They are hungry, even on Easter

 

 

The past few weeks have been busy at the El Roi Baby home and clinic with six new arrivals. Can you imagine welcoming six new babies into your family within just a few weeks? Baby Solomon and Prosper arrived as tiny, but perfect newborns, straight from their young mother’s wombs.  The four girls that were placed with us after that arrived severely malnourished with bodies “wasted” and I can tell you that three of them were starving to death.

 

It takes a LONG time to starve to death, and it’s a slow and painful death. There are two main types of malnutrition, both leading to death if not stopped and properly treated. The first is called  Kwashiorkor, which is very common here in Eswatini. It is often overlooked in the community because a child might look like a healthy (even chubby with a big belly) baby, but the child is protein deficient and the chubbiness is actually fluid build-up in the body, which can lead to organ failure, heart attack and death.  

 

 

The second most common type of malnutrition is called Marasmus, more easily identified because of the obvious body wasting presenting as skin and bones.

 

This week we saw both. Two of the three girls had obvious Kwashiorkor, which we often treat with a special formula called F75 and F100, then move them to a special diet that we have designed called “The Jonathan Diet”, created for our own boy named Jonathan. It is a high protein, low carb diet. But 2-year-old Nsiki presented with Marasmus, and our pediatrician explained that based on the markings/bruising across her whole body, the orange color of her hair and her teeth that are breaking off in pieces, that Nsiki would have had Kwashiorkor (deprived of protein as a baby), but as the time went on, and a new baby sister arrived, she was simply deprived of all food, causing her body to start to waste away.

 

 

At the age of 26 months she can hardly walk, has very little energy to roll or crawl. Her baby sister (10 months) is in better shape, only because she had some breast milk in the early months and had less time to starve.

 

THIS is one of the results of the Covid-19 pandemic in Eswatini. This global pandemic has upended life as we all knew it, but for the unseen, unknown children living in rural Eswatini it just means pain and suffering, and to their families … hopelessness.

 

We don’t typically accept children over the age of 2 years, but these girls presented the size of, and developmentally that of a 1-year-old. So, we welcomed them home. Over time they will get strong and one day be laughing and playing with the others. But for now we monitor them closely, provide medical treatment, special food and lots of love. We love them back to life.

 

 

I know that this probably isn’t the kind of happy Easter blog that you were hoping to read, but it is what it is. For those of you who believe in the death and resurrection of Christ, and celebrate it this weekend with friends, family, chocolate and a table overflowing with food, I beg you to pray for the children of Eswatini (and the world) who are suffering terribly with NO food, NO family, No access to healthcare, NO hope, except in Jesus himself.  But who wants to hear about Jesus when you are starving to death?

Even this Easter weekend so many children will be hungry.

If you would like to do something to help our children, and those who are still to come in 2021 I ask that you consider sponsoring a child today or make a one-time gift to help us provide the extra care that these hurting children so desperately need.

 

Child sponsorship in Canada:  http://bit.ly/hfahopestartsca

Child Sponsorship in the US:  https://www.heartforafrica.org/HOPESTARTS/

 

“When he finally arrives, blazing in beauty and all his angels with him, the Son of Man will take his place on his glorious throne. Then all the nations will be arranged before him and he will sort the people out, much as a shepherd sorts out sheep and goats, putting sheep to his right and goats to his left.

“Then the King will say to those on his right, ‘Enter, you who are blessed by my Father! Take what’s coming to you in this kingdom. It’s been ready for you since the world’s foundation. And here’s why:

I was hungry and you fed me,
I was thirsty and you gave me a drink,
I was homeless and you gave me a room,
I was shivering and you gave me clothes,
I was sick and you stopped to visit,
I was in prison and you came to me.’

“Then those ‘sheep’ are going to say, ‘Master, what are you talking about? When did we ever see you hungry and feed you, thirsty and give you a drink? And when did we ever see you sick or in prison and come to you?’ Then the King will say, ‘I’m telling the solemn truth: Whenever you did one of these things to someone overlooked or ignored, that was me—you did it to me.’

“Then he will turn to the ‘goats,’ the ones on his left, and say, ‘Get out, worthless goats! You’re good for nothing but the fires of hell. And why? Because—

I was hungry and you gave me no meal,
I was thirsty and you gave me no drink,
I was homeless and you gave me no bed,
I was shivering and you gave me no clothes,
Sick and in prison, and you never visited.’

“Then those ‘goats’ are going to say, ‘Master, what are you talking about? When did we ever see you hungry or thirsty or homeless or shivering or sick or in prison and didn’t help?’

“He will answer them, ‘I’m telling the solemn truth: Whenever you failed to do one of these things to someone who was being overlooked or ignored, that was me—you failed to do it to me.’

^“Then those ‘goats’ will be herded to their eternal doom, but the ‘sheep’ to their eternal reward.”

