Taking Inventory

The serious medical cases continue to pile up in our neck of the woods. It is not uncommon to have very serious medical cases here, but we have definitely had more than our share lately.
Today we received word that Kosene lost her baby. She was about 6 months pregnant and has been fighting a very serious throat infection for the last month. The last time she came here, at the end of last week, she was looking quite thin and was having difficulty breathing due to the swelling in her throat. We worried for her life and that she would loose the pregnancy. After receiving sketchy details about the delivery last night and Kosene’s general condition, we decided it would be best for us to go to the camp to do a good assessment. We found her in her house, very thin, looking miserable, but our worst fears were not realized as she was sitting up and conscious. She was bleeding a lot, her pulse was up and blood pressure down, and she had a boggy uterus. We gave a pitocin injection and some teaching about uterine massage to help with the bleeding and we added another antibiotic to help with the obvious additional infection that resulted in the loss of the baby.
While examining Kosene, Jelo came to tell us that she was not feeling well. Last month, we took Jelo to the local hospital with headache, fever, severe abdominal pain and a strange mass in her left abdomen. After some lab tests and some nearly non-existent overnight care, we decided to take her home, convinced that she did not have a raging infection. The mass ended up being a very large and misshapen spleen, and her malaria symptoms and abdominal pain responded, very slowly, to quinine. Her spleen reduced in size some, and she was on the road to recovery. Today, she is complaining of headache, fever, and some abdominal pain. We are treating her for malaria again, but the real question is how do we prevent malaria and subsequent spleenic attacks in the future?
We hoped also to see Jelo’s sister Mbele and her one-year-old daughter at the camp. Mbele is dying of AIDS. We first saw her in January, when she was too week to get out of bed and so very thin. When we saw her a couple of weeks ago, she quite pale and weak, but improved. Her baby, however, was no longer the healthy kid that we saw in January. She was pale and lethargic and her skin hung loosely on her thin frame. She was obviously malnourished and dehydrated, and she may have AIDS too. Her mother is simply too ill to provide her with good breastmilk. We did our best to perk her up with some sugar water and provided some high protein food for the baby and nutrition education for her ill mother. Today Jelo told us that the mother and daughter had traveled to a nearby village, most likely to seek help from a medicine man.
And Yeye continues to beat the odds and is still living, over two weeks since we first brought her back from her father’s other encampment. Her fevers are less frequent, her breath sounds are slightly improved, and the swelling in her hands and feet are completely gone. We know her nutritional and hydration status, though still not ideal, are greatly improved. But her breathing and heart rate continue to be dangerously high and her reserves are very low. The lack of hope in her face may very well be an indicator of her prognosis, but I keep praying that God would allow her to become His child before He takes her. After 2 weeks on amoxicillin, it is time to try the TB meds again. Will her already sore belly be able to handle the medications this time? With our limited resources, what can we do for Yeye, for Kosene, for Jelo, and for Mbele and her baby? Sometimes it seems like we are not doing much, but what we do, we do so that the Baka will hear of the Love of God.