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.

Reality of Sudan uncertainty

Today we received news that we must leave Sudan by mid-December of this year in preparation for the unknown effects of the Referendum—the vote in early January when South Sudanese people decide if they want to be a nation separate from the North. This vote comes at the end of a five year Comprehensive Peace Agreement between the North and South following 22 years of civil war. The voting and resulting decisions may result in trouble for all of Sudan, especially for those towns and villages along the border. Therefore all three SIM Sudan teams will be flying to Kenya in the middle of December for an unknown length of time to ensure safety should trouble arise.

My first thoughts were for the patients who need the medical treatment the clinic staff provides. With the nurses gone, the clinic will not be operating. The patients will have to walk for days to find medical care in some other village while we are gone. When walking long distances is not an option for some, what will happen to them? How many deaths of children will occur because there is no one to administer simple antibiotics to stop infection, Larimal for cerebral malaria and Metronidazole or Flagyl for bloody dysentery. I must learn to trust that God knows the needs and cares for the sick children even more than I do. He is the one who heals.

Our team will have to be out of Sudan for at least six weeks while awaiting the results of the vote and seeing if political changes are implemented. Six weeks is a long time and already I’m finding myself dreading the prospect, but I know I need to “learn to be content in whatever state (or country) I am in”.

Our logistics team is working on some continuing education opportunities for us that will make productive use of the time in Kenya. In addition to that I am going to request permission to spend a week or two as an intern at Kijabe Hospital, an African Inland Church project North of Nairobi, Kenya. There I can observe many births and become better trained to deliver babies in the Doro clinic.

I will keep you informed of the news in Sudan. I am sure the networks in Great Britain and the US will be covering it in January. Please pray for those in authority in both the North and South to seek God and honestly the desire the best for the Sudanese people. There are so many issues of power, land, oil, money, business opportunities, pride, racism, religion and painful, not so distant, memories of the wars and devastation this century. It is a complicated country.

The people I work with on a daily basis are not influential people or even well informed people—they are simply living in the bush, desiring to provide for their families and live a peaceful life. Overshadowing their lives is the concern about a return of war and the chaos that stole many from their circle of family and friends and displaced many more to refugee camps in Ethiopia. Please pray that God continues to keep the peace in Sudan.

"Tis better to suffer wrong than do it." --Thomas Fuller