Saturday, January 26, 2019

Will Elvis be remembered?


The call was urgent, the child was suffering. The child had suffered for the whole 15-months of his life and had been in and out of the hospital many times.  Why? Because he was starving to death.

Baby Elvis was the 9th born child to a woman who is currently 8-months pregnant.  She had been living with her husband and family until recently when the husband left, the family kicked her and the children out of the homestead and she found herself hopeless.  Time and time again she asked for help, and none was given. 

When the child couldn’t hold up his head and he was too weak to open his eyes so she walked 20KM/12.4 miles (remember, 8-months pregnant) carrying her sick child for help.

On Tuesday afternoon, Elvis came to us. I gasped when I saw his body and said, “What a mess!”.  That is not usually how I describe a child who is being placed with us through Social Welfare (or any child for that matter).  Let me describe what we saw – all signs of severe malnutrition called Kwashiorkor. 

His body was very fat and puffy, but that is because his body was storing fluid, putting pressure on his organs, particularly his liver and heart. His feet and hands were hot to the touch, but he didn’t have a fever.  Nurse Anthony did a full assessment to find many things including his skin had split and was peeling due to the swelling from the edema, teeth were rotten and misformed, severe diaper rash, severe thrush and his whole body hurt to be touched. We followed all of our protocols and sought council from two Doctors (our pediatrician and our HIV/TB/malnutrition expert). 


You might think that you could just start giving him food and he would be fine, but in fact, it could be the very thing that kills him. It is called re-feeding syndrome  and it was critical that we handle it properly. We made our own F75 and slowly started treatment. There was no urine or stool for many hours, and then he started vomiting.  By the early morning hours his breathing became shallow and we rushed him to the hospital – me driving like a crazy person who had just lost a baby two weeks ago and Anthony closely watching the baby in the back seat.

The rest of the day was long, traumatic and logic-defying.  By the time we got to the hospital his legs and arms were cold.  His oxygen levels were very low and he didn’t flinch when they stuck a needle in to his femoral vein to get blood.  His veins had collapsed and there was no way to get an IV into him.  His body was starting to shut down.

Earlier that week we had a visit from some US doctors who are in the country working on Emergency Medicine training and they just “happened”* to come and visit us.  Long story … I called to tell them we were losing a baby. They jumped in their car, drove 35 minutes to the hospital and ran straight in to the ER and got to work.  They stuck an intraosseous needle into his thigh bone (something the nurses there had never seen) and things started to look better quickly. I knew that the boy would live (well, I thought/hoped he would live). An hour later he took another turn for the worst.


We had been four hours in the Emergency Department and it was clear that he needed to be put on a ventilator and also needed other equipment and supplies that were not available at that hospital. Note the irony that this team is in eSwatini to teach and train Emergency Room medical workers, but the tools are not there to do so. We had to make a call – to take the dying baby to another hospital.  The team looked at me and said, “Janine, if we don’t move the baby he will die here.  But if we take him off the oxygen, he could very well die in your car.”

I drove my truck around to the ambulance entrance, the team grabbed baby Elvis, who was now blue in the face, and ran and jumped in to the back seat of my truck with an Ambu bag, manually respirating the baby as we flew through Manzini. 

We got to the other hospital (where Doctors were waiting for us) and took him straight to ICU where FOUR US Doctors/nurses and FOUR Swazi Doctors/nurses worked to save his life. It took 50 minutes to intubate him and the machine was breathing for him so they could start working on the other issues.


At 10:10PM I got the call that Elvis was dead. Something about oxygen and a blood transfusion … the rest was a blur.  Two minutes later the Doctor called back to ask me to come pick up the body. What?  I reminded him of the late hour, and besides, what was I to do with a dead baby??

He called again a few minutes later and kindly explained that there was nowhere for the hospital to store the body, and that I must come at once.  What the what??  I refused, then suggested that they call the funeral home and have them pick the baby up. They agreed.

Then I sat down and sobbed and sobbed and sobbed until I was too tired to cry anymore. It was just all too much.

Starvation and malnutrition are rampant in this country and things seem to be getting worse. Add in HIV/AIDS and Tuberculosis and it’s complicates each health situation immensely.  I am told by all involved that this little boy, Elvis, was at the “end of life” stage when he came to us. While we did everything possible to keep him alive, what we did the best was hold him, love him, pray for him and rock him during the night to provide comfort and peace.  He was only with us for 18-hours before he was taken to the hospital.  Our prayers for healing were answered, just not the way we had hoped. Maybe this was also a gift to his mother who didn’t have to watch her baby die in her arms?

