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Thursday, September 17, 2009

Litterbugs

Every community or country has their own anti-littering campaigns: "Don't be a Litterbug" or "Don't Mess with Texas". Zambia is no exception with their "Keep Zambia Clean" motto which you see posted on trash cans or signs all around the country.

The fact that the real message might have been lost in translation became very clear one day when Tom was running errands with our gardener.

Because we don't speak the local language fluently we will take our gardener with us when doing various business so that he can translate. Now that we have a vehicle both of our gardeners are very excited. Status is a big deal here and now that their boss has a car they feel that their job is even more important and they work hard to keep our car looking nice--a tough task in this dusty land.

On this particular day Tom was visiting various places and had stopped to get some bottled water to help fight the heat. Peter, our gardener, kept busy hopping in and out of the car to help load things or talk with people.

As he climbed back into the car after completing a task he noticed the empty bottles lying on the floor next to his seat. He frowned with displeasure and said, "Ah, Keep Zambia Clean!" and promptly threw all the bottles out the window into the street.


Tuesday, September 15, 2009

Hospital Visit


Last Thursday Peter's breathing had gotten much worse so I decided to take him up to see a doctor at the hospital in a nearby city. It is a very small hospital but closer than the large one 3 hours away. Tom was heading there for some business so I quickly threw some things in a bag in case the doctor wanted to keep us overnight and hopped in the car.


Thankfully there was a doctor at the hospital (not always the case) and he saw Peter right away. He gave a quick exam and decided that Peter must have been born to an H
IV positive mother and that is why he has so many health issues. He also said he most likely had pneumonia and ordered a chest X-ray as well as a few blood tests. He said it would be best if we were admitted since the baby needed IV antibiotics and 'observation'.

Because hospitals here are pretty dire I opted to pay for a 'high cost' room. This cost less than $20 but gave us a private room (rather than being in a ward where who knew what germs would be floating around) with a sink and a bathroom nearby.
We 'checked' in and proceeded to wait and wait.

Finally around 2 PM the doctor made his rounds and prescribed 2 IV antibiotics as well as an oral antibiotic and some other medicine to help him breathe better. I asked if they had any oxygen that he could be hooked up to but he said no. The nurses were introduced to me with the qualification that they were the only two nurses on duty for the entire hospital (!) and so to just go hunting for them if there were any problems.

Tom brought me some take away nshima (local maize staple) and chicken with some veggie and sauce on the side. It was quite delicious but as usual I couldn't finish it. Nshima is very filling! He also left behind some bottles of drinking water before heading back to the orphanage.

I was so glad I'd packed several books in the bag because it was quiet and frankly boring sitting in the room. I held Peter and fed him every two hours through his NG tube (first offering the bottle by mouth) and not much else happened.


Around 6 PM two dear friends stopped by to visit and offered to take me to eat some dinner or to bring some. I looked around the room and realized, "hey, this isn't prison. I can leave if I want to." After checking with the nurse for the time of the next injection (10 PM)
I bundled up Peter, grabbed all my stuff and headed out. I had still kept the room so we would have a place to be when the doctor did his rounds.

For the next two days I spent most of my time at our friends' house which was nice. I had access to running water (the hospital didn't have any), could eat regular meals an
d wash Peter's bottles. We only went back to the hospital for the scheduled injections. In other places this might seem crazy--we were supposed to be admitted but in reality we were only a couple minutes away and at the hospital there was no equipment in case Peter got into distress, no monitors to help keep an eye on him.
At night there were only two nurses on duty (for all wards) and they spent most of their time watching TV in the nursing station. At one of the 4 AM medicine times I actually had to wake up the nurses--the door to the nursing station was locked but through the crack I could see them getting up and dressed.
I felt really bad for all the other patients who had
no advocates, no watches to keep track of their own medication times, and no voice. Power and authority is a big deal here. Those without education are awed by those who do. This is not to say that the nurses are purposefully negligent (necessarily), they are seriously underpaid (less than $200 a month) and have to function with very little. I hate to say it, but it makes you stop and think when you see the effects of socialized medicine up close and personal.

Peter did start to do better after switching to these injections. His congestion was still really bad and needed a few steam treatments (good thing I was at our frie
nds' house with plenty of hot water) but he began eating from his bottle. I was so excited!

