We have to take care of each other...
The same as previous weeks, we saw a whole spectrum of patients. It's quite remarkable to realize how holistic this clinic is. We transform on any given day into a myriad of specialty clinics from trauma and infectious disease to OB and malnutrition.
While the clinical team was discussing the latest child admitted with malaria, a group of 4 men whisk by carrying a wooden stretcher after completing an arduous 4 hour journey by foot to the clinic. Helen and I run out to do an assessment and find a 4-year-old boy with the left side of his body scalded with boiling water. We suddenly become a burn center. A few extra hands come in to help and the patient Clovis, a fiesty, and STRONG little boy is stabilized, with wounds dressed, and finally resting.
Twice a day I pre-medicate him with codeine and valium because the anxiety seems worse than the actual pain. I carry him down the outdoor hallway (the walk to hell as we call it) and we go into a private room. It is here that Helen and I remove his old dressings, clean, debride, (scrub off the dead skin to allow new skin to grow) and redress his fragile, vulnerable skin. He kicks, hits, and whimpers like a puppy while reaching for the gauze because he wants to clean the wounds himself...a site that brings tears to our eyes. I'm pretty sure he hates me but I guess that's a part of nursing. I empathize with this kid on many levels which is why he is now "another one of my children." We will come to know him and his mother well as his road to recovery progresses.
This picture is blurry but I love it!
Wednesdays are prenatal care day, Helen and I tag team the preggers. We meet a woman who says that she has been pregnant for 1.5years. She also states that she is having a few, sporadic contractions, Braxton Hicks we presume. We measure her fundal height and it tells us that she should be about 27weeks pregnant. No other complications are present and we were unable to do a sonogram so we send her home with vitamins and ask her to return in 1 month. A few hours later she hobbles down the hallway in active labor. She walked all the way from Tanzania to deliver her baby here at Village Health Works (a true testament to the incredible work that is taking place here). A healthy baby girl was born! (#2 for me).
Life and death. We try our best but with limited supplies, equipment, and severely ill patients death is bound to happen...it's just really difficult when children are the ones to go. This week on Friday and Saturday night at 11pm we had two babies pass. Both children were in the malnutrition ward for severe malnutrition. The baby pictured below is a classic example of Kwashiorkor, a type of malnutrition which causes the individual to swell up making them look "plumpy and fat" but in actuality they are severely malnourished. This baby passed on Friday night. Saturday a little girl named Natasha left us. She was brought here with malnutrition, severe dehydration from diarrhea, and malaria. Her mother is HIV+ and we do not know Natasha's status. On Friday evening Natasha started having uncontrollable spasms. Without diagnostic tests we were unable to identify the cause so we treated for what we thought was meningitis. The next morning she was doing better but Saturday night she went down hill again and didn't make it.
I don't think this will ever become easy, and I'm thankful for that. It keeps me grounded and reminds me that we're all human.
These children died from illnesses that are unheard of in the U.S. Malnutrition. Do you know any child who is malnourished? Sure we have people who have unhealthy diets but it is unfathomable to think of a child dying because they do not have enough or adequate food. This is a horrific disease of poverty that is a far too common site here. Same with Malaria, we don't even learn about it in nursing school because it is eradicated in the U.S. Here it is probably the most common diagnosis and is killing people everyday...again unfathomable.
Another rather harsh reality is the traditional healers or "mupfumu". These are trusted individuals in the community who perform practices such as cutting the uvula (hangy ball) in the throat and cutting babies chests to remove "the bone" (the zyphoid process which is located at the bottom of the sternum.) This baby above was taken to the mupfumu, given herbs for some treatment, and had an allergic reaction. She is thankfully healed but the traditional healers are still a prominent source for "healthcare." One of my goals is to try and figure out a system where we can work together...I'll keep you posted.
Melino showing mothers in the malnutrition that "WE ALL HAVE THAT BONE!"
This is Maombi. A bright, spirited 9 year old, at times shy but full of determination. Maombi has been living here at VHW for about 2 months. We have become quite close as evidenced by the occasional afternoon nap together in his bed. Maombi has a leg wound of unknown origin. For 2 months he has not walked and just last week Helen and I (the unstoppable duo) encouraged him to try using crutches. There was fear and apprehension for good reason but her persevered! "Buke Buke" or Little by Little is the name of the game. He started out only being able to walk to the door of the hospital ward and just yesterday after using the crutches for about 1 week, he walked the entire distance of the hallway!
He finally regained is independence! This is why I do what I do.
Ok now the part you all love...the cute kids
Andre. Admitted with malnutrition- recovered!
Little boy taking a break...
SUCCESS STORY!
This is Divin. He is one of the kids who we thought was going to die because his malaria was so bad. He was able to receive a blood transfusion (a very rare treatment here) and he is thriving! He was on constant oxygen, had a feeding tube, and should have been in an ICU...but we saved him!
...and I'm crying while I'm typing this. wow
Meet Gervair...this is how he takes his pills...and this is why I love him.
We are currently in need of many supplies for the clinic!
CLICK HERE and visit the "Help Us" tab.
Tuzosubira! (talk to you later)
