Limited Resources

At Nkhoma Hospital, Malawi and many hospitals in developing countries, resources such as clean water and elcetricity can be intermittent or nonexistant affecting patient care dramatically. Although there are often back up generators and water in a bore hole which can be carried, the challenges are profound.

ELECTRICITY OUT

Electricity out -oxygen stops,

Electricity out- warning beeps,

Saturations drop, heart rates rise,  

Electricity out- no ultrasound,

Electricity out- computers surge and stop,

Electricity out-charts and children plunge into darkness,

A voice in the dark calling Ali Bwanji "How is he? How is she?

The child can be made out scarcely in the dim light of dawn,

Holding the chart up to the unscreened window,

Trying to make out the orders:

    the medications

          the hemoglobin result

                 the malaria smear

                        the temperature

                                the weight

Listening to this child whimpering  above the general  crying of children on the ward

Electricity out-spiritual warfare

Electricity out-battle cry

 

Cerebral Malaria

Cerebral Malaria is a serious complication defined by coma, convulsions and encephalopathy which can lead to death.

          Yona

Sick two days, fever, diarrhea,

Playing, robust, chubby legs, warm heart, smiling,

Eating porridge in the morning.

Convulsions, coma, diazepam,

Last breaths, strong heart,

Ambu bag pushing breaths in and out,

NG tube placed, stomach decompressed.

Mother waiting watchful,

dreading, hopeful,

hopeless,

1 hour, 2 hours, 3 hours,

When to stop- it is my call,

My wild God is in charge,

He knows the why.

Eyes fixed and dilated,

Let him go quietly.

His mother waits on the floor across the room,

A torn hole in her light blue sweatshirt, blood on her skirt- her child's? her own?

Strong heart. The nurses would have gone on breathing for him for hours,

They were not tired.

Decorticate, decerebrate, brain dead, eyes fixed and dilated,

My wild God loves Yona and He  loves me. Lord, comfort his mother in her pain

and loss.  You understand.

Your son died too.

Jesus,  "a man of sorrows and familiar with sufffering."

Give her strength to bear this grief.

reference: Isaiah 53:3, 4

Anemia Heart Failure

Malaria is responsible for more than 1 million deaths each year. In Sub-Saharan Africa malaria kills 2 children every minute. The parasite is transmitted through the bite of a mosquitoe. The parasite multiplies in red blood cells and destroys them leading to severe anemia and heart failure.

So LIttle

Rachel weeping for her children who are no more. Hemoglobin 2.7. In extremis. glucose 51 too low. 3+ malaria smear- quinine given-blood started- lungs filling up with fluid. Lasix given. Lasix given again. Pink tinged nasal secretions. Let the mother hold her dying child. She should hold her. It is her last chance. Mother singing gently to her dying child, expressing drops of milk into her gasping mouth. Weeping for the mother. Patting her shoulder softly. Listening for a heartbeat, nothing, watching for a gasp, any movement- nothing, weeping inside. I am so sorry. I had hoped... but the nurse said the blood looked like water- so little hemoglobin, so many parasites, so little chance of survival. So little. Little baby, only 4 kilograms-just a few months old. And my tears fall freely as do God's for His beloved suffering creation. Jesus wept. He is weeping still over fallen broken humanity.

Learn more about the Malaria Networkers Mother's Day Project at http://gamc.pcusa.org/ministries/internationalhealth/networkers/

Malnutrition Kwashiorkor Marasmus

Atleast 25% of the world's pediatric population is undernourished, a contributing factor to more than half of the deaths of children younger than 5 in less developed countries.

No Milk



Exhausted, ailing  mother, breasts dried up, wrinkled

Wasted, septic, half-starved, listless infant twin

No milk, no F75, no F100, no supplements,

No energy, no food, no resources

to the market, IV in place

missed medications

morbidity rising

inevitable

demise

making milk

in the blender, F100

according to a WHO recipe

walking in the dark back to the hospital

jars still hot for NG feedings to begin and continue

"He will deliver the needy when he cries for help. The afflicted also

and him who has no helper. He will have compassion on the poor and needy.

The lives  of the needy He will save and their blood will be precious in His sight”

Psalm 72:12

Nutrition Center at Embangweni Hospital, Malawi

 A poem remembering Rebecca Morton who made F100 (a milk supplement for severely malnourished children) in her blender one night, after the electricity came back on. I walked back to the pediatric ward to deliver it around 10pm.

 To learn more about what's happening in Malawi http://www.mbfoundation.org/

A Family Mission Trip To Malawi

Last August, our family spent  five weeks at Nkhoma Hospital in Malawi. While Jim and I worked in the hospital, our children Miriam 22, Ruth 19, John 16 and Christopher 13 helped at Ebenezer School. Ruth became a first grade teacher since one of the teachers had left when a parent died. The boys directed recess and played a lot of soccer. Miriam read books to the children whose first language was Chechewa. We were all challenged by the living circumstances. The kids who ordinarily have their own rooms and space lived in a hut together. We walked a mile to the market to barter for our food and prepared meals as we were able between intermittent electricity outages and water being on or off with no particular warning. It was an adventure much like camping.

Like most hospitals in developing countries we found the needs overwhelming, the work physically, emotionally and spiritually challenging, staff overworked and supplies and equipment inadequate.

On the pediatric ward there were two to three children per bed, most with malaria, pneumonia and severe anemia. The mortality rate for children under five in parts of Malawi is as high as twenty percent although recently there are areas with as low as one in 8. Still throughout Africa, malaria kills a child every second. There was never enough oxygen for all the children who needed it. Every day children died. I wept with mother's as they lost their dearly beloved children. Many children had multiple illnesses. Leonard, an unimmunized 11 year old boy, was  admitted with meningitis, malaria, anemia and schistosomiasis (a disease due to poor sanitation and unclean water)  and developed measles while in the hospital.

One day a teen arrived and collapsed unconscious and unresponsive. Her blood looked like water and her hemoglobin was two (A normal  hemoglobin is 12).  She had malaria, but parasites like hookworm and schistosomiasis as well as  malnutrition can worsen  anemia. Amazingly, that afternoon after a unit of blood and fervent prayer she sat up and ate porridge. After  my 16 year old son donated blood one afternoon, he commented to his friends on face book, "I gave blood today, saved several lives. What did you do?" What a great question and a  challenge to all of us. What are we doing?

Waiting to give blood

Scripture tells us "If one member suffers, all the members suffer with it," I Corinthians 12:24. But do we really? Are we engaged in active sustained commitment to our brothers and sisters in Christ who are suffering in the world? What does partnership mean and what is our response to James 2:15 "If a brother or sister is without clothing and in need of daily food and one of you says to them, 'Go in peace, be warmed and be filled' and yet you do not give them what is necessary for their body, what use is that?" and even more pointedly in I John 3:17, "Whoever has the world's goods and beholds his brother in need and closes his heart against him, how does the love of God abide in him?"

The Lord of the universe, rich beyond measure, chose to become poor, letting go of position, power, reputation and rights. Jesus' life was one of voluntary sacrifice in submission to the will of the Father. He came for the poor, the lost, the grieving, the broken hearted, the oppressed, those in mourning, those in despair, disgraced, shamed, hungry, naked, wandering in darkness. We are called to join Him in restoring, rebuilding, renewing, planting, blessing, healing, satisfying, strengthening, watering, raising up foundations, bringing light, justice and mercy for His glory so that righteousness and praise will "spring up before the nations" Isaiah 61.

I pray my words will inspire all of us to seek after the heart of God and consider how can we get involved?