hard realities

This week has opened my eyes to some of the more painful things you come in contact with being in the bush.  There have definitely been some highlights of this week, but the things that really impacted me most were the tough stuff.

Wednesday we spent the day at Macha Hospital, where we were split into several small groups.  I was placed with Amelia and Joe, and we were assigned to the Pediatrics unit.  I had an idea of what I was in for based on what other students saw the Monday before when we had our hospital tour.  We had very limited time in the wards on Monday, but the Pediatrics group from that day shared a story that was painful to hear.  I took care of that patient today and tonight my heart is heavy for that little boy and another girl in particular.  Let me give you a little background on the boy.  He is a two year old who fell in to an open fire, and he has 2^nd and 3^rd degree burns covering 45% of his little body.  Second degree burns are the most painful, because the nerve endings have been reached and are exposed, but not burned.  Any air movement can be extremely painful.  This boy had burns on his perineum, whole back, an arm, and part of his head and face.  It was incredibly painful to see this child.  He was in a bed laying down, with a wire rack sitting over him with blanket coverings- this way no air was moving around him, and the flies and other “bad things” couldn’t enter.  This boy has never had any pain medications since he has been burned.  This is unreal.  I could hardly stand it and seriously contemplated sneaking him some morphine. 

He was being debrided twice a day.  I knew I would not be able to handle it, and let Amelia and Joe do that task.  My stomach was super uneasy and I felt like I would bawl through the whole thing if I went in to the room to watch.  However, from the nursing station I was able to see some of what they were doing and heard him crying.  He has cried himself hoarse, and he hardly has any vocals left at all.  His breathing rate is out of control, and his stomach is full of misplaced fluids in the body.  He is so pale and dehydrated.  I could go on and on, but I think you can probably visualize the picture I am trying to create.  We were very surprised he has lived as long as he has, and are concerned he may not make it.  The debriding consisted of the nurse bathing the boy with soapy water (not what we would do at all in the states), and then debriding with normal saline, and finishing by rubbing sliver nitrate on all the affected areas.   Silver nitrate is very painful.  I have teared up and prayed so many times about this little boy.  I can’t stand it for him.

While Amelia and Joe worked with that boy, I worked with a severely malnourished girl.  Her name is Annah, and she is 22 months old.  Annah’s skin was sloughing off because of her lack of adequate nutrition.  Her mother and father both stayed very close to her the whole time, which I really enjoyed seeing.  Often times just the mothers stay with the children.  Annah had a hemoglobin level of 4.4 this morning, indicating she was also severely anemic.  She was started on a special diet for malnourished children that begin with small amounts of protein that increase as they are able to tolerate more.  We started a blood transfusion on her this morning to get her hemoglobin levels at a more appropriate level.   She also needed to be debrided in the areas where her skin was shedding the most.  I was able to perform this task with the assistance of Jefferson, the pediatric nurse.  She whimpered through the whole thing, but it was not nearly as traumatic as the boy.  After debriding I applied an antibiotic ointment to all of the areas.  She looked incredibly frail, weak, and absolutely exhausted.  Annah did not have an ounce of energy when I saw her in the morning.  I was so happy to see her after our lunch break sitting up eating a piece of bread.  I think the blood transfusion helped her a lot.  God knew I needed to see at least a little progress in one of the children today.

Now, on a much happier note, the three girls who went to the Maternity ward all got to deliver a baby!  Macha usually has about 50 births per month, and they hit a busy day.  I am so hoping I have the same opportunity! That would be amazing.  Also, in a little bit of down time on the floor, Amelia, Joe, and I went in to one of the pediatric rooms and starting talking with the parents.  They began teaching us the Tonga words for parts of the body.  We learned quite a few, and they laughed and laughed at us trying to say them correctly.  They thought they were hilarious when they taught us how to say “breasts” and “buttocks” in their language.  It was wonderful to see them enjoy us, and see their spirits lifted for even just a few minutes.  The other groups saw some pretty great things as well.  Even though it was a hard day, and very painful at times, I know this is what life looks like for so many of these people. 

The Pediatric group!

Hah! Look at these happy faces.  Clearly the girls who delivered babies : )

A picture up in the Peds ward. I love it! Notice the spider on the far left- they are everywhere!!

This pretty much only covers today, but I wanted to share; and I think it was good for me to write it all out, too!  Please pray for us as we will continue to be at Macha the next two weeks.  I'm sure we will encounter much more of this hardship.