Monday, April 29, 2013

Update on Angel!

Angel was the woman in the previous post with severe pre-eclampsia. I went to see her this morning and surprise surprise she was holding an adorable viable baby boy!!!! She was watching tv last night in the ward and thought that she wanted to take a bath. Went to the bath tub and out he came! She delivered him by herself! She called the nurse and was cared for and the baby is doing great! He was only 28 weeks gestation and is a mere 1.9kgs but he is eating and doing well on his own!! Just the fact that he doesn't need to be in the NICU is a miracle in itself!

I am so thankful that not only did she have a safe delivery he is doing so well on his own! Thanks for your prayers!

Sunday, April 28, 2013

Four Weeks and Purpose

Currently there is a week old little girl at the hospital.  When her mother was pregnant the doctors told her the baby would be born without a brain (anencephaly) and therefore could not live. Regardless, the mother believed God would do a miracle and that her baby would be born alive.  And she was. She was born perfect and alive except for one problem.  She was missing the top part of her skull and any skin covering it.  She had good reflexes, could suck and respond to the world around her.  Her mother named her Purpose saying that God has a purpose for her life. 
The major problem is that there are not facilities here to give her the care she needs. She would need an initial surgery to fit a temporary skull with a skin graft but she is still too young to do this. The doctors here said that the best they can do is wait a couple of months until she has enough skin to perform a skin graft to cover the brain. But this is only a temporary solution. At this point she needs a miracle. Initially she was left to die. Our team stepped in and she has been getting regular dressing changes and her mom is feeding her. She is fighting the clock against infection.
We are also checking out any connections we have in the first world to possibly have someone take her case on as a charity.  Please pray for this family as they face tough decisions. It is so hard when you have to consider quality of life and the costs that they cannot afford.  They also live in a worldview that says why feed the child and change her bandages if it will only prolong the inevitable? But she is not hooked up to any machines. She is eating on her own and responding to life around her. God is keeping this little girl alive.
Angel is a mom who is 28 weeks pregnant with her second child. She has had severe pre-eclampsia for the past 5 weeks. Doctors have been urging her to have a c-section to avoid any risk for seizures or worse.  She knows that if she delivers the baby now the chances of baby’s survival are less likely so she keeps refusing. She is asking God to make it to a more viable time to deliver so her baby has the maximum chance of survival. I met her weeks ago and she is still holding strong! We keep asking for the Lord to keep baby and mom safe and for a successful term delivery. 
This was a very heavy week at the hospital. We saw and experienced many stories of loss and heartache. We fought for life and many times weren’t successful.  I am trying not to make these posts too heavy so I will spare you more details.  I have been wondering why things here seem so much sadder than India or Tanzania. I realize now that it’s not any sadder but we just are understanding more of the full story because English is spoken. 
On Tuesday I delivered an adorable baby boy.  He was doing great on the inside until mom started pushing and not very effectively. This is common in first time moms because it takes awhile to understand how it’s done.  The baby’s heart rate was dipping really low and not coming back up after the stress of pushing. After a while it was obvious we needed to get this baby out!  The mom was having a hard time and I discovered when I reexamined her the baby was turned a quarter turn in the wrong direction.  Aha! We quickly flipped her over on hands and knees which can cause the baby to turn the right way and come out. It worked! Thank you Jesus that I paid attention and knew what to try! The baby needed some suctioning and stimulation but thankfully responded well! It spent a couple of days in the nursery because of grunting but is doing really well!
We have a little less than 4 weeks left here! In about 7 weeks we will be back on American soil! It’s so hard to believe. We are so excited to be almost finished but at the same time are in awe of all that God has done this year. It’s been one of the most difficult and challenging things we have done, but one of the most amazing and rewarding.  We have learned God’s faithfulness and how to push the limits of what we think we are capable of.  This is definitely something that has formed us, shaped us, and hopefully helped us to gain God’s heart. We know it has inspired us to go where God is at work and join Him.  We cannot thank you enough for your prayers and know that you helped carry us through this year.  We want to finish strong!
I leave you with more random pics.
This was my trademark in Tanzania.  I always ate cold beans out of a can at the hospital because I needed to eat frequently because of being nauseated and there were not a lot of options. I always got mocked for it. One of my teammates took this picture.

