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