Thoughts on My First Month of Working in Kenya
All photos are used with consent and permission of mothers
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The past month has certainly been a monumental one for our family. I (Jack) have transitioned to full time at the hospital while Regan has started up a preschool for Micah and some of the other local children. It has certainly been a learning curve for us all.
Our newborn unit (NBU) at the hospital, that really functions as a neonatal intensive care unit (NICU), is brimming with sick newborns currently. Last week there were as many as 22 babies to be seen in one day. So that is where I have been spending most of my time. It’s incredible how sick some of the babies are. Three newborns weigh less than 900 grams (about 2 pounds) and we have several babies that are severely premature. Even in America, it is extremely challenging to care for babies this premature and sick. In a resource limited setting like Kapsowar, it can seem overwhelming at times knowing the best course of action to take.
One of the best parts of my job is working with the incredible nurses here at Kapsowar Mission Hospital. In America, one NICU nurse takes care of only one or two babies, but the NBU nurses here in Kapsowar have had one nurse to 10 babies at a time. It is beautiful to see their dedication to the mothers and babies God has placed in their care.
On rounds each day
On the other hand, it has been difficult to adjust to the reality of having limited resources and caring for extremely sick babies. I have had more babies die over the past month than during my entire practice as a physician. I can recount in my head each baby that has passed, each mother’s reaction, each sting to my heart.
Just the other day I had a baby born premature at 31 weeks. The mother did not have time to receive steroids before the baby was born which is done to mature the babies lung before delivery. The baby quickly went into respiratory failure. Patient’s can’t afford the medication surfactant which can greatly help the babies lung since it costs around $250 USD and people here often make only around $3 USD a day. The hospital also does not have the capacity to put babies on ventilators to help them breath. Thus, on the baby’s second day of life, I was called by the nurses that the baby’s oxygen saturation was below 20% (a normal oxygen saturation is greater than 90%) on the maximum oxygen the hospital can provide.
After arriving at the baby’s bedside and talking with the nurses I knew there was nothing else we could do, the baby was dying. So I sat next to the mother and grandmother and told them that the baby was going to pass in the next couple of minutes. I explained that I did not think we should do CPR since we could not correct the underlying issue without a ventilator. Then the mother began to weep, she wept until tears flowed through her fingers clasped around her eyes, dropping swiftly onto her skirt. The team and I sat there in the sacred silence. She and her grandmother nodded their heads in agreement that we shouldn’t do CPR. And moments later the baby’s heart stopped. The mother asked to hold her baby once last time, so we unhooked the monitor and oxygen machine and wrapped the baby in a blanket. As the mother held her baby, tears continued to stream down her face. Before long I felt tears streaming down my own cheeks. Then we gathered together and prayed.
It is really hard when I think of the resources that come to bear in America for mothers and children like these. The mother would have had regular prenatal check-ups and probably would have been given steroids before delivering. I would have had surfactant to give, a ventilator, and a one-on-one nurse to take care of the baby. But instead, here I am, weeping with a mother that has just lost her child. My heart simmering with the injustice of it all.
A prayer I found myself often praying recently is “Thank you God that you know what it’s like to lose a child.” One of my favorite things about God is that He is always on the side of the poor, the marginalized, and the vulnerable. It is in situations like these that Jesus’ words ring clearly: “Blessed are you who are poor, for yours in the kingdom of God.” (Luke 6:20-21) And even through my tears, I cling to Him, and I clasp to His promises that “He will wipe every tear from their eyes, and there will be no more death or sorrow or crying or pain. All these things are gone forever.” (Revelation 21:4)