Thursday, 26 January 2012

Late Christmas post

An aunt of one of our workers who is a friend of mine has been unable to have children. She and her husband have tried for many years. To not have children is very shameful here. Children are your heritage, your social security, and really a testament to your worth as a person. So to not have children is a great and difficult issue.

On Christmas day in a village away from Koutiala a woman gave birth to a premature baby boy. A little while later, unfortunately, the woman died. The neigher of the father brought the baby to us to take care of. I immediately thought of our friend who was wanting a child. We brought the father in to make sure he in fact does not want the child (he has 5 other children to take care of) and will not ever want the child. The formal adoption is in process but our friend now has her best Christmas gift ever- a baby!

She named him Emmanuel Brett. :) My heart rejoices that God made a way for her to have a child when she could not. As she told me just today, "It is as if he came from my own body. I love him so much!"

Baba (noma)

Baba had his big facial reconstruction surgery the other week. They were in the OR for over 8 hrs working on him. He is doing really well and looks great (considering the before). Tim, the maxillofacial surgeon, does amazing work.

This is his regular past time. He loves watching the Jesus film. He goes to church on a regular basis with some of our staff which is ecouraging. He will be here a few more weeks as he continues to heal. In the meantime his mother will have a baby here. Why not kill two birds with one stone? :)

Moctar, childhood leukemia update

Moctar is a couple weeks into his treatment. Though we've wiped out basically his entire immune system, he is doing well. Amazing that with the chemo he is getting he is actually feeling BETTER than he did when he arrived. He has a long road ahead but we are happy with the current progress.

Monday, 16 January 2012

Moctar, leukemia

Meet Moctar. He came in last Thursday after having spent several days at the government hospital. As you can see, he was wasting away. He hardly had the energy to stand. His leukemia was raging. His total white blood cont was 20 times normal. His was 158,000 (normal 4000-10,000). He didn't have barely any platelets or red blood cells since the white blood cell cancer had left no room in the factory (the bone marrow) to produce anything else. Due to his high count we had to start treatment emergently to prevent a stroke. Amazingly his treatment worked rapidly, quickly decreasing his white count to nearly 0 within 5 days. He has a very long road ahead but we are thankful for the quick response we have already seen. He gets 4 stages of chemotherapy which each last 1 to 2 months prior to starting maintenance chemo. Please remember Moctar during his struggle against leukemia.

Boubacar, Guillain-Barré Syndrome

Boubacar came in last week unable to walk or sit on his own. Over the past month he slowly lost function of all his extremities. His nerve illness was slowly spreading from his toes up to his chest, and now he even had coughing when he ate, a sign that the illness was reaching his core. He didn't have much time left. He was diagnosed with Guillain-Barré syndrome and since we don't have plasmapheresis or immunoglobulins which would be used in the States we decided to just treat with very high dose steroids. Brett confirmed this with his good friend, neurologist Andreas Runheim in Winston-Salem, NC. Andreas felt that if the steroids worked we would see some improvement in 5 days.

Thankfully within two day he began to be able to move more and roll over in bed. Three days later he could stand with support.

Today 5 days into treatment he was even able to walk around the pediatric building with help. Amazing! Here he is standing (as I take the picture while helping him stand).

.I was thinking today how amazing it is to get to be here and see the
cases we do. I know that children are healed daily in the States. I
know that more children are saved rather than lost where here, it is
the opposite. However, there is something special to get to watch
firsthand the lame walking, or a wasting, near death child come back
to life, or severely burned children healed, or anyone of the many
other stories of children who are restored to health. It is even more
spectacular because so often these families come with no hope. We are
their last resort. Their families send them off to die. To see their
joy when healing begins is simply contagious. I can't help but want to
dance. Hope is given to the hopeless. Joy to the sorrowful.

Yes, there are many children who don't find the healing they need.
Yes, there are days when our heart breaks as we know the treatment the
child needs but simply cannot give it to them. Yes, there are days
that feel hopeless. Thankfully, we serve a God of hope. He gives us a
reason to be here. He gives us a reason to love, even when that means
sitting with a mother who just lost her child. Sometimes I feel like
what we can offer our patients is so little and when they walk away
with their child wrapped in blankets to go the grave instead of home
to live, I wonder if they understood why we are here. I think many do.
Not because of our treatments but simply because we are present. A
guard at the border between Burkina and Mali told some friends as they
passed by that he had sent his wife to our hospital. He was so
impressed because it was 2 am and immediately 4 of our Malian nursing staff came around her to help. The nurses
were up and willing to work. That alone spoke volumes. Things we expect in
the States are just not the norm here. So even if we can't provide
physical healing, we can provide physical presence. Sometimes that's
all that matters.

Sweet Kadia, leukemia remission

My dear Kadia was back this past week for her monthly Vincristine dose. She is doing well and has put on a ton of weight. She has a lot of spunk and is just super cute. I love that she plays hard to get and doesn't want to greet me in the mornings. I love that it is only through hugs, kisses, and lots of tickling that I can get her to smile and laugh. Then we dance. I love having her around the hospital. If only I could move her family to Koutiala. I simply love this girl.