Elvis will be remembered by all who touched him as he touched each and everyone of us deeply.

I am always reticent to put a donation link at the end of a blog like this. It somehow seems inappropriate and I don’t want to diminish the message of the blog. But at the same time, we need to pay Elvis’ hospital bill, and so many others who we care for.  So, if you have read this blog and you are moved, please help us to help the next child in desperate need by making on one-time gift to our Emergency Medical Fund in the US or in Canada.

I want to take a moment to give a special thank you to the MESH team from the US who  came to my rescue this week.  I will never forget their love, compassion and “get it done” spirit.  I expect we will be friends for life.
 
Lisa, Janine, Nadeem, Scott.

Live from eSwatini … this doesn’t get any easier.

Janine

*Nothing just “happens”. One of the MESH medical team referenced is a Nurse Practitioner named Lisa. Lisa went on a medical mission trip to the Philippines after the Tacloban tsunami.  Our daughter Chloe was also on a missions trip to Tacloban with her school, Morrison Academy in Taiwan, at the same time and Chloe told Lisa about what we do in eSwatini. Lisa and I became Facebook friends, and this week she came to visit.  God's ways are not our ways, they are better.

Saturday, January 19, 2019

We are fragile right now



“We are fragile right now.” This is what our nurse Anthony said to me yesterday.  It was at the end of a conversation about the baby Pearl, whom we lost last week (https://janinemaxwell.blogspot.com/2019/01/mom-she-isnt-breathing-saturdays-blog.html), and our toddler Morris, who was in hospital with seizures, fever and pain. We also were discussing the 12 other babies who were in the isolation room at the El Roi Baby home with fevers and diarrhea.   We’ve had a tough couple of weeks.

Yesterday we were called by Social Welfare to ask if we could take a 15-month-old boy who was severely malnourished, with dark yellow eyes and looked sick.  After several conversations it was agreed that the child would go to the hospital first, and then come to us once he was discharged. When I told that to Anthony he said, “That is a good plan. We are fragile right now”.  He is right.

As a nurse, Anthony is trained in life and death scenarios.  In fact, as we had many conversations about Pearl’s death, Cerebral Palsy (Morris’ condition), and other childhood illnesses with our medical team (including doctors and nurses), I found myself reminding everyone that medical professionals are trained in life saving, and end of life situations. 

Now think about our staff. 

We have the most incredible team of caregivers and I have the greatest love and respect for each and every one of them.  Each of them started with us either on nightshift or as a cleaner. This is how we are able to observe them, see if they are hard workers and see if they mop around a crying child or stop and pick them up.  We are looking for people who have integrity, are teachable and who love children.  But we don’t hire them with the expectation that they will have to hold a dying child or quickly try to get a fever down so that a massive seizure does not ensue. But that is what they do.


These are not trained nurses, but they have become a crack medical team knowing when to nebulize an asthmatic child, clean a wound and apply glue, or perform CPR in the back seat of a car to a child who is lifeless.  We have learned the difference between treating bacterial meningitis vs. streptococcal meningitis. We know IF and how long a child is contagious when they have tuberculosis and when to notify our Doctor when they see the signs of a child who is not responding to their HIV/AIDS medication.  All of this under knowledge has come under the tutelage of the incredible Dr. Moira Lemmer, and our remarkable nursing team (Hannah, Anthony, Rebekah and Brooke in the early years). I am eternally grateful for each and every one of them.

Some of our Aunties and Uncles are educated and some are not. Some finished High School, some finished Primary School and some do not read or write, but they are teachable and they love our children like they are their own.  They are the hands and feet and arms of Jesus, every day, and that love is reflected the faces of our children.  I would like to take this opportunity to thank them for going above and beyond the call of duty, every single day.


This week we are fragile, but we are not broken.  Morris is home from the hospital and we are focused on loving him and keeping him comfortable (it is evident that he has significantly more brain damage in the past few weeks with ongoing seizures and fevers).

Thank you all for your love, your emails of encouragement and your financial gifts to help us with our medical expenses.  It does take a large village to raise 217 children, and I love our village.

Live from eSwatini … praying for our care givers today.

Janine

Thursday, January 10, 2019

"Mom, she isn’t breathing," – an update



This blog was originally posted on Thursday, January 10th.  Here is an update with the original blog below.