One of our teammates Keisha also gave the kids a gift of snow one day. She had defrosted the freezer and saved it for the kids.

Keisha and I after watching a c-section.

We have no oven but we made mircowave mug cupcakes!
one of our hilarious leaders ready for a day at the hospital! Love the socks!
Busy homeschooling with Daddy.

Wednesday, April 24, 2013

Birthday Roadtrip!! To Livingstone I presume.

So, Monday I celebrated my 36th birthday. And on top of getting a really cool hat I was blessed with a weekend to travel with my family to one of the most amazing places on the planet.
Livingstone, Zambia is about a 7 hour drive south of Lusaka where the Zambezi River creates the natural border between Zambia and Zimbabwe. It was named after the famed Scottish missionary/explorer David Livingstone who was the first non-African to set eyes on what is today Victoria Falls. About 10 years later he went inland again, from Zanzibar along established slave trade routes with the purpose of sharing the Gospel with people who had never heard of Jesus, finding the source of the Nile and working to end the slave trade,. Today he is one of the few European explorers who is still respected by modern-day Africans.
Victoria Falls in a word was stunning. We had brought light rain jackets to ward off any spray but it was like standing in a full on shower so you really have no hope of staying dry. Super fun! Makes it hard to take pictures though. As you walk along the viewing area you come to a deep gorge and “Knife Edge Bridge” which is what it sounds like but probably safer. When you’re close to the falls there’s just tons of mist and spray and 70% of the time you don’t see anything and then everything clears and, wow! “Majestic” can be a pretty cheesy word but this is a place where I would use it unreservedly. Majestic, stunning, yeah. “Wow” might be the best word.
There was also a nearby game park. It was pretty small but perfect for us to do an early morning and late afternoon game drive. Some of the gamekeepers with their AK’s even took us on foot to see the rhinos. What a great birthday! Enjoy the pics

Redbilled Hornbill

Warthog (Pumba?)

Heather and the kids eating lunch in the car because of........

The nearby hippo wanting to join us. Cowards!

An impala marking it's territory. One of the weirdest things I've ever seen.

Buffalo herd.

You lookin at me?


This is a mama rhino with a 2 year old baby.


Victoria Falls. Seventh natural wonder of the world. Beautiful.

You can just make out the bridge through the mist that connects Zambia to Zimbabwe.

A leguan. I almost hit him with the car. Oops!

More impala. I had impala stew the first night in Livingstone. Yum!

If you're familiar with Go Diego Go you may know about symbiotic friends.

A bit of light afternoon grooming.

This scene was great. It was like grandpa baboon got stuck babysitting again.

 So while putting this all together we left Abigail and Josiah playing in the nearby dirt pile. After a while Abigail had a plastic cup and I could hear her making frequent trips to the water tap behind the house. I knew what was coming. Sure enough...

Good times. But I think I'll invest in a deworming treatment before leaving the continent.

Thursday, April 18, 2013

Life and Home Stretch Musings.

So praise God! After one week of paperwork and tons of running around by our amazing staff, we are all legal to work in Zambia. This is amazing since in Tanzania it took us 2 weeks to get approved and 3 months to get an actual legal  stamp in our passports. We actually got our stamp just 2 days before leaving Tanzania!! Whew! So this is much improved and we are really blessed to be back up and running in the hospital.  

