Wednesday, December 28, 2011

#86 Milk

It’s Saturday night. We’re having a good time hanging out with Olen’s parents who are visiting.

Knock on the door. As a good husband would do, Olen answers it. But it’s for me.

I decide to go in to see a pregnant patient who isn’t breathing well.

I didn’t bring my headlamp because the moon is bright tonight. I should have. I get to maternity and the light is not working. I don’t know why. It’s probably burned out.

The nurse points her light on her phone towards the patient so I can see her. She is young and on her first pregnancy at 8 months. She is sitting straight up in bed. I have her lay down. I put my hand on her belly as I try to get a little more history.

She came in this morning. Her hemoglobin was 3. She got a bag of donated blood and got started on IV quinine for malaria.

I can feel contractions while I listen. She needs more blood. We don’t have any in our bank. I tried to get a blood drive going a month ago. I explained it all to the lab and left it in their hands. But sometimes you have to micro-manage everything here. Or it doesn’t get done. So, we have very little blood in the bank right now, and none of her type.

I check her cervix. She’s dilated a little and the cervix is quite thinned out. I wish we could stop her labor.

I asked for more family members to come to give blood. In the meantime I ordered IV fluids, steroids, and antibiotics in addition to the quinine being given. We are all out of nifedipine (a BP med that I give to stop contractions). I ordered salbutomol to try to stop her contractions.

In the meantime I go over to Urgence to tell Baikau what’s going on. She tells me about a woman who just died. They just came in this afternoon. It sounded like malaria. They have a 2 1/2 month old son.

I walk into the dimly lit room of the medicine ward. All 8 beds are full on the women’s side with patients. The family is gathered around one bed that has a brightly-colored African cloth over the body of the woman who died. A female family member sits on the bed with the baby boy. He is a healthy looking boy, but is sleeping right now.

He will need milk. He is sleeping, but he will wake up soon and will need to eat. It is the custom here to take the body as soon as somebody dies to start the funeral services. I told them I was very sorry, but they needed to wait for some milk for the baby. There was no one in the family who was breastfeeding and could share milk.

Thankfully we have a mother Teresa here on our compound. Tammy (who watches my boys) is like a modern day Dorcas here. She has a program for people who need milk formula. They come to her and she has them do a little bit of work to pay for the formula. She has 8-10 in the program right now and gets money from donations to help pay for the milk. It’s about 6 dollars for a little canister. That doesn’t sound like much, but when you are a family that only makes 1 dollar a day (if that), that is way too expensive.

Now when I say NEED milk, that’s exactly what it is. It’s not a choice here to breast or bottle feed. If the mother dies or she has HIV, then the baby NEEDS milk formula.

I walk home quite sad that this cute little boy has just lost his mommy. But we can do something to help here. I knocked on Tammy’s door and explained to Cory (Tammy's teen-age son) that I needed some milk. He brought me out a canister.

Cory was the reason Tammy started this whole program. A year ago he told his mom about a baby in a village who had lost his mom. She decided to help and it has grown from there.

I boiled some water and poured it into 2 glass jars to give to the family. They don’t have means to store clean water otherwise. I grabbed a bottle that I had bought from the states and headed back over to the hospital.

Cute little boy was still sleeping. I explained everything to the dad and 2 female family members. They tell me they can’t stay the night because they have to take the body back to the village.

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