Audrey here. I don’t usually write much because Greg’s stories and pictures are so much more interesting. I figured I should at least say a word before we leave on Tuesday so y’all wouldn’t think I did nothing. 🙂 I have been rounding every day on pediatrics and medicine wards. Peds can be extremely sad or very rewarding. The majority of the kids come in very sick, but after 2 days of treatment (usually for anemia and malaria) they are feeling better and running around. It is wonderful to see so many kids turn around so quickly and go home. Of course there are some that come in very late, or very sick; often convulsing and sometimes with a hemaglobin less than 1g/dL. It is amazing how many of these kids do well with a transfusion of blood and a couple doses of quinine. BUT there are the kiddos that succumb, and don’t make it home. Those are the sad days. The adults on the other hand seem to NEVER get better. This week I had a full ward of men and women, all with ascites from various different causes. Some had liver cancer, some cancer of the spleen. Others had nephrotic syndrome, or Congestive Heart Failure. In others, the cause was a life of drinking way too much alcohol (usually rise or millet wine- bili bili). There are others with hepatitis, or HIV, or Schistosomiasis. Almost all the adults I saw could have benefited from lasix to pull some of the fluid off. BUT… the hospital doesn’t have any. So… they were all sent to the market to find lasix. Some is probably legit, others may be blackmarket or not lasix at all. When I finished rounds Friday, I had 12 adults on the wards. This morning (Monday) there were only 2. The rest just disappeared. Discharged, or ran away without paying the bill. Two women last week had seizures and went into comas due to low blood sugars. I found one, Greg the other. Both came out of it with a bolus of dextrose and a bit of sugar under the tongue. Neither were there this morning. I have heard that they both died when they arrived home. Some left to go to the witchdoctor? To try traditional treatment? I will never know. Today I was called to peds to examine a 13 yr old girl who was “violated”. The story was a bit difficult to figure out. As well as I understand: The 13 yr old is brought by her father to find out if she is still a virgin. The father says this boy had sex with her. The girl says she had sex with the boy. The boy denies everything. I am supposed to be the “tiebreaker”. Is she still a virgin? Will she bring shame to the family? I explain that even if her hymen is no longer intact, it is impossible to determine if it was from sexual relations, or riding a bike, or using a tampon, or, or, or… The father seems to understand but still wants her examined, and the results documented. Their plan was to take the boy to the police if the girl was no longer a virgin. Can you imagine doing that in the US? One amazing story that I can tell you about my time here is about a little baby named Toungou. She is a twin, born 3 weeks before. I met her. She was brought in to the hospital after being taken to 2 different health centers for 2 days of convulsions. When I saw her, 2 of our volunteers here (an RT and a PA) had been trying to ressussitate her. She had stopped breathing twice already and had been bagged and given CPR. We checked her sugar, which was normal. Hemaglobin was normal. Malaria smear was negative. No nuchal rigidity or bulging fontanelle. I helped bag her for several hours. We would stop, and she would breathe on her own. Then the breathing stopped. The heart slowed and stopped. She was pronounced dead. For 30 sec, 40sec…Then she would convulse and start breathing again. She did this 4 times and we decided that she really wanted to live. Fortunately, the midwife here, who is also doing amazing things with preemies and very tiny babies, has a portable cpap machine. Little Toungou just needed to keep breathing to trigger the machine. She was given Rocephin, Dextrose, and put on cpap. Mom agreed to have us take care of her in our homes, so she spent every moment with one of us volunteers. Nights at one house to be watched carefully; days elsewhere. I was fortunate to be able to hang out with her after rounding until she went home with someone else for the night. Within 3 days she started to look better. She was no longer seizing. She was being given mom’s milk by tiny NG tube. She was still receiving Rocephin for probable meningitis. After 4 days with us night and day, she was given back to mom to take care of during day, and just spending nights with one of us. After 6 days, she started breastfeeding on her own. The NG tube was removed and she went home yesterday. Glory Be To God!
I am now sending this from the capitol of Chad, N’Djamena. We are on our way to spend 3 days in Istanbul before flying back to Oregon. This has been a difficult trip for me (maybe more to follow), but baby Toungou and many of the other kiddos have made it beautiful as well.
