A nice cool rain is falling this afternoon, so a good time to do a blog entry. Everyday is different here at ilula hospital, so one needs to be prepared for anything. Today, two unconscious patients were brought in from the ilula orphanage project....they contracted carbon monoxide poisoning after working in a well. Both have recovered and are doing well. Two days ago the hospital had a bee attack over many of the wards and outpatient department. I was in the HIV clinic and we noticed all these people running about with their scarfs over their heads, trying to get away from the swarming bees. Apparently a huge bee nest had developed on top of the hospital water tower, and the bees decided it was time to go irritate the patients and their families. Many of the inpatients just dropped their bug nets( which hang over most beds here) so it was the staff and outpatients and families that were most affected. Never a boring moment here, for sure. Many of the patients and staff were laughing about it today....a good sense of humor always helps in unexpected situations. The bee nest no longer exist as it was smoked and burned out yesterday.
We had a bit of a rough week last week as we lost 3 babies that probably would have survived in US hospitals. One mother lost her second newborn of twins due to probable prolapsed cord. Another baby seemed healthy at discharge but returned the next day, very septic and expired about 6 hours later. The 3 rd baby lost was the "precious baby" patient that I referenced in a earlier blog entry.
I have had 3 "counseling sessions" with Maria, the precious baby mom, and have gotten to know her quite well over the last week. She has given me permission to share her story and photo in this blog. I was expecting her to be in terrible grief over the loss of her 11 th pregnancy, but my talks with her have been quite different. She has been in an abusive relationship with her husband of 15 years. She lives quite far from ilula, near Dar Es Salaam (Capital City), about 300 miles away. She came to ilula hospital because she was originally from here and has family in the area. She did not want to get pregnant this time due to her past difficulties. After discovering she was pregnant, she asked her physician for an abortion and was denied - abortion is illegal in TZ. Maria has adopted her 7 yo niece, after her sister passed away. We have spent a lot of time talking about her next step once she leaves the hospital. I think she will not return to her husband - he has not called or inquired as to how she has been doing over the last 10 days. Maria says he is "fed up" with all her pregnancies. Like many women in the US who are financially dependent on their husbands, Maria is faced with some huge challenges to support her daughter and herself. She is now saying she does not want to return to her husband and wants to relocate with her daughter to the Ilula area. I have been very impressed with her strength and composure as she dealt with "expelling" her 28 week old baby with no viable heartbeat. We we're all hoping delivering the stillborn would go quickly but it did not. All of the docs here, the ilula medical staff, Gary, Steve, Jenna and Theo , checked in on her, but no contractions. She was finally able to start contractions yesterday evening with an increase in medications, and she delivered at 7:30 am this morning, 5 days after she was told there was no fetal heartbeat. This avoided a potentially dangerous c section.
This has been a bit of emotional roller coaster for me. I was happy to get the news of her delivery, knowing that her recovery will be much quicker now. But my excitement quickly turned to sadness, thinking of this tragic loss and it's impact on Maria and her family. Her fortitude through all these pregnancies (at least 60 months of being pregnant and no baby) is amazing. I have learned much from Maria about determination. I am optimistic she will forge a new life for herself as soon as she discharged.
After meeting with Maria and her cousin following her delivery, I went on hospice rounds and visited 4 patient in their homes. This was really enjoyable, as we got a good insight into the life in ilula. All 4 patients and families were very gracious and uplifting.....there is no quitting in these folks. Particularly inspirational was a 52 man who contracted polio when he was 4 years old. He has a severely disfigured body, can not walk, ambulates by shuffling on his hands and knees, and gets around town with a tricycle. He is supporting a family of 6 by operating his own tailor shop. He showed us how he cuts material and operates a sewing machine, even with severe contractures in both hands.... Amazing! His wife is psychiatrically disabled and can not work. Despite all of these pressures, he is making a living and seems really happy. I took a few videos of him and may use those the next time I have a patient that may need a boost.
We are off to Iringa tomorrow as we put on a 2 day conference for local doctors and nurses. We then head off to Ruaha national park for a 2 day safari and then head home on January 28. I will miss making the rounds and these patients. This has been a wonderful experience that I will always cherish.
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