Shanksteps #104
I went to bed at 10PM after playing some games with the student missionaries. We splurged with brownies from a box and Kool-Aid. Knowing today was going to be a “day off” I planned on sleeping in. I awoke at 6AM as usual, wide awake and couldn’t get myself to sleep in. It was finally a cloudy day and cooler than it has been. I made a cup of chocolate with local chocolate powder then went outside to read for my personal worship. Mosquitoes and wood bees keep me company while I read. Up high
in the trees dragon flies fly around looking for insects. I have a peaceful worship then decide to eat breakfast. That consists of bouille (local porridge made of rice, flour, sugar, and a dash of lemon) and toast (made of white flour and millet flour). I then go out to take apart my motorcycle carburetor because it has been choking and coughing for the last few days and new gas didn’t seem to do the trick. I take it all apart and see all kinds of sediment in the bottom. After cleaning this,
Im replacing it when the nurse from the hospital comes by. He wants me to see a patient in maternity that has been in labor since yesterday evening, and has stopped progressing. I finished putting the motorcycle together, and rode it into the hospital.
I find a woman on the bed who is thin and short. After examining her, I find the pelvis is small and the child has not really descended much at all. I decided she needed a cesarean (operation) to deliver the baby. The husband agrees wanting the best for the baby. I nearly gape in surprise! This is the first time I have heard a father say that here. I assure him I think it’s necessary and we will do our best and ask God to be in control.
I slide the knife blade into the handle and after prayer slice open the abdomen. She bleeds and I control this with electrocautery. Through the fascia, muscles and peritoneum. A transverse incision in the uterus. The baby is hard to get out. The head is there but it’s not coming. I ask for forceps and pull it through the incision with them. He is floppy and blue. I ruff him up, drying vigorously, the nurse prepares the oxygen concentrator to give oxygen to him. He finally starts breathing
then yells for all he’s worth. He’s ALIVE! I breathe a sigh of relief and thank God for a live baby. I sew up the uterus, fascia and skin. I want to escape home but the other nurses have a couple patients for me to see.
One elderly man came in with red urine. The nurse put a Foley (urine catheter) in him and didn’t get much so took it out. I feel his abdomen and his bladder is up to his umbilicus. His is full to overflowing! Red blood is coming out his penis. I think the nurse blew up the balloon below the prostate and ruptured the urethra. With difficulty I put in another Foley and get about 400 ml dark red blood/ “urine”. He needs a cystoscopy but we don’t have it. I give him Vit K, to ensure he has part
of the things necessary to clot. The nurse had already given him Diclofinac which affects the platelets and inhibits clotting.
The other one was a 6 month old chunky boy with meningitis. He had been convulsing all night. I had given him the maximum of Phenobarbital without success. This morning he had finally stopped and even had some breast milk. His IV had come out for the 4th time. Yes you DO need to replace it. He still needs IV antibiotics and treatment for concomitant malaria.
I am finally headed home. Our helper has made eggplant peanut butter sauce(affectionately know as “acid”.). I choke it down and take the motorcycle for a longer ride to ensure it’s working well. When I get back we head for a hike up the Mawa Mountain. It goes well but we reach the 2500 ft summit after bushwhacking a path straight up the side to the top. It is near dark and we’ve been walking for nearly 2 hours. We start scrambling back down and choose a nearly vertical route. We stumble,
skid and fall to the bottom and arrive at the village after dark. I’m exhausted. We head home. I check on those same two patients. They are doing a little better. I head home for more “acid”. It is raining and I arrive soaked, thankful to finally be cold once again. Im falling asleep as I write this and will hit the sack. Good, busy day
In His Service, Greg
Shanksteps #104