Matthew 25:31-46

Live from Eswatini … Happy Easter everyone.

 

Janine

 

PS – our Easter service will be on the Heart for Africa Facebook page at 9AM Easter Sunday. Please join us!

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 9^th 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.

The little boy from last week's blog...(warning - graphic photos included).

Last week I mentioned a little boy and showed a photo of him lying in the hospital.  He is now 13-months old and he weighs 6.1 KG (13.5 lbs).   Just after I posted that blog I asked the Doctor how the baby was doing and he responded that the child was not doing well, but he was hopeful that he would live.  He also said that he had just spent two hours with the young girl who was sent by the family to look after the child and he learned that the story that had been told to the hospital was all a lie, but the young girl was afraid and ashamed. 

Here is what we believe to be the truth.

Originally it was reported that the mother of the baby had died, the father had run away (a very common story here in Swaziland), and that the baby was being cared for by a very old Grandmother, who was also very sick. When the baby got sick the family/neighbors (unclear who) sent him to hospital with a young 17-year old girl to care for him.  The cost was almost $10 for public transportation as they live so far out in the rural community. 

As it turns out, there is no Grandmother (she is dead) and the 17-year old is the mother to the sick baby.  We don’t know who the man is who impregnated her at the age of 15, but we know that she had no milk for the baby and only fed him what she herself was eating … mostly ground maize once day if she was lucky (similar to grits, but without the butter or salt).  As the baby neared his first birthday he was getting quite fat and so the young mother thought he was okay. Then his skin started to crack and split and he got very sick and unresponsive.  It likely took weeks for her to find/beg/work for the $10 to take him to the hospital and by the time they arrived he was almost dead … from starvation.  

It’s called Kwashiorkor, and his body appeared to be fat due to extreme edema (swelling), which caused the skin to literally split open.

According to http://www.encyclopedia.com/topic/kwashiorkor.aspx,  “Kwashiorkor is one of the more severe forms of protein malnutrition and is caused by inadequate protein intake. It is, therefore, a macronutrient deficiency. Children are most at risk due to their increased dietary needs. Inadequate caloric and protein intake manifests itself with certain physical characteristics. Symptoms may include any of the following: failure to gain weight, stunted linear growth, generalized edema, protuberant (swollen) abdomen, diarrhea, skin desquamation (peeling) and vitiligo (white spots on the skin), reddish pigmentation of hair, and decreased muscle mass. Mental changes include lethargy, apathy, and irritability. Physiologic changes include a fatty liver, renal failure, and anemia. During the final stages of kwashiorkor, patients can experience, shock, coma, and, finally, death.  Treatment of kwashiorkor begins with rehydration. Subsequent increase in food intake must proceed slowly, beginning with carbohydrates followed by protein supplementation. If treatment is initiated early, there can be a regression of symptoms, though full height and weight potential will likely never be reached.”

Clearly this child was not treated early, but the Doctor is hopeful that he will live.  His development is significantly delayed and much of the developmental damage cannot be reversed.  He will likely be in the hospital for several more weeks until the edema is completely gone and his overall stat are stable.  

The story of the young girl broke the Doctor’s heart and he is seeking help with the Social Workers on her behalf. She has only gone to Grade 6, and even then she does not speak any English so we question whether she has ever been to school at all.  There is no one at her homestead who can help provide for her or her child if she goes back and so we have been asked if we can take the child when he is ready for discharge.

It’s complicated.  Nothing is easy. Oh how I wish we could help the young 17-year old, who doesn't speak English and help her baby. Oh how I wish we could help ALL the babies and young girls who are suffering here and around the world, but we can’t.  We are waiting to hear whether the child will be placed with us or not, but in the meantime we pray for this child, and for the small child that she is caring for in the hospital.

Live from Swaziland … I am on my knees today, please join me.

Janine

Update Monday morning:  I got a call from the Charge Nurse in the Children's Ward at the hospital. She called the Heart for Africa office and the message was passed on to me. When I reached her 30 minutes later she said that the reason she had called was to ask if I could bring more diapers in for the baby, but unfortunately, the baby just passed away a few minutes before I called.  I am in shock.  One of his organs failed, I assume it was his heart.  He is with Jesus now, but he will not be forgotten by anyone who has read this blog, and for that I am thankful that I had the opportunity to share about his short life. His name was Sinethemba, it means "faith".  

Confusion, lies and a new set of twins end up in the hospital

This was a whirlwind week beginning with a call from the Social Welfare department on Monday

morning saying there were three babies in desperate need.  We were already awaiting the arrival of a newborn (who at the time of this writing has still not appeared, despite an October 4^th delivery date).

I was told that one of the babies was a newborn and was dropped in a pit latrine (I never get used to typing those words), but was not ready to be released from the hospital.  The others were 9-month old twins who were in a very serious situation (not to suggest that being dropped in a pit latrine is NOT a serious situation!).  Tuesday Helen and I made the drive to Siteki to visit the baby in hospital and pick up the twins.

