MUDr. Eva Vit\u00e1riu\u0161ov\u00e1 Ph.D., je d\u011btsk\u00e1 l\u00e9ka\u0159ka na odd\u011blen\u00ed 2. d\u011btsk\u00e9 kliniky l\u00e9ka\u0159sk\u00e9 fakulty univerzity Komensk\u00e9ho a d\u011btsk\u00e9 fakultn\u00ed nemocnice s poliklinikou v Bratislav\u011b. V\u011bnuje se t\u00e9\u017e pediatrick\u00e9 endokrinologii a diabetologii, poruch\u00e1m l\u00e1tkov\u00e9 p\u0159em\u011bny a v\u00fd\u017eivy. S humanit\u00e1rn\u00ed organizac\u00ed MAGNA spolupracuje na nastavov\u00e1n\u00ed medic\u00ednsk\u00fdch l\u00e9\u010debn\u00fdch standard\u016f, jako i p\u0159\u00edmo v ter\u00e9nu na projektech v zem\u00edch jako Kambod\u017ea, Ke\u0148a \u010di b\u011bhem ute\u010deneck\u00e9 krize v Evrop\u011b. Na misi do Kambod\u017ei p\u0159i\u0161la v \u010dervenci 2007. V tom obdob\u00ed se rozb\u00edhal projekt obnovy d\u011btsk\u00e9ho odd\u011blen\u00ed v nemocnici Chey Chumneas v provincii Kandal, soub\u011b\u017en\u011b s nutri\u010dn\u00edm projektem p\u0159i existuj\u00edc\u00edch projektech distribuce l\u00e9\u010dby pro HIV pozitivn\u00ed pacienty jako i prim\u00e1rn\u00ed zdravotn\u00ed p\u00e9\u010de. V n\u00e1sleduj\u00edc\u00edm rozhovoru n\u00e1m p\u0159ibl\u00ed\u017e\u00ed l\u00e9\u010dbu podv\u00fd\u017eivy a jej\u00ed zku\u0161enosti z projektu v Kambod\u017ei.<\/p>\n
Jak jste po medic\u00ednsk\u00e9 str\u00e1nce p\u0159istupovala k\u00a0l\u00e9\u010db\u011b podv\u00fd\u017eivy v\u00a0Kambod\u017ei?<\/strong><\/p>\n Nutri\u010dn\u00ed projekt byl velmi ambici\u00f3zn\u00ed, a to pr\u00e1vem. Jeho s\u00edla spo\u010d\u00edv\u00e1 nejen v\u00a0hospitaliza\u010dn\u00ed p\u00e9\u010di o\u00a0podvy\u017eiven\u00e9 d\u011bti, ale z\u00e1rove\u0148 v\u00a0dal\u0161\u00edm pokra\u010dov\u00e1n\u00ed, kter\u00e9 sest\u00e1valo z\u00a0usilovn\u00e9 ter\u00e9nn\u00ed pr\u00e1ce s\u00a0cel\u00fdmi rodinami. Jeho c\u00edlem bylo d\u00edt\u011b v\u00a0\u00favodu stabilizovat, ale po zvl\u00e1dnut\u00ed akutn\u00edho stavu zapojit rodinu, zorganizovat distribuci nutri\u010dn\u00ed pomoci a\u00a0tak p\u0159edej\u00edt recidiv\u011b stavu.<\/p>\n M\u016f\u017eete popsat, jak prob\u00edh\u00e1 l\u00e9\u010dba podvy\u017eiven\u00e9ho d\u00edt\u011bte?<\/strong><\/p>\n C\u00edlem l\u00e9\u010dby podvy\u017eiven\u00e9ho d\u00edt\u011bte je stabilizace klinick\u00e9ho stavu, \u00faprava stavu v\u00fd\u017eivy, \u010dili postupn\u00fd vzestup t\u011blesn\u00e9 hmotnosti a\u00a0terapie p\u0159idru\u017een\u00fdch komplikac\u00ed. Je to velmi pomal\u00fd proces. Z\u00e1kladn\u00edm krit\u00e9riem \u010di se d\u00edt\u011b za\u010dne l\u00e9\u010dit ambulantn\u011b nebo vy\u017eaduje hospitalizaci, je stanoven\u00ed