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Friday, June 07, 2013

A Tale of Two Six-year-olds

Back at Kijabe, back home, and back to work.  Back to reality.  OK, Spain and Portugal are one reality, for some of the world: pastel-painted buildings, ancient churches, hot fresh grilled salmon and chewy calamari, salty olives and frigid water.  A thousand hugs, too many conversations to complete. Worship and community and exposition and challenge.

But for much of the world, reality is quite different.  And so I will tell you the story of two boys on my ward this week.

The first I will call Torit, because that's his home town in South Sudan.  He was playing with his friends three weeks ago when they inadvertently tripped a landmine.  A landmine left by whom, I don't know, it could be the LRA crossing over from Uganda, the Sudanese army when it was fighting the SPLA (Sudan People's Liberation Army) or vice versa.  Because of violence and hatred that preceded his birth, Torit's play area was a death trap.  The three friends died, and his leg was shattered.  You can read about the state of orthopedic surgical services in South Sudan here from Mike Mara's trip last week. Torit's leg was amputated, but then infection set in, and an NGO staffed by Kenyans decided to fly him to Kijabe for rescue.  So there he was, my first patient on our rounds, in our Paeds HDU, diminutive and dark and scared.  I quickly realized that the woman sitting by his bed was not his mother, she was assigned by the NGO to accompany him. She didn't speak his language and knew nothing about his family.  So this kid that has lost his leg and his friends is now in a foreign country without his parents and no one to talk to.  And his family, who agonized through the injury and horrific surgery released him into the hands of strangers hoping for his survival.  And all we can do is prod and measure, administer antibiotics, and smile and try to engage him to play with this incongruously pink plastic truck that the chaplain's department gave him.  And hope this is a scar on his leg and his soul that will heal with time and love.

The second grew up only 60 or so kilometers away, in Narok, and since his name starts with "I" I'll call him Isaac.  My first evening back, I got an urgent call from the nursing staff asking me to help the MO intern who was in casualty.  I rushed over to find the intern with another six-year-old boy, his head bobbing with grunting breaths, his face obscured by a green oxygen mask, his frail body wrapped in a plaid wool blanket with a stick-thin arm protruding.  I pulled it back to listen to his chest, and he took off his mask to complain ninasikiya baridi, I'm cold.  Good, at least he was alert enough to be verbal.  He was emaciated, 11 kg, his entire skin dotted with the hypopigmented scars of an old rash, his bones jutting out.  A concerned father, stepmother, and little sister hovered close by.  AIDS.  I was sure of it.  The rest of the family looked healthy, though his mother had died some years ago of "malaria".  How could they let him get to this point of starvation, I wondered?  His potassium level was 1.2.  He was hours from death.  When the HIV test came back positive, I took his dad into a private room to break the news, expecting either denial or anger or grief.  I was wrong.  I met relief.  Thank you doctor for telling us what is wrong at last, he said.  He had taken the boy to so many hospitals.  So many diagnoses.  One said he was diabetic.  Another diagnosed typhoid.  A third told them Isaac was allergic to protein, so for the last year he had eaten only vegetables and water.  For the last month the boy had intractable diarrhea.  In desperation that morning the family took him to a church in Nairobi for prayer.  The pastor prayed, and then told them:  God has shown me that your son needs to go to Kijabe Hospital, and the doctor there will tell you what is wrong and start treatment.  Wow.  It is not uncommon for Kenyan pastors to confuse faith with a refusal of medical care, but this one was spot on.  And less than two weeks prior, the entire family (those who were well enough to go) went to a wedding where EVERYONE was offered HIV tests, and they were all negative.  So perhaps only the mother who died was infected, passing the virus to Isaac, or perhaps he became infected from a blood transfusion he had three years ago.  Far from being a family that was denying him care, they had really done their best.  We took Isaac up to the ICU.  His chances of survival are slim, but we pray that the same God who led him to the right pastor and the right casualty department will preserve his life for another decade, or two or three.  Refeeding a starving person is a dangerous business.  His body will not be able to handle much.  It is going to be touch and go for a long time.

This is a tale of two six year old boys.  It is also the tale of two fathers, unable to protect their sons from the ravages of this broken world.  Two mothers with aching hearts, separated from their beloved sons, one by death and one by a medical evacuation.  It is the tale of two countries with failing medical systems, unable to offer the basics that could have saved both lives at the beginning of their problems.  It is the tale of too many children everywhere, who are victims of an evil beyond their control, beyond their choices.

This is also a tale of rescue, and of Kijabe, and why it is a privilege to work here.  And the tale of a God who sees each six-year-old's story.  This was the Psalm that I happened to read this morning:
The LORD looks from heaven;
He sees all the sons of men.
From the place of His dwelling he looks
On all the inhabitants of the earth;
He fashions their hearts individually;
He considers all their works.
(Psalm 32).  Every individual uniquely fashioned, every heart and work seen and understood.

Which reminded me of this video produced by a friend who was working here, Beth.  It is stunning and redemptive conclusion to the tale of two patients, to the tale of our world.

1 comment:

Melanie said...

Thank you for sharing these touching stories. It gives a "face" to statistics.
I have followed your blog after seeing an article in WORLD magazine.