Morris' fever broke last night for the first time in 7 days, but all blood work shows a very very sick little boy.  Our Doctor says, "Morris is a very sick little boy, with no obvious cause, apart from the very
severe cerebral palsy. Probably brain damage contributing to all his systemic incapabilities".


Isabelle is without fever this morning, but still a very sickly baby, struggling for life.  We have 12 babies in isolation with fever and diarrhea, but most are on the road to recovery. Still 3 more children with fever due to ear infections and teething.  All sickness is at the El Roi baby home - we are thankful that all other homes have not been affected or infected. 

Our volunteers gathered with our Aunties and babies on Friday morning for a time of prayer, and it was wonderful.  I admit, I opened my eyes a few times to watch 27 little faces looking around at us from their highchair tables. They were quiet as church-mice for the 15 minutes of prayer, just looking around at the adults holding hands and crying out to El Rofi, the God who heals.  The Holy Spirit was palpable. 

Thank you all for your prayers, words of encouragement and financial gifts to help with Morris' mounting hospital bills. 

Original blog posted Thursday: 


On Monday morning at 7:10AM I was called about one of our babies who had been running a small fever through the night and the Supervisor wanted me to ask the nurse if they could start her on an antibiotic.  I contacted our nurse and we were in the process of sending a photo of the baby’s chart so that the nurse could see what the baby had recently been taking.  At 7:40AM I was called again, this time I was told that the baby had stopped breathing.

I jumped in Ian’s car (which handles our terrible roads better than mine) and met Margie at the baby home less than a minute later.  She jumped in the front seat with two Aunties in the back seat holding a lifeless baby.  The baby’s name was Pearl.

We all prayed over the child, crying out to the Lord over and over again to heal her in His mighty name. We prayed, and cried and one of them did CPR while I drove at a break-neck speed to the hospital in town, only to have her pronounced dead at 8:30AM.

What??  She was alive less than an hour before? 

Pearl was a sickly baby, struggling with fever and diarrhea from time to time and then every now and then she would puff up. We had her tested for every possibility from allergies, to renal problems. All tests came back negative.  And then she died.

The next morning, at around the same time of day, Margie called me and said that Morris was not doing well and needed to go to the hospital.

Morris as he was being admitted
Morris is a 2.5-year-old boy who has never sat, never walked and doesn’t hold his head up due to severe Cerebral Palsy.  He was born at 28 weeks and lived the first five months of his life in a rural clinic (left there by his 14-year-old mother who promised to return for him). Since he came to us we have struggled treating his fevers, pneumonia, choking and seizures. He is the happiest little boy, except when he is sick, and then he cries all the time.  We have had many “close calls” with this little guy, but in December we rushed him to the private hospital in town where he was admitted for two weeks. He returned home on December 28th and eight days later, the day after we lost baby Pearl, we were rushing him back to the emergency room.

After Morris was admitted and they started suctioning mucus, it was time for me to leave (I don’t do mucus well).  We always have an Auntie stay at the hospital with our children 24/7 and so he was in good hands and I went off to run another errand – buy a coffin for Pearl.

I am not unfamiliar to the DUPS Funeral Home, and sadly knew where to go to register the baby’s death, where to choose the coffin (size #2), and what dark window to slide my money under to make payment.  I forgot to drop off her burial clothes, so I could only think of little Pearl lying wrapped in a hospital sheet until Margie took the clothes the next day.

Early this morning Denis picked up two of our baby home Supervisors (the ones who held Pearl as she died in their arms) and together they would go and get the tiny coffin and bring sweet Pearl home to be laid to rest in the Project Canaan Cemetery.


We notified Social Welfare and they came to the funeral with some very distant family members who were notified of the death.  It is common for Swazi’s to travel a great distance for a funeral, even if the relation is distant. It is also common for the family to want to see the baby in the coffin (which takes me by surprise every time) so Cynthia and I were asked to open the coffin for the family to see Pearl. 

They don’t embalm bodies here, so unscrewed the lid of the coffin to reveal sweet Pearl laying there peacefully, covered in condensation from being removed from the cold refrigerator and being brought out in to the deep heat of a Swazi summer day.  The lid was screwed back on, songs were sung, scripture read, and then the coffin was carried to the grave site that had been dug by hand minutes before the service began. 

