Amalia’s Story
As it goes with much of life, time seems to pass quickly here. A lot has happened since we moved to Kapsowar. Regan and I (Jack) have tried to do our best to keep people updated; however we certainly wish we could do more, in-between our work, adjusting to life here, and raising two young children.
A lot of people have asked how working at the hospital has been. It’s been incredible to put it simply. Now, do not mistake me, when I am working 72-hours straight and am woken up at 2 AM for the third night straight, it certainly makes me rethink what I am doing. But since my time here I have literally seen miracles happen before my eyes and I truly think I have the best job in the world.
Before I fully jump in, I want to take a moment to say thank you to everyone who has made this dream to bring healthcare to a remote part of Africa a reality. This blog post is dedicated to all those who have supported us in our moving to and serving here in Kapsowar. Without you we would not be able to do what we are doing. Your support is saving lives here, and that is the definition of being the body of Christ.
As I’ve mentioned before, I work on the inpatient adult ward, pediatric ward, and newborn unit (NBU), but I spend most of my time in the NBU which often has the sickest patients and is the most specialized unit. Our newborn unit usually has anywhere from 10-22 babies in it at a time. As a referral hospital for the area we often get the sickest babies sent to us from around the county. That means we often have a handful of patients with extreme prematurity or in critical condition. Caring for these babies is hard enough in the US, even with all of the tools and support services at physicians disposal. But here, in an under resourced area where many of the mothers often can’t afford diapers, caring for these precious little ones is daunting to say the least.
For example, the other day we had a baby born two and a half months premature who developed severe respiratory distress. The treatment is to give a medication called surfactant which is about $230 USD which is often just unattainable for most mothers here. Without the medication the patient slowly spiraled into worsening respiratory failure and died while her mother looked on helplessly. Because of this issue, thanks to all of our supporters, we have now purchased several doses of surfactant which just recently arrived.
Yet, against all of the odds here, we are making great strides. This next story is really just one among many, that highlights the work we are able to do here, all because of our supporters.
Last month a newborn baby, Amalia, came into the hospital incredibly ill with a severe infection, kidney failure, and seizures. They had some of the worst labs I have ever seen. Their creatinine (a kidney marker lab which should be low normally) was over 800 (a normal level is less than 100), their sodium was the highest I have ever seen (often a marker of extreme dehydration, it was 191 for those who are medical), and they had an extremely high blood potassium level. With labs like these, she could die at any moment.
So I started treatment and then took the entire family that was present into my office. There were perhaps ten family members, a nurse, and myself cramped into my office for the meeting. I informed them that the patient was extremely sick and unfortunately was likely not going to make it. I explained that they had some of the worst labs I had ever seen and that the baby needed to go to the referral hospital in Eldoret for emergent dialysis. After I spoke, they all convened together. Their reply was that they wanted Amalia to stay at the hospital with me. I am not exactly sure of their reasoning. I don’t know if it was a cost issue, a lack of hope the baby would make it, or confidence in me. I like to hope it was the latter. Never-the-less, I told the family to please pray for a miracle and have everyone they know pray as well. Then we all stopped and prayed for God’s intervention that evening.
The next day I walked into the NBU and was so relieved to find her still alive. The nurses explained that their seizures had stopped after the medication I had given, but reported she was not moving or crying, even when they placed an IV, which is a really bad neurological sign. We did labs and thankfully the sodium and potassium had started to improve slowly. However, their kidneys were still not working and she was still not urinating. So we adjusted her IV fluids and continued to pray.
Amalia and her mom at the resuscitation table
Thankfully, the following day, Amalia started making a little urine! Yet, she was still not moving or responding at all. The mother, who was sitting at bedside during rounds, was obviously dismayed. I explained that there was some improvements, but there was a long way to go. I’ll never forget as she nodded her head in understanding. She didn’t say much, but I could feel the tension of her clinging to hope, but also trying to prepare for the worst. My heart was doing the same.
The next day Amalia started moving his limbs, a glimmer of hope! We again adjusted our treatment as the urine output was steadily picking up. After we finished rounding that day I told the NBU nurses, “if Amalia survives we are all going to have a big party after she goes home.”
We have a special resuscitation station located in the NBU. It is basically a bed under a warmer next to the nursing station where we keep critically ill babies so we can keep a more careful eye on them. Amalia stayed at the special resuscitation station for approximately three weeks, each day making slow improvements. She slowly began to cry and then her fully body swelling began to decrease as her kidneys began to recover. The mother, who initially was downcast, began to smile on rounds. And after approximately two months of intensive care in our NBU, Amalia and her the mother went home. She was breastfeeding well and had no apparent neurologic deficits at the time of discharge.
Although I chose Amalia’s story to tell you, the fact is that hers is just one of many similar stories. Now the last thing I want to do is put myself on a pedestal, but in all reality, Amalia and many others would not survive without the advance pediatric training that I have been blessed enough to received. I tell this story not to pat myself on the back; in fact it feels incredibly untoward for me to write that last sentence. I tell it because I want all of those who support us to know that your support and sacrifice is truly saving lives and I want you to share in that joy. There are few more beautiful and joyful moments than getting to tell mothers that they get to take their healthy newborn home. I wish I could properly describe the utter joy and happiness that the mother had at hearing the news that she was going home with her baby that day. And I want all of you to share in that joy as well, because without your help, without you being the body of Christ, this would have never come to pass.
So again, thank you, most sincerely,
Jack and Regan Strutner