November 23, 2005

  • First Inpatient

    November 17, 2005

     

    So much happens around here that it’s difficult to capture it all.  Last Monday Joann went out to get a one month old set of twin boys whose mother was very sick and unable to feed them.  When she brought the babies back to the farm, she told Sal about the condition of the mother and asked him if he would make a house call.  Tuesday, after clinic hours, Sal and Joann went off in the Defender, medical bag packed to one of the villages to see this woman.  When Sal walked into the grass hut, the woman was lying wrapped up in blankets on a bed positioned along one side of the hut. On initial assessment Sal found Susan very diaphoretic with a fever of 103.5, having difficulty breathing and a heart rate of 160 plus.  She was very emaciated looking, having a large weight loss within two weeks after the babies were born and now having watery diarrhea.   

     

    Sal performed an HIV test (OraQuick, donated by Abbott Laboratories and just brought to us, that uses saliva and has been found to be 99.3% accurate). As he imagined, the test was positive. Sal informed Susan of the results and immediately laid hands on her and prayed.  After removing the mound of covers over her, he gave her two injections, one for fever and one for infection.  He gave the family instructions on giving her (ORS) Oral Rehydration Solution and keeping her head elevated.  He left the village with Joann that day and returned home.  He told me, “I really wanted to bring her to the clinic, but she has to show me some fight.”  It was that afternoon when we discovered both of her babies also tested positive for HIV.  I started to question Sal with things like what are you planning to do with her?  Knowing that she can’t afford Antiretroviral ARV medication, are you going to purchase it?  Are you going to take her to Livingstone to get on the free medication program if she qualifies? Once you start, you will commit her to taking the medicine and what if she can’t get to town to get it?  What if she has to pay and can’t afford it?  To whom are you going to make it available?  How can you say no to one and yes to another?  In the middle of all my questions, Sal turned to me with tears in his eyes and a quiver in his voice and said to me, “I don’t know…all I can do is what is before me.  That’s all I know to do.  I can’t look at anything beyond that.” So Wednesday, again after clinic hours, he returned to the village to check on Susan.  This time when he walked in he found her sitting upright with a temperature of 100.8 and a pulse of 130.  Her breathing was less labored and she was not diaphoretic.  After discussion with her and her family, Sal brought Susan and her mother to the clinic to stay for a few days in order to give IV’s and IV medications and monitor her more closely.  This morning, Susan was alert and more responsive, breathing easier with a temperature of 97 and a heart rate of 110.  She got up and with the assistance of her mother walked across the farm compound to go to the bathroom.  With ORS, IVs and IV medications for fever and infection, tonight she is at 97 with a heart rate of 90.  Whenever anyone goes to a medical clinic to stay for any length of time, a family member always goes with them and stays.  The family member is responsible for meals and giving any help the sick person may need like assistance with bathing and walking to the bathroom, etc.

     

    Now you may be wondering where I was when Sal was making the house call with Joann.  Well, I had a previous commitment to teach in the primary school here on the farm (about 70 students from second and sixth grades).  I had promised to teach about teeth.  Armed with 70 toothbrushes and 70 tubes of Colgate, I met with the whole group in the church building.  When I asked the kids if they brushed their teeth, I was pleasantly surprised that most of them said that they did.  I was equally surprised when I asked what they used for a brush and all but one told me a stick.  They told me they get a soft stick, chew one end until it’s frayed and then brush their teeth.  When I asked what they used on the stick, the answers varied: ashes (from a fire), salt, some stuff whose name I didn’t catch used to make okra and just water.  These students were very attentive, smiling, answering questions and they were very excited to get their toothbrush and toothpaste.  I decided after hearing what they were used to using, that dental floss would just be too much!!!  When I asked them if they knew what the doctor who took care of teeth was called, no one could answer,,,,and that’s simply because there are very few if any actual dentists in Zambia.  The reason I was stirred to teach about teeth was because of all the sore mouths, toothaches, broken teeth, abscesses, missing teeth etc that Sal and I have seen in the clinic.  That, along with all the donated toothbrushes and toothpaste was my incentive.  After the class, the teacher asked me if I had noticed any difference in the children.  I told him they seem to be more attentive today than the last time I taught and they are smiling more.  They have been playing games between classes outside the clinic and have been horsing around more at the water faucets.  He smiled and said “That is all because of your program.”  I asked what program because I did not understand, and he said the “feeding program.”  Ever since Sal started supplying the students with a bowl of HEPS (High Energy Protein Supplement), he said he has noticed a difference both in the classroom and on their faces.  Praise the Lord!     

     

     

     

    Renee has been composing all the updates so far, but I felt the need to add this because it is on my heart…...

     

     

    Susan has a dilemma that I fear is common to a lot of Zambians:  What to do now?  To receive the free HIV Medications from the government she must travel to Livingstone for additional blood tests to determine if she meets the WHO (World Health Organization) criteria for medications.  If she does the only way she can get the medications is to travel to Livingstone once a month to pick up and sign off for them.  Now some of you may be saying what is the big deal about that?  Well the deal is that most of the Zambians that have the greatest need for the medications do not live in the cities.  They live in the bush and must travel long distances (25 kilometers or greater - 45 km in Susan’s case).  Also, please remember that these are sick people.  So their options are to walk or get public transport which is very expensive for someone that lives in the bush. Often the expense of food is all they can handle.  If they are unable to pick up their medications in Livingstone, they must purchase them on the open market.  The cost of HIV medications is about $40 to $50 per month.  This is more than the average Zambian makes in a month. (The average Zambian makes 6,000 kwatcha or about $1.50 per day.)  I do not know what the answer to this problem is, but I firmly believe that God did not send me here to idly stand by and watch as His people perish.  But I also realize that the problem is beyond anything that I can do, so I will stand and watch God work this out as only He can.  Thank you for your prayers, your encouragement and

     

    your support.

     

     

               

     

                                        Susan's Home

     

     

     

                               Susan in Hut

     

     

                           Susan in Clinic