As in Swazi tradition, a grass mat is placed down in the hole, two people jump down in to the hole and the coffin is passed down.  It is covered with a blanket and then men take turns shoveling dirt on to the coffin.  Every couple of feet of dirt, one of the men jump in to the hole in bare feet to stomp down the dirt so that it is well packed.  As the grave gets filled with dirt, the women collect rocks from the bush to surround the top of the grave and hold the piled-up dirt. 

Graveside

Shoveling dirt to cover the coffin.

Stomping the dirt to pack it down.

Our Aunties gathering rocks
When this was finished, we placed the flowers on the top of the grave, and a rock cross made on Project Canaan at the head of the grave.  Kind words were spoken, a prayer said, and it was finished.


Morris’ fever continues, his seizures are increasing in frequency and we continue to pray for health and healing, in this life.

I am not writing this blog today (rather than Saturday) for sympathy, but writing is how I process things. I just don’t know what else to do today. I don’t want to go and design beaded décor at Khutsala. I don’t want to go have fun with the big kids. I don’t want to drive to town again.  I am tired of crying. So, I thought I would write, and make sure Pearl is not forgotten, and that Morris is being prayed for.

I do appreciate your prayers and words of encouragement, and I also think it’s important to try to explain just some of what happens here on a daily basis.  There is so much that I can’t share publicly out of respect for my Swazi sisters and brothers, and because you simply wouldn’t believe most of it. Life is real, and it’s hard. Death is real, and it’s ugly. And we deal with both daily.  

Matthew 11:28-30 says, "Come to me, all you who are weary and burdened, and I will give you rest. Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy and my burden is light."

Thank you all for your love and support and your prayers for all of His children who are suffering around the world.  We are not discouraged, just sad.   We are not giving up or running away, we are just taking a time to mourn, and we know that there will be joy in the morning.

Live from my yellow chair in eSwatini … it is Thursday afternoon.

Janine

Saturday, January 5, 2019

What if He wants to use your boat?


(Yes, this will be the 2019 travel shirt design)


Yes, I completely forgot that today was Saturday until 30-minutes ago!  So sorry for the late post.  Happy New Year!

2019 marks the 10th anniversary of Project Canaan.  We will be hosting a huge celebratory trip from July 12-23rd, which will include a formal celebration chock full of performances and messages from around the world.  We will end the week with a live music concert at the top of HOPE mountain for our visitors and everyone in the surrounding communities.  

 
It’s hard to believe that it was 10 years ago when we purchased a piece of bush in the middle of nowhere, in a tiny African Kingdom.  Back then the question was “can you even buy land in Swaziland?” and the answer was yes, but it wasn’t easy (or cheap).  While we had a very generous family donate the $1,000,000 US (yes one million dollars) that we needed to buy the land, there were also many naysayers back then who did not agree with or support  the vision.   We even had Board members resign because they didn’t believe in the vision and didn’t’ think it sounded like something God would do.   

It just seemed too crazy, too “out there”, and they knew that neither Ian nor I had any experience in land development, construction, farming or raising sick/diseased orphans (in Canada let alone in Africa).  It did seem crazy, and many days still does seem crazy.

But here we are, almost ten years later, able to clearly see the hand of God on this project with 217 orphaned or abandoned children living here, oh, and WE live here now!  I have a friend who says that our lives here are like reading a continuation of the book of Acts (if were still being written).  I tend to agree with her assessment.

I was listening to a podcast in the car by a Pastor named Steven Furtick. The message was called “There’s a catch”.  There is a point in the message that he is talking about Jesus asking Simon (Peter) if he could get in Simon's boat. That question, and Simon’s affirmative response, changed the trajectory of Simon’s life, but Steven points out that if Simon had said “no”, Jesus would have gotten in to someone else’s boat, and the story would have continued without Simon.  Imagine that?

It’s a new year. Please say yes to allowing Jesus to use your boat when He asks.  Do not be afraid.  The journey will not be as you had planned it to be, and it will likely be fully of challenges and uncertainty, but I promise, it will be a better plan than you could have ever imagined. Our family is living, breathing proof of that truth and promise.

We have a few spaces left for the July trip and if you join us, it will be a trip that you will change your life.  If you have been before, but not in a while, or if you have been following from a distance for a long time, and feel that now is the time to travel, please consider coming and serving with us in July.  You will not regret it. 

To register today, please go to:

Live from the highway to eSwatini …. heading home from a few days in South Africa.

Janine