Today started like the rest of the days so far. Chapel in the morning, followed by morning report, and subsequently rounds. The team from Hong Kong shared how they made it to Impfondo, even though their flight was late and delayed, and really the miracle that took place for them to get here on Monday. Had they not, they would have had to wait until Friday, and considering they're only here for a short time to fix the internet, it really would have made things difficult. Things really worked out perfectly, and I guess there was a thunderstorm that delayed their other flight, so they were able to end up making it just in time. Morning report was pretty short, and we talked about the guy we saw late last night who I stitched up and splinted his broken finger. We were just heading off to rounds when we heard that there was an emergency delivery happening, so we ran over to the maternity ward.
The woman was young, probably late 20s, and we weren't exactly sure how far along the baby was, but I think they said about full term. The baby was in breach position (coming feet first as opposed to head first) and when we got there we could see the baby's rear and genitals sticking out a bit. Basically he was folded up onto himself. We went back and forth on trying to take the mom for a cesarean section vs just doing an episiotomy, but the midwife just kept telling her to push and tried to get things to happen. I guess it takes about 45 minutes here to get an emergency cesarean set up, so they're tough to pull off really quickly. And in this case the baby was already out of the uterus, so we would have had to push the baby back to take him out. The baby's butt came out first and then the midwife pulled each of the legs out (a little aggressively I might add). From here things really slowed down again. The mom seemed to be getting tired and it took us another 5-10 minutes to get the baby's head out. Up until this point we had check for fetal heart tones about 3 times, which we heard, loudly and briskly. As soon as the baby was completely out we rushed him over to a separate area and suctioned his nose and throat and tried to get him to start breathing. We listened and didn't hear any heart tones so we started CPR. I started bagging over the child's face and Jason continued compressions while Dr. Kiong drew up some epinephrine. After 15 or so minutes of trying to resuscitate the baby, we sadly lost him. Jason and I were just chatting about it, trying to figure out maybe what we could have done differently. I think part of the problem was when the baby was out, except for the head, there may have been some compression on the cord, which prohibited the baby from being able to get any oxygen. Maybe. I guess we won't know. Nothing about the situation was ideal, and in the states we would have been able to do things so differently. We would have loved to do a cesarean section, but with it taking 45 minutes just to get set up, it wouldn't have mattered. Probably could have done an episiotomy to help get the baby out quicker, but the Congolese midwife seemed really hesitant to do it, so I don't know if there's a cultural thing there or not. Either way, it was quite sad. Birth and bringing in new life should be a time of great celebration, and sadly watching the little body fall limp in my hands as we tried to resuscitate him, and then having to inform the mother that her baby was dead.....not many words to describe it.
We continued to round on our patients, and it took a little longer today, but I think that's because we actually went and saw each and every patient. Our little man with the chest tube (confirmed he's 14 months old) is doing super well. Breathing 100% on room air, not retracting or grunting, and chillin' out a lot more. Chest tube is draining clearer looking fluid too, so I was really happy to see that. That's what I'm getting in the Congo -- a wide mix of emotions. In one second there is complete sadness as you watch a newborn baby die, and in the next there is happiness as you watch a child that you worked on start to improve. It's hard to grasp the emotions of the days, and you just have to keep doing the best you can. It's different than American medicine in that, at least in America you know that you are providing the best medical care that exists in the world. In the Congo, you are providing the best medical care that money can buy in the middle of nowhere in Africa, which is very very limited. So, it's different, and losing patients that you could otherwise save is what makes it difficult. But, we do the best we can and we are doing more for the patients than if we weren't here.