z\u00e1va\u017enost\u00ed podv\u00fd\u017eivy. Pokud mus\u00ed z\u016fstat v\u00a0nemocnici, za\u010dneme ho l\u00e9\u010dit tzv. terapeutick\u00fdm ml\u00e9kem. Toto \u201eml\u00e9ko” m\u00e1 podle Sv\u011btov\u00e9 zdravotnick\u00e9 organizace p\u0159esn\u011b ur\u010den\u00e9 energetick\u00e9 a\u00a0nutri\u010dn\u00ed slo\u017een\u00ed, n\u011bkdy jsme ho museli pod\u00e1vat sondou. Po kr\u00e1tk\u00e9m intervalu p\u0159ech\u00e1z\u00edme na ml\u00e9ko energeticky a\u00a0nutri\u010dn\u011b vydatn\u011bj\u0161\u00ed, p\u0159i\u010dem\u017e tento postup respektuje mo\u017en\u00e9 komplikace z\u00a0n\u00e1hl\u00e9ho p\u0159\u00edsunu \u017eivin. D\u00e1vky se postupn\u011b zvy\u0161uj\u00ed podle hmotnosti d\u00edt\u011bte, nakonec m\u016f\u017eeme pacienta propustit. Dom\u016f odch\u00e1zej\u00ed d\u011bti s\u00a0tzv. Ready To Use Therapeutic Food (hotov\u00e9 energeticky v\u00fd\u017eivn\u00e9 j\u00eddlo). Ka\u017ed\u00e9 podvy\u017eiven\u00e9 d\u00edt\u011b b\u00fdv\u00e1 chronicky dehydratovan\u00e9, to znamen\u00e1, \u017ee jeho ledviny a\u00a0srdce nepracuj\u00ed tak jako u\u00a0zdrav\u00e9ho d\u00edt\u011bte. Proto mus\u00edme velmi opatrn\u011b zvy\u0161ovat p\u0159\u00edsun tekutin, abychom nezp\u016fsobili selh\u00e1n\u00ed srdce. Bezprost\u0159edn\u00edmi komplikacemi jsou tak\u00e9 n\u00edzk\u00fd cukr v\u00a0krvi, zm\u011bny v\u00a0metabolismu miner\u00e1l\u016f, kter\u00e9 nel\u00e9\u010den\u00e9 mohou po\u0161kozovat mozek d\u00edt\u011bte. Na druh\u00e9 stran\u011b d\u011bti \u010dasto trp\u00ed pr\u016fjmy, z\u00e1paly d\u00fdchac\u00edch cest a\u00a0k\u016f\u017ee. Ur\u010ditou specifickou skupinou jsou d\u011bti s\u00a0tzv. kwashiorkorem. Je to stav zp\u016fsoben\u00fd v\u00fdrazn\u00fdm nedostatkem b\u00edlkovin ve strav\u011b. D\u00edt\u011b je cel\u00e9 natekl\u00e9, proto vypad\u00e1 zd\u00e1nliv\u011b jako dob\u0159e \u017eiven\u00e9. Stav t\u011bchto pacient\u016f je v\u00a0kontrastu s\u00a0jejich zjevem kritick\u00fd, nebo\u0165 po zah\u00e1jen\u00ed l\u00e9\u010dby terapeutick\u00fdm ml\u00e9kem opuchliny okam\u017eit\u011b miz\u00ed a\u00a0demaskuj\u00ed se v\u0161echny z\u00e1va\u017en\u00e9 komplikace v\u00a0pln\u00e9 s\u00edle.<\/p>\n S\u00a0\u010d\u00edm jste se v\u00a0ter\u00e9nu setk\u00e1vala?<\/strong><\/p>\n Pacienti a\u00a0rodiny jsou \u010dasto nevzd\u011blan\u00ed lid\u00e9 s\u00a0ur\u010dit\u00fdmi p\u0159edsudky v\u016f\u010di \u201ez\u00e1padn\u00ed” medic\u00edn\u011b. \u010casto se setk\u00e1v\u00e1me s\u00a0ned\u016fv\u011brou v\u016f\u010di l\u00e9ka\u0159\u016fm a\u00a0na\u0161im postup\u016fm. Nejednou up\u0159ednostn\u00ed neov\u011b\u0159en\u00e9 \u201etradi\u010dn\u00ed” l\u00e9\u010debn\u00e9 postupy. Kdy\u017e se bari\u00e9ra prolom\u00ed, jsou to velmi disciplinovan\u00ed a\u00a0vd\u011b\u010dn\u00ed pacienti.