After two days of staying with friends and driving back and forth to the hospital I convinced the doctor to 'release' us. We arranged to continue treatment at our local clinic. This meant that we had to go to the clinic four times a day for injections but at least we would be at home and I could get some work done.



Here is our 'high cost' room. To put it in perspective--the price I paid was equivalent to 8 days of minimum wage work here.

All this can sure make you thankful for our imperfect health care system.

Until next time, may God bless and keep you on your own personal adventures.

Love!

Amy

Sunday, September 13, 2009

What do Babies and Fish Have in Common?

A few people had questions/comments about how we weigh our babies so here is a step by step.

First we load the baby in a shopping bag. Here is Peter with two of our volunteers, Katherine and Kirstie.

And there he is. Peek a boo, baby!


Next we hang the bag from a fish scale. This gives us accurate weights so we can log tiny gains and (God forbid) losses. The bag has to hang freely but we keep our hands close to prevent any accidents.

And there you have it. Stay tuned for more wacky, out there solutions in the adventure that is my life.

Until next time, may God bless and keep you on your own personal adventures.

Love!

Amy

Jasmine

Jasmine turned 14 on Tuesday!

Happy Birthday! We love you and are so proud of you!




Sunday, September 6, 2009

Our Kids -- Volume I


Note: I wrote this blog last week with the idea being it would be published today. It is fortuitous that Jennifer was the baby chosen for this week. I needed the opportunity to look back on our journey/adventure with this little baby in light of the new addition to our family who I wrote about yesterday.


Baby Jennifer


Jennifer joined our home in April, 2008. I was away in the States at the time and Tom and our Jennifer were called to a small hut behind the clinic. Outside the hut, under a makeshift shelter, lying right in the dirt was a young woman in the end stages of a terrible illness. Her parents were with her but despite their efforts, Tom was unable to have any type of conversation with her. Lying with her was a tiny baby girl—more dead than alive. Little Jennifer was completely listless. The grandparents explained that they had been feeding this one month old baby a porridge made from cassava (the root we get tapioca from) only twice a day. As a result her little body had almost completely shut down.



Tom brought her home and our Jennifer made a bottle of milk and began feeding baby Jennifer. Immediately her tiny eyes flew open and she started to gulp the milk. She came to life and seemed to be so thankful.

Unfortunately, whether due to health issues caused by malnutrition or disease, baby Jennifer still had a long road to recovery. Her body struggled to absorb nutrients and she had diarrhea nearly all the time. She also vomited regularly and when inserting an IV proved difficult due to the size of her veins she was admitted to a local hospital.



Nannies from the orphanage took turns staying with her as nurses are in very short supply here in Zambia. After a few days there had been no improvement and when one day Tom visited and found that absolutely nothing had been done that whole day to care for Jennifer by any medical staff, he told off the doctors and nurses and brought Jennifer back home.

Our Jennifer looked after her fulltime—a huge responsibility for a 17 year old girl. Our local staff began talking about how perhaps it was better to just send baby Jennifer back to her grandparents. She could die with them. But as my mother in law pointed out when she saw the picture below, “She’s a fighter—you can see it in her eyes”. We had to give her a chance.


About this time I returned from the U.S and while I had been in constant communication with my family over the 2 and a half months I was away fundraising and I had seen all the pictures of baby Jennifer, nothing could prepare me for how tiny and fragile she was. She cried a lot and seemed unhappy and uncomfortable.

I helped big Jennifer to look after the baby and did all I could to nurse her back to health. I did kangaroo therapy and probably one of the turning points for her was putting her on a fairly strict schedule. So much attention had been spent in getting nutrients into her and she had also most likely been so uncomfortable that sleeping wasn’t the peaceful time it should have been. In order for her body to fully recover she needed good times of rest along with regular feedings.

Almost immediately upon moving her to a regular schedule her whole personality changed. She became happier and much more peaceful.


She was also put on an antibiotic which is given as a prophylactic to children when it is suspected that their mother had HIV/AIDS. She does really well with this medicine and for whatever reason her body seems to need it. On the rare occasions that we’ve not given it to her she almost immediately gets sick.


