The sad side of medical missions

Today we lost two patients, a newborn who required surgery immediately following birth (a surgery we are not equipped or staffed to perform) and an older man with pneumonia who was brought for help too late for the medications to have time to be effective. This was one of those difficult days that I thought about months ago--knowing I'd be emotional with losses. Tonight their families grieve and I ponder their unnecessary deaths.

This newborn had Gastroschisis.

The surgical team: Julie held "retractors" and Dr Rob, over two patient hours, pushed the intestines back into the abdominal cavity through the small hole in the abdominal wall that had allowed them to come out in utero. I decompressed the badly swollen bowel by providing suction through a naso-gastric tube with a syringe attached to it. Kurase (the clinic guard) heated water in a tea kettle to warm clothes to keep the infant from becoming too chilled from the exposure. Masir, (community health care worker) brought supplies to us as we needed them and provided translation to the family who was standing around us watching the procedure.

This is the infant just after Dr Rob was able to get the digestive system pushed back through the small hole in his abdomen. The hemostats kept the intestines from coming out again until it was appropriate for the hole to be sutured closed.

This "incubator" made of a plastic crate and bottles full of hot water under blankets kept the newborn warm enough to survive the night while we prayed for God to wake up the too quiet digestive system so that he could live.

The following morning his mother was able to hold him and breast feed him, but he died in the afternoon. In a hospital setting his chances of surviving this congenital defect would have been excellent, but we do not have the capabilities of providing the extent and quality of care that he needed. We take comfort in the fact that the new parents were able to hold the infant for several hours as a "normal" baby. When he was born with the intestines outside his body, they were swollen to about 1/2 of his body mass and it was probably frightening to them.

He was born at home and brought to us immediately by the father and some other family members. The mother arrived about a half hour after them. She walked over an hour--after giving birth--to be with the newborn at the clinic. We pray that God used us to show His love and grace to the family.