Just wanted to give you update of the 15 year old hope that was bleeding from a post or 2 before. Remember the young girl who had delivered at home and was bleeding, yet wouldn't let anyone near her? Well I got and update from the doc I was working with that day. They ended up taking her to operating theater because even the senior doctor could not examine her even with sedation.  She ended up having tears throughout her entire birth canal.  Thankfully operation was an option because she would have kept bleeding and not made it.  Today she is doing well and her and her baby were discharged in good health! 
I also heard word about the young 15 yrs old momma who had a baby in distress but was waiting for hours for a c-section.  She was finally able to get the operation and the baby is still in the hospital. I am unsure if the baby will make it but so far it is alive!
It’s good to be back in the hospital this week. I was in the labor room last Tuesday and spent all day with a laboring momma. This was her 5th pregnancy so I thought was gonna be a fast one. She had her first by emergency c-section 13 yrs ago because the baby was 3.9kg and obstructed. Since then she has had 3 normal deliveries so she was in the clear so to speak for her 4th normal delivery. Since her first four babies were large and her first delivery was a cesarean the doctor was concerned and kept asking me to monitor her for signs of shock. This can be a sign that the uterus is actually rupturing. Everything was progressing along fine until she reached about 9 cm and I noticed some active bleeding. I did a quick V.E. (vaginal exam) and although most of the cervix was gone there still remained a segment not dilated and very swollen.  With the bleeding and the mysterious tissue that I deemed was a portion of the cervix I decided to inform the docs. The first doc came in and said the tissue was actually placenta and that she should be rushed to theatre. The second doc said it’s probably just swollen cervix but with the bleeding and her slow progression past 8cm she still needs to go theatre in case of a rupturing uterus. Her vitals had also dropped and labor slowed way down in the last hour. I went with her to theatre and a beautiful healthy chunky baby girl was delivered.
Afterwards the doc was really nice and spent time explaining the risks and signs of a rupturing uterus and some of the signs the patient was presenting. She also said when you’re in a position with limited monitoring resources sometimes you just have to go with your gut and to do what’s best for mom and baby. If her uterus had ruptured with that current amount of staff and supplies there was a good chance that mom and baby would lose their lives.
 In India they didn’t usually even attempt to let moms try for a natural after c-section. Sadly they will even go so far as to let a baby in distress die with the thought, “Once the mom has a cesarean she’s stuck having cesareans for the rest of her pregnancies and if she can’t afford the medical costs she’s better off letting this one go and trying for a natural delivery again with the next pregnancy”.  This was an actual conversation I had with a health professional there during a labor! Thankfully our team was able to spend a lot of time with the staff advocating that every life is worth fighting for and in that particular case above, thankfully a beautiful baby boy was born that day. 
In Zambia and Tanzania they’ve been more willing to let mothers labor after c-sections. This is partly because they don’t have the surgical staff or the after care staff to give every woman a c-section for her future pregnancies. I’ve seen mothers with the vertical incisions labor and do well.  However, this last weekend a woman lost her life because her uterus ruptured (this wasn’t a VBAC) and despite surgery to remove her uterus, and over 7 liters of transfused blood they were unable to save her. This was one of 3 ruptures that happened that week. 
Again, I’ve really been thinking a lot about why I wanted to get this training and constantly trying to make sense of everything I am seeing and experiencing in these 3rd world settings. I came across this statistic this week from the World Health Organization.
“About 1000 women and almost 10,000 newborns die every day due to largely preventable complications during pregnancy, childbirth and the immediate postnatal period. In addition, every year, nearly 3 million babies are stillborn. Many of these lives could be saved if every birth were attended by a midwife.”
I know these statistics seem high but I’ve seen these things. I’ve seen so many babies with heartbeats hours before being born dead because someone didn’t pick up on the baby’s distress early enough. I’ve seen babies not even make it to term because of malnourished or anemic mothers. I’ve seen mothers come close to bleeding to death because their uterus failed to deliver the tiniest portion of membrane (left over from the birth sack) or their uterus was unable to contract from being tired but their life was saved with IV fluids, an oxytonic drug and a staff member with training. Our team has been fortunate not to have lost mothers but mothers have died at these hospitals during our time in these places and we had been monitoring the mother that was in the case above.
I’ve also seen babies born completely flat and God bring them back to life, sometimes through resuscitation, sometimes through straight prayer and intercession. I’ve seen mothers stop bleeding after praying when everything else was failing to stop it. I’ve seen God do things that make no medical sense.
I can’t make sense of everything but what I can say is that God loves life. God wants life to be fought for and he is looking for God fearing midwives and other medical staff to fill the gap. I am so grateful to have had this experience, to have this training and to know that I could be available someday to save a life. God loves people so much and has a special place in his heart for mommas and little ones growing inside them. They are loved. They have value. 
I leave you with a few pics from the past 2 weeks.