Today you can’t even recognize the sickly baby that fought for her life over a year ago. Baby Jennifer is a happy little girl now. Amazingly, she reached most of her developmental milestones such as crawling, walking, etc. on time.

Right after she turned one year old she decided she didn’t want to be with the babies anymore and although she wasn’t walking yet she began spending time with the toddler group. She quickly learned to walk and now runs and plays so happily with them.



Our kids all enjoy baby Jennifer. While we don’t shouldn’t try not to have favorites, when a baby has spent months in your home and you’ve watched that child develop and grow and you’ve invested in them there will always be a special bond.


Jennifer has a special relationship with Tom. It’s a bit of a love/hate relationship. More love on his side and hate on hers but we know she doesn’t really mean it.

When Tom returned from his fundraising trip to the States earlier this year he was so excited to see Jennifer that he scooped her up and hugged her. She responded by screaming loudly and clawing his face. We couldn’t even reprimand her because we were laughing so hard.


He has slowly been gaining her love back by bringing her pieces of chocolate.

Lesson learned for her: Treat a man terribly and he’ll bring you candy.


Oh dear!

Saturday, September 5, 2009

Adventures in baby care.


We have a new baby! Peter comes from a village called Lukwesa which is about a 30 minute drive south of us. Little Peter was brought to our door Thursday morning. His mom passed away during childbirth and after his family tried to care for him but just couldn't because milk is so expensive they brought him to us. Sadly, at 13 days old he was in pretty bad shape. He is severely malnourished and dehydrated. The family was only giving him some formula from a sippy cup twice a day.
He also has very congested lungs and some diarrhea. All of this is going to be challenging to work with so we have agreed to take Peter in for one month. If he survives the first month he will become a permanent part of this orphanage.



Peter's dad (also named Peter) looks really young but is actually the father to 6 children. The lady sitting next to him is his mother-in-law. Little Peter's grandmother. I can't even begin to imagine what it feels like to sit in an office not even two weeks after the death of your daughter or wife and try to find a new home for your son or grandson.

Oh, don't be confused by the pink get-up. Peter is indeed a boy. (I checked) Most babies brought to us are clothed in girls' things. I'm not sure why. Almost never will a girl be brought in say, sports clothes. Also, the community seems to share clothing because whenever a baby is brought to us the relatives ask us to hand back the clothing because 'they've borrowed it'.


Because of Peter's fragile condition we called in the local clinic officer and also phoned a doctor in Lusaka. Between the two of them, and thanks to a grant which enabled us to build a little clinic and stock it with basic medical supplies, we got Peter examined and set up with an IV drip of dextrose (sugar water) and two different medicines.

He is lying on a bed Tom installed that folds up against the wall when not in use to save space. It's just like a train berth. The chain also makes a handy holder for the IV bag. We tied it up there with some gauze.

It's hard to tell from this photo but Peter is very tiny. At 13 days old he weighed only 2.6 kg (5.75 lbs) and was 51 cm (20.4 in.) long. His skin was completely wrinkled from dehydration and he doesn't appear to have body fat anywhere. His skull is shrunken so the bones are overlapping some. I plan on weighing him this morning and hope to see some improvement.

The stick next to his arm is a splint we used to hold his arm straight for the IV. It didn't really work because he is a little fighter and kept waving the whole stick around so I ended up just sitting next to him to keep his arm still.

As of this morning, nearly two days after his arrival I am cautiously optimistic. We still have a long way to go. His lungs are quite congested but thankfully he does not appear to have pneumonia. We have him on a 10 day course of antibiotics and will put him on IV fluids periodically.

He is drinking some milk but struggles with the sucking part. Also when he does get a good suck going he forgets to breathe and that sends him into a spasm of coughing. He is drinking about 30-50 mls per feeding. That is around 2-3 Tbsp.

Please pray with us that we can indeed nurse him back to full health. We lost a couple babies this year who were brought to us in such a state so we/I am finding myself very nervous. Even when Peter sleeps at night I wake up every few minutes and check his breathing. He and I are sleeping in the living room--I am on the couch and he is in a little laundry basket next to me. I look forward to the day he outgrows it.

Thank you for praying. Stay tuned for updates.

Related Posts: At the Hospital
                       Peter and His Sister
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