We have been enjoying our time here as much as ever this past week. As to the norm, God continues to do incredible, miraculous things here. I wish you could be here to witness it all first hand.
This little guy is standing on the streets of downtown Karanda. The word is that this little place was quite busy back in the day. With the economy suffering here, most of the shops are closed and the street vendors are elsewhere.
This is one of God's miracles. She recently fractured her hip and went to surgery to get it fixed. The day after surgery she looked like her days were numbered. The second day after surgery the only response I could get from her was a slight grimace to pain stimulus. She was otherwise unresponsive to audible or visual stimuli. During rounds I explained to her daughter, standing to the left of the patient in the pic, that she had a very poor prognosis and that she would most likely not be with us much longer. "Oh ye of little faith...." so goes the well know scripture. I nearly withdrew all care so she could die as comfortable as possible. We then decided to place a nasogastric tube and give her liquid feeds to provide her some source of nutrition. The daughter placed her mother's life in the hands of our Lord and prayed. Needless to say, the next day on rounds the patient was wide awake, smiling, and talking. Wow, wow, wow.....God never ceases to amaze. I went back to the patient yesterday to take this picture to find the daughter just full of joy and thankfulness. As we talked I said, "You've been praying, haven't you." She just smiled ear to ear and said "Yes."
This is yet another of God's gifts. The woman on the left was transferred to us one afternoon at 4 pm with a histoy of continuous vaginal bleeding after a vaginal delivery at 9 pm of the prior day. The baby was doing great, but the mother was in hypovolemic shock. She was anxious and sweating with a blood pressure of 80/40 and a thready pulse in the 130-140s. We then had to decide how to best care for this patient. It may seem straight forward for some of you, but let me remind you that you are in an African country that is currently withstanding a devastating economic crisis. So, with that said, we have no donated blood available and only about 3 bags of isotonic i.v. fluids. One of the hospital workers thought we should send her to another nearby hospital where they reportedly have blood to give and i.v. fluids as well. The only concern with that option is that we will never know what kind of medical attention, if any, they patient will receive from a physician. Many of the physicians here are on strike or are working in a very limited fashion due to economy. Some of the hospitals have closed altogether, and some are operating as a clinic only. So, what do you do? After a meeting of the minds and a changing of our plan several times, we decide to first take her to the theatre to see if we can find the cause of her bleeding. Oh yeah, and Dr. Stephens, the surgeon, is out of town for the weekend. So we get her to the theatre and find that the entire placenta is still in her uterus. She is given ketamine and the placenta is extracted and the bleeding almost completely stops. Her vital signs are still about the same, and we get her hemoglobin result back, it's 5 (normal is somewhere around 12). We tried to get her typed and crossed for a potential blood transfusion, but I guess the lab tech decided it was time to go home before the test was completed. If we were to give her blood, it would have to be someone who has the lowest risk of HIV because we just ran out of the kits to test blood for HIV, i.e. one of us would need to donate. But, we never got her blood type result back and it's Friday, which means that we will not be able to get any labwork done until Monday and a result most likely not until Tuesday. So yeah, managing something like this can have it's challenges here. Anyway, after the placenta is removed, the patient is sent to the "ICU" with our last bag of isotonic i.v. fluids. What do you do next? That's right, you pray and watch God's hand at work. And then you get to experience the true joy of being a part of God's gift to the three generations of family in the above pictue. What a blessing of blessings this is.
The mission field experience isn't always nothing but miracles and praises as many of you know. There are often very tragic things that happen her that are difficult to understand and accept. One such case involves the baby girl above. She was attacked by a jackal and suffer many lacteration to the scalp. We were all concerned that the jackal may have had rabies and transmitted the virus to the baby during the attack. The patient's family was able to purchase some rabies vaccine (we have none here), and we were able to give it to the patient. We also cleaned her wounds and repaired the lacerations. She did great during her hospital stay and the sutures were removed in about 7-8 days. She never had a fever or any other concern while she was here. We then decided to let her go home to finish the rabies vaccination course at her local clinic. A few days after her discarge, we received news that she had been doing very well and then died suddenly during the night. The rabies virus can act very slowly, but the news of her death still had us stratching our heads. Did she die of rabies? But she had received nearly all of the vaccine course. Was the vaccine given properly and soon enough? Was the vaccine still good or had it expired or was it not stored properly? Was it even rabies that she died from? The jackal's head was sent in for examination to detemine if it had rabies or not, but I kinda doubt we will ever hear back from them. So...many questions and not many answers.
This is a pic of the guesthouse here at Karanda. It's been a more than adequate place to stay. We have running water (at least in the mornings), electricity (most of the time...especially here as of late), a small open air courtyard in the middle of the building, a computer / TV room, a large meeting room, fully equipped kitchens, wireless internet (yeah....crazy isn't it), a laundry room, and even a nice little gazebo out back.
This is one of those "only in Africa" pics. If you look closely there is a sign posted on the tree that basically says "car parking" in Shona. This is the "parking lot" outside the hospital, and we do tend to have quite a few cars parked in it from time to time. I chuckled when I saw that this guy decided to park his ox cart in the parking lot. Makes sense.....why not? ....just kinda funny nonetheless.
So were still experiencing the beautiful changes of springtime here. This tree is known as the Flamboyant tree around here. It's red blossoms are quite stunning and add great color to the landscape here. I wish I could take own back home with me.
This is another pic from downtown Karanda. The guy up front here is holding his dinner......a little black chicken. The lady back by the ox cart is waiting to load up some ground corn from the corn mill inside the shop.
Here's Katie working on a bleeding wound on a patient in the theatre.
Here Katie and I are taking out a calcified trochanteric bursa on an ol' ambuya (grandmother). That thing was as hard as a rock! We both laughed when the patient asked to see it after it was removed and then oooh'd and aaah'd over it as she poked it with her finger.
This patient here has a jaw tumor that we may be taking out soon. We're waiting on the pathology to come back first. If it's a Burkitt lymphoma tumor, we'll try a chemotherapeutic agent before any surgery is done.
Here's Katie and I enjoying an African sunset walk. Katie just finished her time here and has since arrived safely back home. Everyone loved having her here, and our time serving at the hospital together was incredibly enjoyable and fulfilling. I'm now suffering from KWS (Katie Withdrawal Syndrome).....so any and all prayers will be appreciated.
Well I think that's all for now.
In HIM>
kevin.
kevin.
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