Today I’m on the ward with the children who have been discharged from the ICU. During rounds I watch Dr. John, one of the neurosurgeons, discuss each child with the medical officers. He greets each mother and says “Are you happy today mama?” He explains in very simple terms what is happening and what they can expect. He tells one mother she can take her baby home now, but she will need to come back in a week for further treatment. The mother cries and tells him she cannot afford the 8,000 Shillings (about $5) to ride the bus to go home and then back. Sometimes this happens and CURE will let them stay over. Sometimes the women have no home to return to.
A baby was brought in last night with sepsis. His mother was putting cow dung on his umbilical cord because she thought it would dry and fall off more quickly. The antibiotics that were started here could do nothing for the massive infection and the baby died. Four more die by the end of my first week.
On Thursday I observed a craniotomy on a 2 month old. I asked the surgeon if the baby was dropped? How did he get this head injury? In the US we would probably assume child abuse for this sort of head injury. He told me the child’s house fell on him. Many of these people live in mud and straw huts, and when the rains come the roof caves in and the houses fall apart. So sad.
The OR had a full schedule of surgeries yesterday so the PICU is full. Today there is no water. I am told the tanks have run dry. The surgeries scheduled for today will have to be pushed back until tomorrow. The mothers have traveled so far to be here and then they must wait. We are never sure if the water or power will be off, or what child will develop a fever and be too sick for surgery.
I meet a woman from Sudan. Her daughter is 17 and has a brain tumor. Once a healthy teenager, she is now deaf and blind. Her words are unintelligible. The family did not know to take her to a doctor when she lost focus in one eye, but when she went blind and her behavior changed, they had to. Even then they could not come right away because they did not have the money to travel. Today the surgeons will try to remove the tumor, but are not sure if it will restore her sight.
Another young mother tells me her back is hurting. I know it must be painful because she never talks about herself, only her daughter “Mercy.” I can’t help but wonder if her back hurts from her cramped bed, from lifting her 4 year old daughter heavy with hydrocephalus or because she is so worried about Mercy’s surgery tomorrow. The mothers come with their babies and rarely does anyone accompany them. Such a heavy emotional load for a young mother to bear alone.
In the next bed is a 1 month old baby who looks chubby and has a healthy cry. He has myelomeningocele, a condition where the neural tube in the spine fails to close. He is having surgery tomorrow also. I see his Mom struggle to keep him dry, but there are no diapers, cloth or disposable. The mothers use thin rags from torn up sheets that they wash when they are soiled and then use again. Not the best for preventing infection when your spine has a hole in it. Children with this condition are incontinent of urine and stool and have a constant stream of both. The mothers simply keep wiping it away. It’s almost impossible to keep their incision clean.
I spend the afternoon cutting my brand new, lightweight flannel robe from Land’s End into large squares. The material is absolutely perfect for soft diapers – even if it is magenta. I can’t help but giggle as I think how silly it was to bring a flannel robe to such a hot and humid country. Now it makes perfect sense.