The mother of the baby gave birth in a pit latrine that had not been finished yet.  I never thought that I would write this, but unfortunately there were no feces/urine in the pit latrine to catch the baby when it landed, and instead the child hit his tiny newborn head on the bottom of the 6’ deep hole.  The mother left the child and it was only 12 hours later that he was found by a family member who heard his cry. It is a miracle that this baby is still alive, but not without injury.  He has several large wounds on his head and an abscess of some kind (the size of my fist), so we will not receive him from the hospital until the surgeons are finished and confident in his recovery.

From there we drove to the office to pick up the 9-month-old twins. I am not quite sure how to explain what transpired in the minutes to come, other than to say that there was a lot of confusion, there were lies, and then suddenly we had a set of twins in the car.  Their story took twists and turns that started with them looking like they were 18-24 months old and ended with them not even looking like siblings or the same age (let alone twins – neighbors maybe?).  The problem is that our policy is to only intake children under the age of 12 months because there is such a great need here in Swaziland for a home for little babies.  We want to have space for children of that age when a hospital or Social Welfare office needs to place a baby.  Secondly, the little ones come with much less hurt and emotional challenges than the older ones, and so our first children can be the leaders of the younger ones in the future.

But God is God, His plans are not our (my) plans, and He cheated and tricked me. I was “hoodwinked” as Ian told me later.

The children were living 100 km from Siteki, which is a 90-minute drive from Project Canaan. The police were the ones who reported that the children had been abandoned, so they were asked to drive the babies to Siteki and we would meet them there “half way” so to speak. By the time we arrived, the police had dropped the babies at the government office and turned back home. We looked at the children and laughed because they were walking, likely talking and had a full set of teeth!  I told the Social Worker that there was no way that these children were 9-months old and she insisted that is what she had been told. Well, maybe that is what she had been told, but there was NO way that was the truth.

 

Then there was the confusion. The Aunt of the children was the one who told the police that the mother had abandoned the children at her front door step when she wasn’t there (in fact she didn’t arrive home for three more days!).  The father of the children is HIV positive and has fathered 22 other children, to her knowledge, and was focused on passing on the deadly disease to as many women as he could before he passed away.  He is living in South Africa now.  When we asked how the boy was so very dark and the girl so very light, we were told, “Oh, the mother is a Zulu and the father is Afrikaans, that is why”.  Oh brother.  That might be true, but the mother is not a cat!

And then it got worse.  What are the children’s names?  Well, the Aunt didn’t know because she hadn’t seen the babies in six months, so she named them Rose and Gabriel. Why those names?  Because the girl was as pretty as a rose, and the boy would be protected by the angel Gabriel.

I told the Social Welfare officer that I really didn’t think these children qualified to come to El Roi as they were too old, but she assured me that they were less than one year and I couldn’t say no.  Where else would they go?  And so Rose and Gabriel, our “twin 9-month old babies” came to El Roi that night and it became their home.  They are actually 22-months old, the eldest children at the El Roi home for abandoned babies.  (Just for the record, I do believe that my friend at Social Welfare had no idea that the children were more than a year when she first called me.  She was only working from information the police had given her).

We have some issues with these beautiful children. They are angry, afraid, very hungry and both showing signs of severe malnutrition.   While they look round and plump, they are suffering “Kwashiorkor,” a form of malnutrition that is caused by inadequate protein.  In fact, yesterday afternoon we had to admit them to the hospital because their condition is acute and in the final stages (life threatening) according to malnutrition doctors here in Swaziland.  They will be there for 10 -14 days and that means that a caregiver from the El Roi baby home must be with them 24 hours a day.  There is no question that they have been abandoned before and mistreated based on how they cling to/fight for food, scrounge for tiny kernels of rice left on the floor even after they have had a full meal, and how they will bite in self-defense even when self-defense is not required. 

We have a long road ahead with all of these children, but we know that the Creator of the Universe and God who SEES them has brought us all together and He will make the way straight as we continue to seek His will and direction.

Thank you for reading this blog and for your continued support and prayers.  I can honestly say that I am at peace about what we are doing here and I believe that I have the best job in the whole world.  The rains are starting to fall again, the vegetables are being harvested and sold, and the babies are starting to crawl and walk. God is good and I am thankful.

Live from Swaziland…we have 14 babies!

Janine

PS - Just want to shout out to Beth Blaisdell, Kim Kennedy, Pam McReynolds and Sherri Troyer from the US Bank who were visiting this week and were a huge gift in assisting with many moving parts and sick children.  Special thanks to Beth and Kim who did "night shift" at El Roi last night with Helen while Thabile was doing night shift at the hospital.  We are so thankful for your hearts and hands.