty with Uganda.


Note: This is a reaction to the headline, which has an obvious statistical problem and therefore smells dishonest. It's not a reaction to the story, which has value in it's own right.


The internet doesn't need more hot take reactions to headlines. The internet needs more people who read articles and comment on their actual content.

What's more, simply by reacting to the headline as you've done, you've validated their choice of headlines. Journalists are more worried about apathy to an article than anything else. Any engagement is preferable to no engagement.

Finally, complaining about headlines on HN is not effective. It is essentially preaching to the choir and little more than virtue & identity signalling on HN at this point, since it happens on every single mainstream article that HN discusses. If you believe that headlines of this type are pernicious then your time & energy will do far more good talking about them in other contexts. For instance, with your family over dinner or with friends while pursuing a mutual hobby together.


Agreed. However, it also needs fewer headlines designed to invoke visceral reactions based on bad statistics.


As a general recommendation, try to avoid oneliners in HN. It's better to explain why the headline is wrong and why the article is interesting anyway. Sometimes you can pick the subtitle or a sentence of the article and propose it as an alternative title, and the mods may change it. Sometimes the only sensible title can create be made out of thin air, but the chance that the change is accepted is minimal.


To decompress a little, I feel strongly about this particular careless pattern of thought because it can have real negative consequences.

In particular, when you apply it to a doctor or a clinic it gives them strong incentive to reject those who need help the most. They'll have great stats if they only accept people who are fine anyway. But the people who needed a boost will be left to die on their own.

This then becomes an argument for avoiding applying metrics to doctors or at all, which is dangerous in and of itself. In order to improve, any person or institution needs feedback. In order to make informed decisions, people need useful data. Sloppy statistics block that. Charging those statistics emotionally only makes it worse.


I agree that the headline is silly, not least because '105 died' is meaningless without knowing how many were admitted.

It would have been better focussed on the extent of the untrained 'treatment's.


They give the denominator in the article, as well as context around what mortality rates are normal for comparable programs.

A headline isn’t a replacement for reading the article.


Not to be a killjoy but how is this relevant to HackerNews? HN isn't reddit.


If it makes it to the front page, people find it interesting. HackerNews is self-regulating enough with the voting system, so clearly it is of interest.

Does not seem off-topic to me.


https://news.ycombinator.com/newsguidelines.html

"On-Topic: Anything that good hackers would find interesting. That includes more than hacking and startups. If you had to reduce it to a sentence, the answer might be: anything that gratifies one's intellectual curiosity."


It has same relevancy than your answer and it was posted for same reason, as you, someone thought it could be interesting to someone else. And that is the reason of the voting system.


> HN isn't reddit.

Yeah, reddit wasn't slashdot, either.

Sites change. Its the people, duh.

/off-topic

Re: the "American" part of this: guess what kids, anyone can think they know best and end up in tragedy. That's why its good to know what you're doing.

Its not just Americans who get befuddled with this, btw.

In the real world, cargo cults abound!


If you read the article it shows that the murdering babies part of the story is merely incidental to a woman running an internet blog, which is old school Hacker News. I think its relevant as an examination of what could happen to us if we crank the narcissism and acquire brain damage simultaneously.


The article does a poor job of describing the actual situation that these parents face. What would have been the alternative when the local hospitals regularly refuse treatment? If these malnourished children could just get proper care at a real medical facility, why would they be malnourished in the first place? It's much cheaper to just feed a child instead of giving intensive care.

Ironically, in that one instance where this woman put a child in a critical condition, she might have saved it, because now the hospital would take it in, where it would have been refused before.

Don't get me wrong, I'm sure this woman could've done more good by just working an ordinary job in the US and donating a fraction of her income to trustworthy charities. Still, I'm not convinced she did more harm than good by performing this job.


There are quite some parallels here with the Theranos story. Both seem to come from a place of ignorance mixed with unearned self belief and exceptionalism.

Your suggestion that surely this person did some good is, it seems to me, a smaller example of the attitude referred to in the story.


This person did some harm, she also did some good. It wasn't all harm. Could she have done better? Of course.

Still, you have to put it into perspective. Remember, Uganda is in the bottom 10 countries in terms of human development. Your options are limited.


> Ironically, in that one instance where this woman put a child in a critical condition, she might have saved it, because now the hospital would take it in, where it would have been refused before.

This is accidental. I'm not going to go around stabbing people just in case someone looks at them in the ER and notices an early melanoma. But you could write a comparable "ironically" if it worked.

The kid could recover without intervention, could die immediately, could recover in the hospital, could die in the hospital. We can't just count on lucky harm in cases like this.


> This is accidental.

Of course it is accidental. I wrote that to highlight the difficulty of getting admitted to a hospital, not to argue that this is a good way to get admitted.

> I'm not going to go around stabbing people just in case someone looks at them in the ER and notices an early melanoma. But you could write a comparable "ironically" if it worked.

That wouldn't really be ironic, that would just be stupid. It would be ironic if you went out stabbing a person in order to harm them, but as a result you actually helped them (relatively speaking).

For further reference:

https://www.youtube.com/watch?v=nT1TVSTkAXg




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