Yesterday we wrote about Dr. Travis, a team leader, colleague, and friend who died on Thursday of colon cancer.
At about the same time he was dying, one of the two-month-old severely malnourished patients on the paediatric ward also passed away.
MJ was the first baby his mother had. She delivered in a small government health center, and was sent home. Only her bleeding continued post-partum, and by the time she and her family returned a day later, she was in serious condition. According to her mother-in-law (MJ's paternal Grandmother), the health center had no blood to transfuse and so she died, leaving him motherless. So this grandmother and her grieving son did what they could. They bought straight cow's milk, which is not common in Bundibugyo, and fed it to MJ. They took him for his immunisations at 6 weeks, but no one noted the baby's weight or any problems. A week or two later, they brought him to our District Hospital. Where we noticed he was starving, anemic himself, and extremely ill. Over the next couple of days we were able to transfuse, start antibiotics, start gentle feeds alternating with oral rehydration, start a program for his grandmother (who had a 3 year old, so had only stopped breast feeding in the last year or so) to re-lactate. We moved him from the back corner of the ward to the acute area in the front, and put him on oxygen. We confirmed he did not have serious underlying malformations or infections; he was "just" starving and reacting poorly to the cow's milk protein, causing him to loose a lot of blood in his intestines.
We did all we could, and he died anyway.
After two marginal months at home, he only lasted a few days in our care.
This is a story of a broken system. MJ's mother should not have been sent home bleeding. She should have received one of several medications very effective for post-partum hemorrhage. She should have been transfused, immediately and repeatedly. NO ONE should die of bleeding, and certainly not a 20 year old in good health who just delivered a baby. MJ's grandmother should have been given advice and resources to care for him. The 6-week check should have screened his weight and pulled him into care. When he finally came to the hospital, it should not have taken an overnight wait for me to be the one to check his vital signs and find out just how sick he was.
I suspect that MJ was buried by mid-day Friday, wrapped in a cloth, with a handful of family in attendance. I suspect that once his mother died, no one really expected him to live anyway. I suspect that thousands of people are mourning Travis's death right now, around the world, and many many of us hoped he would live into old age. Besides the day of their death, there is very little in common between the two stories of MJ and Travis. But as I felt heavy hearted last night, this is what shocked me:
God knew each of them. God knew the days they would have. God knew the hairs on their heads. God loved them equally well.
I can feel sad, and even angry at the brokeness of the world, at cancer and hunger and poor supplies of blood and inadequate research. But the truth that God knows MJ and Travis and loves them both, that God is at work for good in the very moments of these deaths, that God continues in the process of redeeming all that is wrong and making it right and new? That is news so good and so big it is impossible to fully grasp. The truth that Travis and MJ could be sitting down to a banquet together right now? Also beyond comprehension, but why not? Maybe they recognized each other's Lubwisi greeting, or smile.
That's an image that gives me hope. And for Travis and for MJ, we bear witness that their lives mattered to God and to those who knew them. We go back into the battle of each day's push, bringing a little more light into dark corners and prayerfully making small bits of progress. That's about all we can do.
At about the same time he was dying, one of the two-month-old severely malnourished patients on the paediatric ward also passed away.
MJ was the first baby his mother had. She delivered in a small government health center, and was sent home. Only her bleeding continued post-partum, and by the time she and her family returned a day later, she was in serious condition. According to her mother-in-law (MJ's paternal Grandmother), the health center had no blood to transfuse and so she died, leaving him motherless. So this grandmother and her grieving son did what they could. They bought straight cow's milk, which is not common in Bundibugyo, and fed it to MJ. They took him for his immunisations at 6 weeks, but no one noted the baby's weight or any problems. A week or two later, they brought him to our District Hospital. Where we noticed he was starving, anemic himself, and extremely ill. Over the next couple of days we were able to transfuse, start antibiotics, start gentle feeds alternating with oral rehydration, start a program for his grandmother (who had a 3 year old, so had only stopped breast feeding in the last year or so) to re-lactate. We moved him from the back corner of the ward to the acute area in the front, and put him on oxygen. We confirmed he did not have serious underlying malformations or infections; he was "just" starving and reacting poorly to the cow's milk protein, causing him to loose a lot of blood in his intestines.
MJ on rounds, so thin and wasted, an allergic rash, and oxygen saturations of 73% (should be 95-100%).
He was back in that corner with the 37 on the wall . . .
We did all we could, and he died anyway.
After two marginal months at home, he only lasted a few days in our care.
This is a story of a broken system. MJ's mother should not have been sent home bleeding. She should have received one of several medications very effective for post-partum hemorrhage. She should have been transfused, immediately and repeatedly. NO ONE should die of bleeding, and certainly not a 20 year old in good health who just delivered a baby. MJ's grandmother should have been given advice and resources to care for him. The 6-week check should have screened his weight and pulled him into care. When he finally came to the hospital, it should not have taken an overnight wait for me to be the one to check his vital signs and find out just how sick he was.
I suspect that MJ was buried by mid-day Friday, wrapped in a cloth, with a handful of family in attendance. I suspect that once his mother died, no one really expected him to live anyway. I suspect that thousands of people are mourning Travis's death right now, around the world, and many many of us hoped he would live into old age. Besides the day of their death, there is very little in common between the two stories of MJ and Travis. But as I felt heavy hearted last night, this is what shocked me:
God knew each of them. God knew the days they would have. God knew the hairs on their heads. God loved them equally well.
I can feel sad, and even angry at the brokeness of the world, at cancer and hunger and poor supplies of blood and inadequate research. But the truth that God knows MJ and Travis and loves them both, that God is at work for good in the very moments of these deaths, that God continues in the process of redeeming all that is wrong and making it right and new? That is news so good and so big it is impossible to fully grasp. The truth that Travis and MJ could be sitting down to a banquet together right now? Also beyond comprehension, but why not? Maybe they recognized each other's Lubwisi greeting, or smile.
That's an image that gives me hope. And for Travis and for MJ, we bear witness that their lives mattered to God and to those who knew them. We go back into the battle of each day's push, bringing a little more light into dark corners and prayerfully making small bits of progress. That's about all we can do.
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