<\/p>\n Dal\u0161\u00edm \u00faskal\u00edm na\u0161\u00ed pr\u00e1ce je dostupnost l\u00e9ka\u0159sk\u00e9 pomoci a\u00a0limitovan\u00e1 dostupnost terapeutick\u00fdch vy\u0161et\u0159en\u00ed. Jsou m\u00edsta, kde prakticky neexistuje odborn\u00e1 pomoc, nav\u00edc pacienti nemaj\u00ed dost finan\u010dn\u00edch prost\u0159edk\u016f a\u00a0samoz\u0159ejm\u011b fyzick\u00e9 s\u00edly p\u0159ekon\u00e1vat dlouhou cestu do zdravotnick\u00e9ho za\u0159\u00edzen\u00ed. I\u00a0kdy\u017e n\u011bjak\u00e9 v\u00a0okol\u00ed je, \u010dasto nem\u00e1 logistick\u00e9, v\u011bdomostn\u00ed a\u00a0materi\u00e1ln\u00ed vybaven\u00ed na pomoc pro podvy\u017eiven\u00e9 d\u00edt\u011b. V\u00a0tomto sm\u011bru v\u0161ak MAGNA vyvinula maxim\u00e1ln\u00ed \u00fasil\u00ed a\u00a0zabezpe\u010duje z\u00e1kladn\u00ed vy\u0161et\u0159en\u00ed p\u0159\u00edmo v\u00a0provin\u010dn\u00ed nemocnici a\u00a0promptn\u00ed spolupr\u00e1ci s\u00a0l\u00e9pe vybaven\u00fdmi za\u0159\u00edzen\u00edmi, abychom l\u00e9\u010dbu zvl\u00e1dli.<\/p>\n Co jste si z\u00a0mise v\u00a0Kambod\u017ei odnesla?<\/strong><\/p>\n Cel\u00fd program jako takov\u00fd a\u00a0mo\u017enost b\u00fdt jeho sou\u010d\u00e1st\u00ed byl a\u00a0je pro m\u011b obrovsk\u00fdm p\u0159\u00edb\u011bhem. Jednotliv\u00e9 osudy vyl\u00e9\u010den\u00fdch d\u011bt\u00ed jsou inspirac\u00ed pro dal\u0161\u00ed pr\u00e1ci a\u00a0pomoc ostatn\u00edm nov\u00fdm pacient\u016fm. Dojemn\u00e9 byly i\u00a0p\u0159\u00edb\u011bhy samotn\u00fdch \u010dlen\u016f terapeutick\u00e9ho kolektivu, v\u010detn\u011b l\u00e9ka\u0159\u016f, sester, ter\u00e9nn\u00edch pracovn\u00edk\u016f, kte\u0159\u00ed se velmi odevzdan\u011b v\u011bnovali pr\u00e1ci za \u010dast\u00fdch nelehk\u00fdch podm\u00ednek. Bylo mi ct\u00ed pracovat s\u00a0takov\u00fdmi lidmi.<\/p>\n L\u00e9\u010d\u00edme tady a te\u010f. D\u00edky V\u00e1m.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":" Eva Vit\u00e1riu\u0161ov\u00e1 spolupracuje s MAGNA na nastavov\u00e1n\u00ed l\u00e9\u010debn\u00fdch standard\u016f, p\u016fsob\u00ed i v ter\u00e9nu. V n\u00e1sleduj\u00edc\u00edm rozhovoru n\u00e1m p\u0159ibl\u00ed\u017e\u00ed l\u00e9\u010dbu podv\u00fd\u017eivy a jej\u00ed zku\u0161enosti z projektu v Kambod\u017ei.<\/p>\n","protected":false},"author":1,"featured_media":7108,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[1],"tags":[],"post_country":[],"post_year":[],"post_layout":[],"post_topic":[],"class_list":["post-7106","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"acf":[],"yoast_head":"\n