We saw our 3 other kids who all have cerebral malaria, and they are doing pretty well. The one girl is starting to eat on her own, so she's responding the best. The one boy is starting to spontaneously open his eyes, but is otherwise still unresponsive. And the third is still the worst, still having seizures and still more or less comatose. But we are treating them, and they have diazepam for the seizures, so we will just keep hoping they improve. Our lady from yesterday with the hysterectomy seems to be doing well. We got her confused with another patient who had a cystectomy and Jason and I did an ultrasound, checking to see if her kidney was enlarged from maybe damaging the ureter. Than we realized that it was the wrong patient. So, didn't need to take her back to the OR thankfully as she was actually urinating just fine. We checked on some of our other patients, placed an IV for a patient or two, and that was about it for the day.
Today for lunch we had a really treat. The cooks and Sarah made homemade tortillas with some ground corned beef (affectionally called cat food....really looks like it too, but it's Africa) and some tomatoes, avocados, beans, and tomato sauce. Have I raved about the avocados yet? Probably, but I'll do it again. They are amazing! Considering there is an avocado tree not far from here, it makes sense. Also the bananas. They're different from bananas you would be used to, they are shorter and fatter, and much much sweeter. Amanda says they taste like strawberries.....not quite, but I can see what she means. Becky brought us a banana tree today, but I think these are more like plantains, since they're a bit bigger and look more like traditional bananas. For dinner Jason and I ate popcorn and freshly sliced pineapple -- a lot of nutritional value when Jason and I "cook." The pineapple is also amazing. I hear mango season is about to start, and I really really hope I catch the beginning of that. I love mango (who doesn't!?) and I can only imagine what it would taste like. We also did our laundry today....and by we I mean the cook also did our laundry. She had mentioned to Sarah that we were much dirtier than the last group and we had mud all over our clothes. Sarah then explained to her how we had mudded a house over the weekend, and she was like, ohhhhhh that's why. I can only imagine what she was thinking -- that Jason and I were rolling around in the mud or something before laundry day. Which, we were actually, just with purpose. We made sure to grab all our clothes from outside so we don't get any bot fly eggs laid in them. Most of the clothes were dry by this point, except for some of the socks and a couple shirts, so I made a makeshift clothesline in the house with some twine I had.
Around 4pm today we also had a team meeting with everyone and discussed everything going on and all the upcoming travel plans. Jason will actually be able to take an Air Congo flight out on Tuesday, so we get him for one day longer than I was thinking. I'll be leaving on that Friday like I thought, to make sure I catch my Monday morning flight. The Hong Kong team and the girls will be leaving about the same time on the 13th to catch their respective flights. We prayed afterwards and I talked with Becky a bit about the details for the upcoming Sunday. We will be meeting at their house again for "Sunday Night Live," and they would like me to just take over the worship for that while I'm here. With this week being Easter, she had a couple song requests and she gave me their music book. I hope to be able to teach them a couple of my favorite worship songs while I'm here too, including my all time favorite worship song by Phil Wickham, "Divine Romance." I've taught it to a lot of people and congregations and have always gotten a great worshipful response from everyone, so I'm hoping they can connect with the lyrics as well here. We'll see, maybe I'll teach that on Easter Sunday.
Thats about it for the day. As usual, we'll see if anything rolls in tonight. Just chillin' in the room sitting in our puddles of sweat. I'm going to try to shower tonight for my 2 minutes of relief, but I'll be just as covered in sweat as soon as I finish again, sometimes I'm not quite sure it's worth the effort. Tomorrow there should be a couple surgeries planned, though not quite sure what yet.
Thanks for reading. I hope you feel blessed tonight. I am greatly honored and feel privileged to be here with this community serving the Congolese. It's a tremendous experience and I hope that Jason and I can bless the people and the staff in the short time we serve them. I hope you feel that same sense of privilege in the ways that you are connected to these people as well through your support of us. I hope my stories give you a glimpse of what's going on and you feel connected to us down here as well. We have many blessings in the United States, and access to just about everything that exists. But I feel more blessed here in Africa, working with nothing, than I have in a long long time. Thanks for all your support and helping to make this possible, please continue to pray for us and think and pray about ways you can continue to support us moving forward. If you have any thoughts, feel free to shoot me an e-mail and we can discuss it moving forward.
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