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Tuesday, May 06, 2014

Serge Internships: not for the faint of heart

Every summer our mission brings young people who are on their holiday from college, or recently graduated, and places them with teams around the world.  Our kids always looked forward to "the interns", who were generally way more fun and hip than the old parents.  They helped with nutrition programs or taught in schools, coached, distributed goats and led Bible clubs (oh, and once helped us carry kids as we ran for our lives from rebels, but that's another story).  Now that we're in Kijabe we are focused on Kenyan medical interns and have less exposure to American college students.  But it turned out this year that one of the Nairobi interns was arriving a week or so ahead of the rest of her group, and as an aspiring premed student wanted to visit Kijabe.  So Mae Mae caught a ride out to our rural hospital and is spending a couple of nights.

On rounds this morning, we plugged along seeing our patients, until we came to baby I.  He was born precipitously the night before on Scott's call, and we were glad to see that in spite of being only 32 weeks gestational age (out of 40) and 1.3 kg he was breathing well and active.  He was also, however, yellow.  His mother is B- (negative for the Rh antigen on her blood cells), and he inherited O+ blood from his dad.  His mother had lost her previous baby shortly after birth because of jaundice.  So her body was primed to recognize and react to those + markers on his blood cells, and her womb became a dangerous place for him.

God, however, had plans for his life it seems.  For no known reason his mom went into labor so fast and hard last night that Scott and team had no way to attempt to stop his early delivery, and out he came.  His hematocrit was about a third of the normal at birth, showing that he had been breaking down his blood cells in utero.  If he had continued to term, he probably would have died of heart failure.  But when we rounded this morning the whole story came out, and we saw we would need to do an exchange transfusion to save his life.  This involves taking his blood out a teaspoon or two at a time, and putting someone else's blood back in, blood that matches and is less likely to break down.  This removes the dangerous levels of bilirubin that cause not only yellow skin but permanent brain damage.

Only to do this, we need just the right O- (neg) blood, to match him AND his mom.  And it has to be fresh.  So as I was trying to figure all this out and see our 24 critically ill babies and get up to my weekly RVA clinic, Mae Mae our visiting intern mentioned, oh, I have O- blood. What?  Really?  It is a precious and relatively uncommon type.  Within ten minutes she was in our lab donating.  Meanwhile I walked our new Kenyan medical intern Beatrice through putting in a special umbilical IV line that is used for the blood drawing and transfusing.  Then we sat and pulled blood out an pushed blood in, 10 cc in, 10 cc out, 22 times.


Baby I's mother hovered close by, moving from distraught to smiling with hope.  We prayed over her baby with her and she watched us painstakingly spend the hours this procedure takes.  How amazing is it that her 2-month-early baby popped out in the exact 48-hour space when we had a willing and able donor to save his life?  Or that God sent this young woman around the world for just such a time as this?  That a Serge intern's blood will live on in a tiny Kenyan infant? 

Baby I still has a long way to go.  We may need to repeat the procedure in the middle of the night tonight.  He will risk infection and bleeding and take weeks or even months to recover.  Mae Mae has a long summer ahead too, learning Swahili and delving into Kenyan culture and loving kids through football coaching, all while working on med school applications.  But for today their stories intersected in a way that blessed baby I with life and intern Mae Mae with purpose and the privilege of loving.

Stay tuned for more internship stories from around our East Africa region.


3 comments:

lovesafrica said...

God is never early or late, is He???PTL!!

tscarlet said...

Awesome.

Jennifer Ronco said...

As someone who has dealt with the RH factor as I am O- and my husband is A+ this really touched me! Praise God!