Friday, May 29, 2009

Fighting Polio

This year Kenya has seen a few small outbreaks of Polio. Fortunately none of them have hit our area. This week our clinic partnered with the Kenya Ministry of Health (MOH) to provide an anti-polio campaign in our community. The goal was to provide an extra oral booster for all children under the age of six.

We spent a week putting the word out that the campaign would take place on Tues. The first mamas arrived shortly after 8AM on Tues morning. By the time the clinic closed at 5PM we had vaccinated over 380 children. Talk about a busy day! We saw several mamas come who had never brought their children to our clinic before. It was good exposure for the clinic and the first of what I hope will be many preventative health events this year!

Monday, May 25, 2009

Unwanted Guest

Last week we had an unwanted guest in our compound. I was more than thankful to Musa (William's cousin) who killed it. William came in while I was eating breakfast and told me "The snake is dead, do you want a picture?" Here it is:

I have no idea what kind of snake it is. After Musa beat it, it was pretty covered in mud.

The snake slayer.

Tuesday, May 19, 2009

Quick Update

Today is a crazy busy day but I just had to get this update posted while on my lunch break. So here I sit munching on fresh pineapple while writing this post.

This morning we had a super busy mama/baby clinic. But I wanted to share with you that I got to see the baby I talked about in the last post. He now has a name, Desmond. He is actually looking really good. He's been doing what babies do best, eating, pooping, and sleeping! He was pretty alert for his visit to the clinic. He got started on his immunizations this morning.

I actually didn't recognize him or the mom. They both looked too good! I was asking her for all the info and then it hit me, this is her! This is that kid who I bagged for 45 minutes! She laughed when she saw it hit me. She told me that she was wondering why I had to ask her name and birth info for the baby.

I told her to please keep bringing him for follow up at the clinic.

Well now I'm off to help get soccer camp set up. We have a medical intern who happened to play soccer in his undergrad program. He's going to be running a soccer (football) camp at our local public primary school. Today is the planning meeting where we get all of the assistant coaches together on the field. Ahh, the many hats I wear here on the mission field! But the fact is that I really love the diversity.

Friday, May 15, 2009

A Chance to Save a Life

Early in March I had the amazingly wonderful experience of attending a Nursing Conference hosted by a group from the United States. Nurses traveled from all over Africa and the Arabian Coast to attend. Lucky for me it was close to home just outside of Nairobi.

As soon as I got the schedule I noticed a neonatal resuscitation class being offered one afternoon. Other than my healthcare provider CPR courses I had no training in this area whatsoever. And considering I now assist in delivering babies and run the well-baby clinic I figured it was in my best interest to get in the class.

I was blown away by what I learned. I had always thought that if you couldn't get a floppy baby breathing with suction and stimulation there was no hope in the third world setting. With the hospital being an hour away and no NICU on hand I figured that CPR would be a hopeless cause.

Well the class I attended definitely said otherwise. I learned that bagging a baby can make a HUGE difference in survival rates. For those of you non-medical people that is basically using a special bag and mask to provide artificial respiration to a baby. What blew me away was the video footage in the class. Babies who looked dead at birth would pink up and scream their little lungs out with just a few minute of intervention.

While I was in the states going to school I would often explain that one of the reasons that I decided to pursue a masters degree was that I wanted to be as equipped as possible. I said several times during those years "I don't want to stand in front of a patient and think that if I had gone to school a little longer maybe I could have saved this life." I realize now that it is impossible to be completely prepared for any situation but I still want to do my best to be as prepared as possible.

I went home to Kipkaren determined to incorporate what I had learned. That week I asked the entire staff to start calling me for every delivery. My intent was two-fold. I knew that our staff, not unlike myself a few months ago, didn't have that neonatal resuscitation training. I wanted to get in and make a difference. I also want to boost my delivery skills so that I can get to the point where I feel comfortable doing deliveries on my own.

I've been involved in a handful of births since then. A number of them have had complications but nothing too major. Well all that changed one night last week. I've been fighting bronchitis for a few weeks now. So I will admit that I thought twice when I got a call at 9PM that there was a delivery. But I felt like I really needed to be there. For some crazy reason William insisted that I put on a lab coat. It turned out to be great advice when I got doused in amniotic fluid later!

The labor was strange and really difficult. I'll spare you the gory details. But through a series of crazy circumstances the mom wound up delivering on the floor. She had worn herself out pushing really hard before it was time. So when the head finally did appear she suddenly lost all strength to get him out. His head was stuck for a while. Looking back I really wish I would have performed an episiotomy. I have never done one though and that is probably why the thought didn't even enter my mind.

We finally got the baby out and the cord was wrapped around his neck. He was floppy, blue and looked dead. Ascar and I dried him and kept trying to stimulate him to cry. My class came to mind and I realized that this baby needed some serious intervention. In the past we probably would have kept suctioning and stimulating for a few more minutes and then called it (pronounced him dead).

I told Ascar "I'm not giving up on him." Then I started tearing the place apart looking for an ambu bag. I remembered that I had an adult sized one under my guest bed. I called William and told him to bring it as fast as he could and pray. I wasn't sure how I would modify an adult bag for an infant but I was determined to try something. As I hung up the phone I found a pediatric ambu bag.

I had NEVER done this before in my life! I've never even done CPR on a child; only adults. And let me tell you a floppy baby is a heck of a lot harder to work with than the mannequin that we practiced with at the conference. The baby's grandma stood at my side as I suctioned and bagged him. Every few minutes he would shudder and gasp. As long as he continued to try and I could feel a heartbeat I was determined to keep going. At one point we did CPR for just a minute and then the heart rate picked back up. It took 45 minutes of bagging him and then he started breathing on his own. By then he was really hypothermic.

I did something else that the staff never does in our clinic. I took the baby and put him skin-to-skin with his mama so she could warm him up. I stayed by his side with my hand over him praying and watching for an hour while he took shallow breaths. I finally realized that there was nothing else I could do so I headed home.

I called my mom and asked her to pray for this little one. As I crawled in bed I had no idea if the baby could possibly make it. The next morning I learned that he started crying about the same time that I went to bed. He went home later the next morning fully alert, crying and moving his arms and legs with no problem.

I have no idea if he will have long-term complications or brain damage from that traumatic first hour of his life. But he lived and breathed on his own! The baby who completely flunked his APGAR went home crying less than 24hrs later! Knowing that you were used by God to save a life is an amazing feeling. I don't think there can be a greater high!

This month I have had several affirmations that this is exactly where I am supposed to be right now. This was by far the best one!