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| All of us missionary women joined the Congolese women's celebration, and matched our Congolese friends in fabric too! Their idea of fun- sitting for 7 hours and listening to someone preach-- is not exactly what we'd consider fun, but it was wonderful to take part with them in their festivities! |
This free care at our hospital started March 1. Whew! The sick have flooded into our
hospital. Serge has asked, in order to
protect our kids, that only one of us do direct patient care for this season
while Ebola is in our region. Since
Patrick did direct patient care in the Fall, I am now doing direct patient care
at the hospital and Patrick is doing administrative tasks, physician and
nursing education, quality improvement projects and is keeping our house going. I’ve been the only one on the pediatrics
service at the hospital for all of the kids at the hospital with medical
problems. It's been crazy! It’s been trial by
fire. Patrick has been an invaluable
resource and partner that I consult multiple times daily as I manage cases that
normally would only be cared for by sub-specialist physicians in the USA. Let me know if you want to hear my stories
about the epigastritis turned cardiac tamponade, or the liters of pleural
effusions released, or the heartbreaking 5 cases of fulminate bacterial
meningitis in kids ages 5-15 over the last month. I’ve lost so many sweet kids. I’m not cut out
for this job emotionally! Patrick has
been a good shoulder to cry on, and I’m not sleeping well many nights, but I’m
so glad for the chance to be here during this time and care for these kids.
Here is one day I recently had caring for children at CME
Nyankunde hospital, where we live and work:
I showed up, as usually, at 7:00 AM to start rounds in the
intensive care unit (ICU). There were no
gloves! I’m not allowed to provide care
without gloves because of the risk of Ebola. I found an expensive pair of
sterile gloves and put them on, using the same pair with all of my patients
that morning and cleaning them with alcohol after touching each child.
Soon after I arrived, a new case arrived at the ICU, a 9 month old,
severely dehydrated, who had been having diarrhea for 3 days and 1 day of
vomiting and fever. I quickly placed a
naso-gastric feeding tube and asked that oral rehydration fluids be given. But alas, there was no clean water in the
hospital! Even if we could have found
clean water, the family didn’t have a cup for us to put it in, and there are
definitely no cups sitting around for anyone’s use. We have donated 2 water filters, but both were
out of commission and there was no filtered water. The family
had no money to buy bottled water, and I searched through my purse with no
luck. Did we really not have this most
basic, fundamental need, water?! I then
tested a blood sugar because the baby hadn’t eaten for over 36 hours. It was 580mg/dl! This is about as high as blood sugars
get. I ordered more labs to discern the
cause for his high blood sugar, and headed down to the pediatrics wards. When I returned a few hours later, the baby
had passed away. Oh how fragile life is
here! The wails of the mother echoed
throughout the hospital, and the mourning family loomed large, waiting to take
the child’s body to burial.
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| Zawadi (gift), is 7 years old. She has a large belly and puffy skin (edema) everywhere due to severe malnutrition and a kidney disease. I knew she was starting to get better when I took this picture, showed it to her, and she smiled her FIRST smile in the hospital! |
When I arrived in pediatrics and started rounds, I soon
found out that the hospital was also out of IV tubing and IV needles. These items are basic materials that are
necessary for any dehydrated or septic patient.
I thought a prayer, asking God to keep his children well with the few
resources we still had. As I continued
to round on each patient, evaluate their state, diagnosis and treat, I found
out that our severely malnourished children had not been getting therapeutic
milk for over a week! As fertile as the
lands are here, the impact of war, drought, family problems, and the lack of birth
control have led to an impressively high rate of severe acute
malnutrition. These kids rely on
specially formulated therapeutic milk, given by NGOs to slowly walk toward
health. You know they are improving when
they finally smile and start to play. We
had run out of this specially formulated milk a week before, so we bought
powdered milk for our nutritionist and reminded her of the WHO recipe of how to
make therapeutic milk out of local ingredients.
A week later, it came out that she had been just mixing the milk powder
with water, meaning our severely malnourished kids had missed out on a week of
critical recovery time. That same
morning I verified with each mother how many glasses of milk and peanut paste
their kids had been served and many kids had been altogether forgotten and
although hospitalized for malnutrition, had received no nutritional aide. HOW?! I wondered, and ached. Even among the kids who had been receiving
nutritional aid regularly, none of them had had milk since the night before and
it was already noon. Why can’t it be
made quickly now and given, I asked?
Because, once again, there is no clean water. They were in the process of boiling a large
pot of water on charcoal. Somehow the
water that had been boiled over the weekend for making the formula, had ‘walked
away’, probably for nurses to make coffee.
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| Both Sarah (left) and Furaha (right in red) have congestive heart failure. We lost Sarah a few weeks ago..... We had the chance to walk across town and visit her family recently. 3 days after her funeral, at least 20 people were still camped out, in grief and solidarity with her family. I sent Furaha home recently because if she didn't leave soon, she'd have to repeat this school year. She just came back for a follow up today and isn't doing great. Its so hard to manage chronic disease when families don't have money for meds, nor an understanding of their disease. |
Little 4 year old Patience was one of the last patients I
saw before I finished rounding. Her mom
had brought her to the hospital after she got news that she was ill. Her mom
gave birth to her, then later on her father left the family and the mom found a
new husband. Many times, the new man in a family rejects any children that are not his own flesh and blood, so the
mom must abandon her children from a previous husband. Patience had been dropped off at her uncle’s
house, and had become so severly malnourished that her legs were swollen to
twice their size; she had no hair; and she was the size and weight of her
healthy 6-month-old sister. Most of our
severely malnourished patients have a similar history. Wonderfully, after being reunited with her
daughter, the mother tells us she will bring her home with her so she’ll get
better care. We’re praying her husband
agrees and allows it.
 |
| Patience on left |
There are hundreds of other stories to tell. But that’s all for now. The electricity is out, the mosquitos are buzzing
in our ears, and bed is calling!
Goodnight.
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| Miriam loves everything BABY. She pretends to be a baby, she grabs every baby available, and from the minute she wakes up in the morning, she's strolling her baby around and finding nice places for her to sleep. Here she's holding Dan, our doctor colleagues, Patrick and Nono's, son. We still rejoice in his safe and healthy birth. |
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| I couldn't help but snap this shot. Lukes favorite thing in the world is stories. He demands a story every night before bed. I love watching his rapt attention to Patrick as Patrick's story unfolds. It's an amazing age in our kids lives when they are so easily entertained by simple things! |
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