January 23, 2006

  • Patients

    January 17, 2006

     

     

    Last Thursday…the Land Rover was packed with 7 patients, 1 family member and 1 baby in lap.  These were some of our HIV patients we take into Livingstone Hospital for ARV medications. This time we had 5 new patients and 2 reviews (follow-ups). Livingstone Hospital is the only place in this area to get the Anti-Retroviral medications for HIV and the system has been frustrating to say the least.  We have had difficulty with many departments.  Problems with the Lab….no reagents to do tests that have been paid for, lost blood samples so patients have to have their blood redrawn and return in a week, and disorganization with finding results amidst a sea of papers. Problems with the Outpatient Department….clinical officers not showing up at all to see a whole Outpatient Department full of patients, long cues (lines), and nurses with attitude.  Problems with Pharmacy…. medications out of stock, long cues, and changing locations.  Problem with Registration and Cashier….we have never been charged the same thing twice when registering patients to be seen.

     

    This was the largest number of patients we had brought at one time and we anticipated a long day.  ……….But today was to be different.  When we got to the lab, (where by the way I had almost burst into tears the week before and prophesied a full state of the art lab at Sons of Thunder with all properly working equipment and a never-ending supply of reagents.  I told all the lab techs standing there listening to me to get ready if they were tired of trying to do a good job with inadequate equipment and supplies because we were going to be needing them!!)  Today when Sal and I went to the lab to get results for 5 patients…anticipating a total of 20 pieces of paper scattered all over the room….we were ready for the fiasco.  But to our amazement they greeted us with a smile and handed me 5 stapled packs of results!!  One patient’s tests did not get completed because the blood clotted and they taped the tube on the pack to show us.  I was so impressed and thanked them for their organization and efficiency!!  All the patients this day qualified for the drugs except for the patient who needed to have her blood redrawn, so with the results in hand we proceeded to register our patients and then take them to Fast Track.  When we registered the 5 new patients and went to pay the Cashier, they told us there was no charge because they were HIV patients!  Now all this time we have been paying 10,000 kwatcha each for an OP registration card….so this was a blessing today and saved us 50,000 kwatcha(about $14-15)!!  The staff at Fast Track was taken back with so many patients even though I completed all the interviews and filled out their initial paperwork for them.  The Administrator came to see us and requested that we let them know next time how many we would be bringing….now imagine 6 patients threw them into a spin!!  They felt stressed!  The physician that they saw was from Lusaka and he was happy that people were being treated, but nevertheless we promised to stop in on Tuesdays and inform them of the numbers they can expect on Thursdays.  That seemed to ease the situation and we were out of there by 12:30pm!!!!  Thank you, God. 

     

    The smiles on these faces when we walk back to the vehicle are worth more than gold.  Clutching their medications they have a new hope.  They see a reason to live. Now you are going to say “But Jesus should be their hope” and we agree…..but I think they see Jesus through us.  What they see is that Jesus sent us to show them He cares …to show them they are worth it….to show them that their life matters….to show them the love of Christ.  Just months or weeks prior they may have been dying in their huts crying out to an Almighty God in despair and hopelessness….and now they know that God answers prayer.  Even Jesus, my friends, met people’s physical needs.  When Jesus fed the multitudes and healed the sick…He had compassion on them and met the physical needs He saw in front of Him.  I believe we likewise are to meet the needs put in front of us.  Jesus said whatsoever you do for the least of these brethren, you do for Me.  Ours is not a ministry to just preach the Gospel.....I believe this ministry has been commissioned to show it. For a year prior to our leaving the US, our Pastor had us going out into the local community on Sunday afternoons meeting physical needs…practicing servant hood…living the Gospel…making a difference.  I see now where our preparation was not only believing the Gospel and sharing the Gospel…but actually showing the Gospel in action!!!

