Sunday, February 1, 2009

Multiple Losses

Hellen, a very reliable Ward I nurse, was absent yesterday. Two of her sisters were among the victims trapped unmercifully inside the downtown Nairobi Nakumatt (Kenya's equivalent of Walmart) when it caught fire Friday. At least 40 people died because the doors were locked when the fire broke out "to prevent looting."

We learned Thursday that Rabson, the young boda-boda driver whom we had discharged on TB medication January 20th, died at home ten days later. His family reported that he had refused to eat... but no one brought him back to the hospital for NG tube feeding. Although we had admitted him at no charge, they said they were afraid of incurring any expense.

A sister of Japhreth, our lab technician, was clearly suffering from aplastic anemia a month ago. We referred her to the Provincial Hospital in Kisumu, which was ostensibly better equipped to deal with her needs. However, she and her newborn died in childbirth a few days ago.

Dorcas, a beautiful 10-year-old diagnosed with Guillian-Barre, died at home in Esiola last week. Her caregivers had insisted that she be discharged, against medical advice. They asked the orphan program for help with the burial expenses, or we might not have otherwise known.

Paul, a young man riddled with malignant tumors, and Erasmus, an elderly man with the same, are being discharged today with pain medication. We can do no more for them here.

Zablon, 10, was admitted with staph abscesses over almost every joint in his body. He was also limping. Upon xray, Zablon was diagnosed as having probable osteomyelitis. His left femoral head (hip) has essentially disintegrated, and holes are visible in multiple bones. We can prescribe cloxacillin for the rest of his life, but Dr. Hardison says no surgeon in Kenya would operate.

We are still giving almost-three-year-old Zedekiah lots of rice and beans and eggs and TLC, as well as ARV's, anti-TB meds and now steroids. However, he still weighs 7 kgs (about 15 pounds), and there will be no food for him at home. His mama is too sick to work, his father has abandoned them, and Zedekiah cannot survive on USAID supplements alone. He was hospitalized in November, then again in January. Will we see him again?

Dr. Hardison drained six liters of bloody abdominal fluid from Christabel, 48, yesterday. She is much more comfortable now, but she will be discharged home with very little time left. She has been diagnosed with Budd-Chiari syndrome, secondary to a hepatoma (liver cancer).

Rosemary, also 48, lies in a semi-coma on Ward II. She is apparently suffering from an HIV-related encephalopathy, with left hemiparesis and intermittent seizures. We can control the latter, but we cannot make her well.

"Some days are just too sad," as Linet says. I'm glad it is Sunday; I can go to St. Philip's to pray in the company of kindred spirits. May God grant us the serenity...

1 comment:

Anonymous said...

Diane, I'm enjoying catching up on Maseno with your blog. We all made it safely back to Wisconsin and began school again right away. Thanks for all you do. God bless,
Maggie and the rest of the WI nursing students.