C-sections, new friends & a joyful noise to the Lord!

          Two weeks ago I had the opportunity to meet 4 amazing people that I am honored to call friends.  Ben Anderson, Ann Clawson, Jaron Hall and Dr. Hailey Hall (an OB/GYN) visited Karanda for one week and were a source of encouragement, inspiration, fun and even kept me well fed!  Hailey provided a wealth of OB/GYN knowledge and patience while teaching in the OR.  As I am currently alternating cesarean section call with the general surgeon and am gaining much c-section experience, her mentoring was timely and appreciated.  Usually my srub tech or ‘assistant’ during c-sections is a nursing student who is often learning both the procedure and surgical instruments, so it was a treat to work with an attending.  One of my favorite memories happened at the end of a c-section when the OR staff began singing a beautiful song a cappella amid the silent background of the OR.  It’s one of my favorite Shona hymns.  The chorus and translation are below with lots of c-section photos!

Mweya Wangu Uno Muponisi

Ndoda, ndoda, ndoda, 

Mwari muyamuri muri wangu, 

Ndakatengwa neropa ralshe, 

Ndava wenyu chose.

Translation:

I need my God, my helper

You are mine

I was bought by the blood of Jesus 

I am Yours forever.

Hailey showing step 1: choosing the right changing room

Dr. Hailey and I finishing a section

Hailey & I out of the OR

Just about to enter the uterus

Baby is out and the umbilical cord is being clamped

Nurse-midwife students suctioning a healthy baby!

Some sights of Karanda

I would like to show you a bit of Karanda in pictures!

My home at Karanda

Female ward

Serving the Zimbabwe staple food, sadsa with veggies

Bovies for use in the OR hanging out to dry

Checkers anyone?

Our PICU (pediatric intensive care unit)

So cute.
She actually did a happy dance when I showed her this picture!

Land mines

          PC is 17 years old and likes to play soccer.  Unfortunately, about 3 weeks ago he was leading his family’s cattle to the river when he stepped on a hidden land mine, losing his left foot.  He was taken to surgery where his left leg was amputated just above the ankle.  PC’s stump became infected and so the area was cleaned and debrided.  Although the area now looks healthy without any more purulent drainage, he will have another amputation this week just below the knee.  

          

          PC is one of many land mine victims still being seen across Zimbabwe today.  During Zimbabwe’s independence war in the 1970s, approximately 3 million land mines were laid by the Rhodesian Army along the Zambia and Mozambique borders to prevent independence fighters from neighboring countries from entering.  While there have been land mine removal projects, support and effort for such projects is dwindling.  And sadly, the effects are often seen on young adults and children like PC and our 4 year old little girl recently admitted after stepping on a land mine and losing her leg above the knee.  

          PC is resilient.  Despite his situation and phantom limb pain, he continues to give a thumbs up during rounds every day and is scheduled for his next surgery tomorrow.   

PC 

PC and I with sister Zengeya

The HIV effect

          HIV is ravaging much of southern Africa and its effects are devastating & heartbreaking.  Education regarding prevention & management has not yet permeated all areas of the country.  Karanda is actively addressing the growing HIV/AIDS epidemic through an opportunistic infection clinic that provides education and regular follow-up, testing all pregnant women (& treating to prevent mother to child transmission) and mobile outreach clinics to rural areas.  Recently, I had the opportunity to be part of the mobile outreach clinic to the town of Pachanza.  

           It’s been an eye-opening experience to see the reality of HIV/AIDS here in Zimbabwe.  A story that was shared by a patient’s daughter several weeks ago broke my heart and is representative of other stories I’ve heard.  FK’s father died of AIDS about 4 years ago, leaving her mother a widow with 3 girls to raise and support.  Her mother had been sick for the last 2 years with HIV and therefore wasn’t able to work, so the girls decided which 1 of them would have the opportunity to attend school while the other 2 worked and cared for their mother.  As they had little money, they weren’t able to seek care for their mother until she was very, very sick.  FK brought her mother to the hospital where she ultimately died of AIDS-related complications.  FK, age 16 without much formal education, was now the head of the household and is left to raise and support her 2 younger sisters. HIV/AIDS is real and its effects are permeating all aspects of society.   

“Fifteen thousand Africans are dying each day of preventable, treatable diseases--AIDS, malaria, TB--for lack of drugs that we take for granted...We can be the generation that no longer accepts that an accident of latitude determines whether a child lives or dies--but will we be that generation?"  -- Bono

We came a long way together

Special family

At Pachanza 

Pachanza

Pachanza

Pachanza OI clinic

         

Blooming Jacarandas

         The Jacarandas are in bloom and they are gorgeous!  I love how their purple flowers carpet the ground and brighten the courtyard.  Just looking at them is enough to make anyone smile, especially in contrast to the dusty brown everywhere.  The only thought that makes me tiptoe around the fallen flowers is what might be hiding underneath.  

        The other night while watching a movie with some friends, I felt something soft & fuzzy crawl over my feet.  Looking down, a long and wiggling creature caught my eye--my first thought was ‘oh, it’s just a centipede,’ until my 2 friends began shouting scorpion, scorpion and smashing it with the bottom of their shoes!  Fortunately, the scorpion had found an insect treasure and wasn’t interested in stinging my feet.  And apparently there are different types of scorpions--the classic-looking kind and the long centipede-looking kind.  That's another check off the venomous organism list: a close cobra sighting 2 weeks ago and scorpion encounter this  week! :) 

So colorful! 

Bath time :)

A day at Karanda

          This week we have been stretched thin with few doctors which has made for an interesting week!  Wednesday I had the opportunity to round on all the patients in the hospital (it happened to be with the nursing students because they were doing their ward management experience).  We saw patients with a wide range of illnesses including meningitis (bacterial, malarial and cryptococcal), TB, CHF, end-stage AIDS, femur fracture, prostate cancer, CVA (stroke), life-threatening anemia from antiretrovirals and children with kwashiorkor, hydrocephalus, myelomeningocele and pneumonia.  I saw post-operative patients who had undergone prostatectomies, hysterectomies, skin grafts, VP shunt placements, cesarean sections, and a thyroidectomy.  After rounding on over 70 patients, it was time for lunch (well, maybe a little past lunchtime :)).  

          After a quick lunch I headed back to the hospital to do an LP (lumbar puncture on a splenectomy patient with fever & headache) and a VP shunt aspiration (to check for shunt blockage) before starting clinic.  During this time, a call from the charge nurse had me racing to male ward.  Our post-op thyroidectomy patient had developed a huge hematoma (swelling of the neck filled with blood) and was desaturating to 69% WITH oxygen.  I began opening the wound, the surgeon came and removed clots of blood as the patient was rushed back to the OR (he has done very well since).  

By now, it was quite a bit past the start time for afternoon clinic.  Fortunately, the clinic staff had been forewarned that there would only be 1 doctor in clinic and they extended much mercy and help to me until reinforcements came later in the afternoon!  The evening continued with call & ended with a successful neonatal resuscitation (Praise God!) and c-section for a young mother with cephalopelvic disproportion.  Walking home at sunrise I was thankful to be here at Karanda, thankful to have shared the day with many of God’s beloved, thankful that He is ultimately in control and thankful that ‘because of the Lord’s great love we are not consumed, for his compassions never fail; they are new every morning’(Lam 3:22-23). Very thankful for a brand new day. 

“Do not fail to do something just because you can’t do everything.”  

--Bob Pierce: Founder of World Vision & Samaritan’s Purse

We had such a good time!

Miliary TB--unfortunately real and not just in a textbook