Patients in Africa
My guest blogger, Tracy RN, continues to tell us about her 2 week medical missionary trip to Africa. (See Part 1 also).
On this trip, we were blessed to eat very well. Breakfast usually consisted of American type foods, with the occasional bowl of hot cereal millet (a grain which is often used as bird seed in the USA). The nutritional mainstays for the people were millet, sorghum, and corn. Vegetables and fruits were harder to find during this season, but the missionaries were able to buy some in the capital when we arrived. For lunches on clinic days, the village church ladies would cook a big pot of rice, another pot of beans, and another pot of tasty sauce to go with it. Occasionally the sauce would have tough pieces of chicken in it as well, which I found could be challenging to get off the bone! In place of rice, they also made dough out of corn that resembled a scoop of thick cream of wheat that they also served with sauce.
Now I would like to highlight a few of the more seriously ill patients we saw during this trip. In one village, the church had built a small four room clinic next to the church building. The closest government clinics were several miles away, and many did not have the ability to get to them. I went about my daily tasks of taking blood pressures, pulses, temperatures and weights on the children, and lining people up who were waiting to be seen.
All of a sudden, I saw a woman being helped through the crowd and into one of the clinic rooms. As we began to examine her, we learned that she had just fainted outside the clinic. We were told that she had been pregnant, but had been bleeding for the last few days. A urine pregnancy test was checked which was positive, but it seemed likely that with all the bleeding, she had lost the baby. Her pulse was too high (over 100), and her blood pressure was too low (in the 80’s). I inserted an intravenous (IV) line and we gave her a liter of saline fluid. She said she felt slightly better, but was still very weak and bleeding. Her pulse remained high and her pressure low (signs of shock).
We knew this lady needed a blood transfusion and most likely a surgical procedure, but we didn’t have the ability to provide this at our clinic. We recommended she go to a hospital, but she didn’t have any means to get there. So, one of our vehicles that was heading back that evening became a makeshift ambulance. We helped the woman into the backseat of the truck and we were off, bumping along dirt roads as we drove to the closest clinic. When we arrived, we helped the woman out of the truck.
The clinic workers came out and said they could not take the woman because she was too sick. As she was standing there, she fainted again! The clinic worker grabbed another bottle of IV fluid, which we hung from the handle on the ceiling of the truck. We took off again, with the lady lying in the lap of her family member. When we arrived at the town of our destination, we assisted the lady into a taxi for another drive to a bigger clinic where she was able to receive the help she needed in time.
We heard later that she had recovered and was back in her own village again. I was very thankful to hear the news that she had healed physically, and pray that she finds the true spiritual healing that can only come from a saving knowledge of Jesus Christ.
An unfortunately common sight in these villages is that of malnourished babies. With several issues, including a poor diet, many of the women do not produce enough breast milk to feed their babies. Without breast milk, the baby does not eat at all as they have nothing else to feed them. This is a very sad and very real problem. We saw many babies who were way below the expected weights for their age. One baby we saw was three months old, yet only weighed 6 pounds! The missionary we work with has been trying to obtain formula for these babies when possible, and providing it to the mothers and following up with them, and thus has been able to help some. However, malnutrition continues to be an ongoing problem.
One last case I will highlight is that of a one year old baby that was brought to one of the clinics. When the mother arrived with the baby, she was very lethargic and gurgling on her own saliva which she was unable to swallow. We did a malaria test which was immediately positive. My brother, the physician on this trip, suspected the baby had cerebral malaria. We immediately began arrangements for the baby to travel to the nearest hospital, and attempted to start an IV in the meantime. The baby’s veins had collapsed and were very difficult to feel, and so, without any ultrasound machine, my brother placed an IV in her femoral vein in her groin. The baby was so sick that she didn’t even move or cry during this procedure.
As I began to give her the IV antimalarial medicine we had brought, I noticed the baby’s mouth begin to twitch followed by more pronounced seizure activity. I pointed it out to my brother, knowing there was nothing we could do about it. There are times when the lack of resources or ability to help in certain situations can be overwhelming when compared with the resources we have in the USA. I couldn’t help but think of the seizing adult patients under my care where I simply rush over to the machine outside the room, grab some IV Ativan, and give it almost immediately. In this case, the seizing baby was taken on the back of a motorcycle to the nearest town that had a larger clinic. I prayed for the baby and wondered if she could possibly survive.
Later on that day, to our great joy and surprise, one of our team members passed the mother and baby on the road returning to their village. The baby looked much better, as it seemed the anti-malarial medicine had begun to work! I am so thankful that God chose to save that baby. Life is truly in His hands!
In whose hand is the life of every living thing, and the breath of mankind. Job 12:10
Pamela's Nursing Reflections 