     

    It’s only halfway through the month and we have already seen over 400 patients!  More than 50% continue to be new patients coming from all over….from Zimba (about a 45 minute drive one way) to Livingstone (about 25 minutes in the opposite direction)!! Since Linda and Mike returned to the States, we have seen over 15 inches of rain….mud everywhere…water everywhere….rivers rising….even the dam nearest to the farm broke with the force of the waters.  So much rain is also not good for the crops….I am not a farmer but even I recognize too much rain is just as damaging as not enough.  Everything in moderation!!! Because of all the standing water, the mosquitoes are out in force.  So, needless to say, we are treating a lot of malaria.   We have seen multiple cases of cerebral malaria in young children.   Having only one bed in the clinic has proven a problem as we have had to sponge bathe children under trees to aid in bringing down fevers as we wait for the injectable medicines to take effect. Probably the scariest case was a five year old little girl named Ilena who came in with a 105 degree fever with delirium.  We immediately stripped her of clothes, praying over her as we went, started an IV and gave her a concoction of IV medications…one to bring down the fever, and one to save her brain. She was then carried over to the bed in the other clinic room and we started to sponge bathe her, teaching the mother and father how to do it also.  After a few hours, her fever had come down and she awoke recognizing her parents and talking coherently.  Hallelujah God!  She stayed with us for the night as we observed her fever and started her on oral medications.  We got her to take ORS and then eat….She went home the next day on oral medications with a normal body temperature.

     

    The Zimba Hospital runs have included another woman for surgical removal of a breast mass and three TB patients.  One of the TB patients, Liz, is also HIV positive.  Before we can get her on HIV meds, we had to take care of her TB….her chest x-ray was completely white on the left side!!!!  That means that her entire left lung was filled with fluid…there was no air exchange moving on the left side.  She had so much fluid that even her trachea (windpipe in the throat) was shifted over to the right, not in the middle as is normal.  The American doctors were still at Zimba thankfully and removed 4 liters of fluid from her lung!!!  She is breathing much better now. J   She is staying at the hospital until the general surgeon gets there today to see if she needs a chest tube for awhile….Once the lungs are somewhat under control…then we will concentrate on the HIV

     

    Another one of our antenatal patients went into labor one day last week and came to the clinic at 10:00am to deliver her baby.  After 12 hours of contractions with very slow dilation….the labor pains just stopped!  We could still hear the baby’s heartbeat which was strong and steady…..baby was in position…everything seemed to be alright but why had labor stopped???  Not being experts in Obstetrics, we decided at 10:00pm to take her to the hospital….they requested to go to Zimba.  The American doctors had already gone but we knew there were Clinical Officers and midwives there and we thought that the Clinical Officers at Zimba could do C-sections.  No one at the hospital answered the phone when we called, so we just headed out with Ruth lying on the back seat with her head in my lap.  Forty-five minutes later we arrived at Zimba only to find out no one was able to do a C-section…..but they did call the ultrasound tech to do a sonogram.  The ultrasound showed cardiac function and baby in position….placenta was okay and there was no rupture of the uterus…..so WHY did her labor stop?  Well, the ultrasound tech started conversing with Ruth in Tonga and we discovered that she had taken a traditional herb to initiate her contractions.  The herb causes very strong uterine contractions but the cervix doesn’t dilate or dilates very slow…..then the medicine just wears off.  The problem is that a lot of these women have ruptures of the uterus and the baby dies….and if in the hut, probably the mother too.  Is this another reason for maternal/child death?  God just uses all kinds of situations to teach us things!!!  All things are revealed in the Light!  Armed with this new knowledge, we proceeded to Livingstone Hospital (approx another 65-70 minutes) again holding Ruth’s head in my lap as she slept on the back seat. A nurse met us at the door of the hospital and wanted to know where her antenatal card was…..I told her we didn’t have her card with us and she proceeded to insist she needed to have the card so they could tell the fundus height etc.  It was after midnight and I had about all I could handle at this point…I proceeded to inform her that we didn’t need the card to tell us the fundus height since we had the fundus with us!!!!  She became very quiet and led us to the maternity ward with Ruth in a wheelchair.  I told her instead of being a nurse to the card that sometimes we just had to be a nurse to the patient!  Sal was behind me just smiling and shaking his head. I know what he was thinking… “yeah…that’s my wife!!”  We left Ruth and her mother and sister in the labor ward with a midwife.  They had Pitocin and/or a physician to do a C-section if necessary…..so we felt okay to leave her there.  It was 1:00am when we finally got back to the farm….where a cup of tea and a hot shower were in order.  The next day after clinic , we picked up Ruth and her new daughter Sarah at the hospital to take them home to meet daddy (who by the way didn’t know about any of this!)