April 24, 2008 Thursday

Kasango:
Dr. Lynn writing:

Today we saw over 525 people in Kasango in the hot sun! We used over 75 blood tests for malaria today of which many were positive. Many people, including young children, had the shaking fever and couldn’t afford the expensive medicine, Coartem, which costs K45,000 or the equivalent of $12.00. A two year old had just gotten out of the hospital and had been given quinine ( an old medication). The doctors had wanted to put him on Coartem but the family didn’t have the money. He is now on Coartem! Many of these children with malaria get liver complications and severe anemia. Malaria is the number one cause of child mortality in this country. He may have a chance now with the meds recommended.

We had a few HIV positive tests and realized that we and the locals do not completely understand the public health system in place and what level of counseling a person might get or the treatment given. In this community, there were many older women caring for multiple grandchildren whose parents had died. One older woman cared for five young children around the same age from three of her own children who had died. She will do her best I’m sure, but her advanced age of 58 in this environment makes it exhausting for her.

There were many pregnant women to whom we gave those prized birthing kits. This community had two trained birthing attendants who would deliver them in their home (swept dirt floor) or in the community birthing room. I will try to describe the birthing room but I am already tearing up…

This room was in an abandoned health building and was quite dirty. There were two old metal cots in the room with only metal slats and no mattresses. There was no light as a window was covered for privacy with an old door. There was an abandoned rusted pitchfork on the side and a coal pot for warmth if needed. There was no running water. I was here two years ago and there were no mattresses then and they hadn’t had them for many years.

I needed to check three women at term with “labor pains” with an internal exam. They calmly placed their shetengis (cloth used to make a skirt or a backpack for their babies) on the chipped white metal cots and lay down. The birth attendants were very, very knowledgeable and even deliver breech and twin deliveries. One of the women said she was in labor and was breech. That scared me! She also had had fast labors in the past. When I asked her how many children she had, she replied through the interpreter, that she had six children of which three were living. Two of the others had died at birth. The birth attendants and I agreed that she was not in a breech position. She had been told, however, that she would possibly need surgery and should get to the community hospital. OMNI got her there so she wouldn’t have to walk a mile to get to the main road to take a bus to the hospital while in labor! All the women in line holding their own babies, shouted and cheered her as she left. The hospital expected her to deliver early this evening. By the way, she had to bring her own linens, one set of clothing for the baby, food, and her own sanitary napkins for herself and the baby (used as a diaper). This costs money so many women don’t deliver at the district clinics or hospitals but rely on the community clinics or home.

I couldn’t help contrasting this experience with the birthing rooms that I have used personally and with patients. We have TV’s, cold drinks, calming music, epidurals, etc. These women were so grateful to have a piece of plastic to lie on during the birth. I am stunned and humbled by their courage and strength.

We saw two children with club feet that have been being serially casted for a year. One improved quite a bit but the other with bilateral ( two) club feet will need extensive surgery. There is hope – CARE has opened a new free clinic in Lusaka and Ndola which can help with surgeries such as these. Two years ago, when this child was seen, it seemed hopeless.

Yes, this is the clinic with goats, chickens, and cows that are free range, sometimes even in the clinic! There was another large snake that was right next to the clinic and killed a chick but was sticked off by the villagers. Our guard told me that the children here in the bush become very “clever” because they have to.

There are too many stories to tell and Karen will continue. The team is tired but content in its continued quest to help the poor in Africa. We know lives were saved today. We know that each person was treated as made in the image and likeness of Christ. We are counting our blessings tonight.