nee-wan-tan-ga (good afternoon)

5 Jul

We didn’t have a moment to spare for blogging yesterday…  Clinic days are [apparently] crazy busy.  It was a full day, from the moment we stepped out for our six a.m. run to the  moment we finally arrived back home at nine p.m. to eat dinner.

We haven’t mentioned yet — the weather is surprisingly temperate here (compared to Texas!).  It is fairly humid and hot, yes — but the mornings and evenings are cool, and the breezes combined with the beautiful landscape can actually make you feel like you’re in paradise at times.  Anyway, we decided to go for our first run yesterday, and while we’re a little out of shape for running, it was so refreshing.  The beginning of the day is so quiet here.

After our run, we went for our usual rounds in the pediatrics ward.  We found that our little boy with the persistent fever and sepsis had finally stopped having fevers, and was looking much better, and even got to go home today!  Unfortunately, we had a couple new sick kids.  Both had malaria — one with seizures who was very sleepy (unclear whether because of the anti-seizure meds or his malaria) and not breathing very well as a result, and another who was incredibly lethargic and stiff.  We’re still watching two little babies for NEC (necrotizing enterocolitis) — they’re stable, but they make us a little nervous.

We finished rounds at a reasonable time, and headed to clinic — where we planned to spend the rest of the day.  We joined one of the Ghanian medical assistants (like a nurse practitioner in the US), who sees most of the children during clinic, to observe him and get a feel for the way clinic works here.  Unfortunately, we saw only two patients before we left clinic for a procedure… and didn’t return to clinic for the following 5 hours.  We did an I&D of a breast abscess on a little baby, sutured a man’s leg after a moto (aka motorcycle) accident, resuscitated a 30 week baby, and went to a C-section delivery of twins to help resuscitate the second of the babies who was having difficulty breathing.  We finally made it back to clinic to see the last 5 patients of the day with Dr. Hewitt (one of the career missionary physicians here).

We then went to check on our patients in the peds wards.  We unfortunately found that several of our patients had become very sick during the afternoon.  Two with malaria were seizing persistently despite treatment and were unfortunately too sleepy to get another anti-seizure medication at a high enough dose to stop them.  Our lethargic and stiff child with cerebral malaria from the morning continued to be in critical condition.  And our babies on NEC watch had increasingly distended bellies.  We put our heads together and read every resource we had available to us at the moment to come up with a plan for the night – no eating for the babies, small doses of seizure medication for the kids with seizures.  We discussed them with Dr. Hewitt who agreed with our initial management and said he would check on them later in the night.

We came home feeling a bit defeated and worried for our patients, but had to remind ourselves that God is sovereign and our work here is good because it is through Him.  Even if we can help only a few children, it is worth all the effort in the world.  We finally went to bed after a quick dinner and shower around 11 p.m.

Today was both difficult and rewarding all at the same time.  Bruno, one of the peds nurses, informed us that our lethargic patient from yesterday died overnight.  Another patient who was admitted by Dr. Hewitt later in the evening had also passed away.  It was difficult to hear and even harder to process at the moment.  But we had to continue to take care of our other patients.  Amazingly, our new 30 week preemie had made it through the night on only a nasal cannula and was doing wonderfully.  To our surprise, we found another preemie, estimated to be 32 weeks, in the same incubator with her this morning who also looked fantastic.  She later was able to breastfeed very well – a huge accomplishment and a good sign that she might do well.  Our little boy with fevers for 10 days got to go home, and our kids with seizures were finally seizure-free on the second medication.  One of them is awake and improving today, the other remains in a coma and unresponsive, but his breathing is improved.  We had a new 3 year old patient with a distended belly, stiff neck, fever, and trouble breathing.  It remains a mystery what could be causing all of his symptoms, but we did some studies today including X-rays of the belly and chest and lumbar puncture.  The spinal fluid looks like meningitis of some kind – we don’t have cultures here so we just have to treat with antibiotics based on cloudy vs clear fluid.  Her chest X-ray is interesting and we are not sure what to make of it – maybe TB vs pneumonia?  And her belly is concerning for typhoid fever with possible need for surgery.  Clearly, we are having trouble making a diagnosis, but for now we will try to keep her stable.

We were exhausted this afternoon and took a long nap.  Rachel and Aaron played volleyball in the afternoon with nurses and other Ghanians while Courtney (along with probably 20 Ghanians) cheered them on.  Adam played soccer with kids.

It’s been a long two days, but we are again so thankful to have each other here to talk to and process it all with.  Thank you so much for your prayers and encouragement.  Please pray for us to continue to trust that God is in control of all of this and that we will rely on His strength and peace.

Courtney & Rachel

8 Responses to “nee-wan-tan-ga (good afternoon)”

  1. Carl Baldridge July 6, 2011 at 4:07 pm #

    Courtney,
    The microbiologist in me can hardly stand being quiet after reading your post.
    A few questions, what kind of labs do you have available? Apparently no cultures?
    What antibiotics do you have? Do you have any internet internal medicine contacts?
    Carl

  2. Jonathan Whitmore July 6, 2011 at 5:12 pm #

    You guys are doing great work! Your quote that, “[we] had to remind ourselves that God is sovereign and our work here is good” reminded me that I have that same thought at some point just about every day that I’m involved in ministry on campus. To be honest, I get a little jealous as I read your blogs because your work is so tangible… how awesome to wake up and see a child’s life revived because of your work with him/her! I wish the college students I work with would be a little more quick to respond to my input sometimes :).

    Anyway, we’re praying for you guys. Keep up the good work!

    J.

  3. Karen Tucker July 6, 2011 at 9:04 pm #

    Rachel & Courtney – We are in constant prayer for you and the boys. Reading your blog today makes me aware of how fortunate we are to live in the United States – even with all our crazy medical system issues. And, even though your time in Ghana will be filled with joy and heartache, God is definitely in control of your days and nights and will bless you and the medical team there for responding to his call.

    We miss all of you but are so proud of you and happy for you that you are having this amazing experience. I am looking forward to the day when we are there with you – I’d like to get my hands on those babies.

    Love to all of you!
    Mamasita

  4. Marcela July 6, 2011 at 10:08 pm #

    Love you both girls and praying for perseverance and strength for days like these. I am praying for much wisdom and discernment for treating the difficult cases. I will be praying for those precious children. What a blessing you both are!

  5. Doug and Karen Whitmore July 7, 2011 at 12:19 am #

    First of all…happy 4th anniversary to Aaron and Courtney!!! We love you tons!!!

    Secondly, now that we have had a chance to catch up on your blog after returning from vacation, we are loving it! It is great to get a glimpse into your days and to read the stories of how God is using you in the lives of the children(and their families). Thank you for your diligence in keeping us updated. We love to know how you all are doing and how to specifically pray 🙂

  6. Denise July 7, 2011 at 10:45 am #

    i am amazed by the experiences y’all have already had, only being there a week! i know it must be really hard to see such sick kids. it sounds mentally and physically exhausting so i will pray for strength and energy for you all. i’m so proud of the four of you and know that God is using each of you in mighty ways on this trip, some you may never even know about. we’re praying. love y’all!

  7. Karen Tucker July 7, 2011 at 6:03 pm #

    Congratulations Aaron & Courtney! 4th anniversary – smiles for the Baldridge Family!!

    Love you both, Karen

  8. Jen July 7, 2011 at 9:04 pm #

    So thankful that God worked out His plan so that you four could experience this together… having each other day in and day out can only make it a richer time. I’m sure the Ghanians think Rach and Court are one in the same person by now. =) Love you all!

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