Her poor mom has a ton on her plate. She is well into her 40s and nursing Kadia's little brother Amos. She told me that her stomach was bothering her so I set up a consultation for her. Then she mentioned she had not had her period in several months. I asked if she was pregnant and she said no because she didn't feel sick like she had with all the others. I believed her because, well, when you've been pregnant six times already you know what it feels like. And, in my opinion, she looks closer to the age of starting menopause than pushing out a baby. But after talking with the doctor who would see her we decided it was best to test her anyway. Well, to our shock it was positive. When I told her, tears came to her eyes. You could feel the stress she was now under. She had her dr visit and not only is she caring for her child with leukemia who is in remission and must come to the hospital monthly and stay often for several days, not only is she pregnant even though she is still nursing her last child, but she also has hyperthyroidism and will have to be on treatment from here on out since medicine is all we can do here in Mali. Pray for her as she carries this heavy load.

Tuesday, 10 January 2012

We've been published!

For those who may care, the first medical research article from the Koutiala Hospital for Women and Children has been published! This is mostly thanks to Rosanna Hess, a nurse who has worked overseas before but now works in research. She and her husband, Nelson, are regular visitors to our hospital. It's probably more accurate to say that they are a part of the Koutiala family.

The article is about the prevalence of Hepatitis B in the pregnant women who have delivered at our hospital.

If you care to read the details, you can go to:

Wednesday, 4 January 2012

Mahamadou- Wilm's tumor

Sweet Mahamadou had surgery last week to remove the cancer from his kidney. After six weeks of treatment his cancer had greatly reduced in size and was no longer as firm and solid as before. We believe the cancer was all removed and there was no sign that it had spread to other locations so we are praying for a full recovery.

Mahamadou after 6 weeks of chemo but prior to surgery

Mahamadou when he arrived

Francois (leukemia in remission)

Seems that it has been awhile since I've written about our leukemia patients...

Francois came back with his grandfather for his monthly dose of Vincristine. They are dressed in the Christmas cloth that we bought for them. (Each year the church has a designed cloth that people buy to support Malian missionaries-Malians who leave their home to go live elsewhere in Mali. The cloth is a sign of comradery. )

Francois is doing really well. He's been able to go several months without a transfusion and his lab values are good. He is also really happy now that we cleared up with Alan Anderson (Peds Oncology doctor) that he CAN drink coffee and milk with his daily chemo pill. Kids in Mali commonly drink coffee in the morning. He only has to wait an hr after taking the medicine to do so. This was great news to him as he had been asking me every month if he could start drinking milk as he needed it in his coffee. :) I'm not kidding. And as Alan said we wouldn't want to deprive a man (or boy in this case) his coffee. :) So life is good for him.

I must admit I'm kind of glad the kids have to come back each month. I enjoy seeing them, even if it is only for a little bit. We will pick up Kadia (other leukemia patient) this weekend and she will receive her treatment.

Sunday, 1 January 2012

Baba, facial noma -- graphic pictures

This is Baba. He came to our hospital through missionaries in Bamako. He has a facial noma that basically ate away at his face. We now have a maxillofacial surgeon here that is working to reconstruct his face. Baba has been at our hospital now for several months. He has had two of the at least three surgeries for reconstruction. He is doing quite well.

The thing that makes me happy is that while being at the hospital he has really gained confidence. Now I'll admit, when kids start having confidence they can bit a bit tiresome as they test our limits of what we will allow or how much we will give them. It is neat, though, to see one who has been shunned start to feel loved. They are a few boys that have been at our hospital for awhile. Baba, Abdoulaye (he had broken his femur and the bone had "healed" outside of the skin) and Balla (the colon cancer) had become the three amigos. Balla then left and Modibo (post "On Thanksgiving" where he lost his arm) came. They go everywhere together laughing and playing.

Chronic Osteomyelitis

This boy came in with a chronic osteomyelitis at only 6 months of age. Since he was 2 months old his leg had swollen and drained pus from an infection in the bone. As you can see it was severely swollen.

They come from a village outside of Koutiala. Just the other day the family came by just for a visit and show us their son now almost 2 years later. These are his residual scars after his surgery to remove the dead infected bone.

Here he is walking normally without difficulty! Amazing that his leg was able to be saved!

Mariam, severe malnutrition

This little girl, Mariam, was about a year old in this picture. I'm not kidding. She was skin and bones and weighed less than 7 pounds. She was severely malnourished as her mother had abandoned her and the grandmother was trying to nurse her. We hospitalized her for several months and she really started doing well. Unforuntately, a few months later she was back with kwashiorkor malnutrition which is a protein malnutrition. They are fed rice and millet but no protein so then they begin to swell all over. She was hospitalized AGAIN for a long time. We, the foreigners, really wanted to take her from her family as they obviously were not doing a good job but the grandmother refused and there aren't the necessary laws to protect children in Mali. When we sent her away the last time I don't think any of us really thought she'd live.

But, THANKFULLY she has and is doing well! Here she is from a recent visit to the hospital with Alyssa who kept her during her initial hospital stay.

That is not swelling but chubby cheeks!

Sweet little girl! Thankful she is alive and doing well!