“I Will Be Still and Know You Are God”

Saturday morning started early with the traditional herbalist. He talked through a translator about remedies he uses to treat various conditions in the village people, and then we hiked with him around the mission so he could show us different plants and bark he uses to make the concoctions. It was hot and dusty, but everyone found it fairly interesting.

Sunday we packed tightly (an understatement) into three cars and took the bumpy dirt road to the village of Basibi, where our cook Leonard is from. The “building” was poles made of logs supporting a straw roof. There were backless wooden benches lined up underneath, and it was open on all sides, which was more conducive to air circulation. Three hours later, after the service and “songs from the visitors” (as always), we walked half a mile or so up a dirt road deeper into the village for our meal. They had prepared traditional nshima, rape, cabbage, rice and curry sauce, and chicken for us, and we ate outside on the ground under a big tree for shade. After lunch a band from the village played songs for us. All the instruments were handmade traditional African instruments. Everyone from men, women, and children to those of our group danced circles in the dirt around them while they played and sang in the hot sun. We even made room for a few chickens, a stray dog, and a goat who ventured over from a nearby hut. We got back to the mission just in time for dinner.

Kathy (the American missionary who started the Haven) came during church Sunday night for a consult on two of the newer babies who were sick. We found out they had not been eating for at least 36 hours, but because of the lack of early recognition, this was the first time a problem was reported through the live-in Auntie. Just short of two weeks old, they had both begun losing weight. Trey at 2.2 kg and Tori 1.5 kg. Dr. Black and Ba Janice decided to put an NG tube down their noses to try to catch them up on nutrition since there were no other symptoms of infection, and I elected to pack a bag and spend the night at the Haven so I could feed Trey and Tori every 2 hours. Callie, one of the students here who is pre-nursing, offered to go to help me and keep me company for the night. We got there around 9 pm, and they both looked bad, but Tori especially. She was hypothermic and none of our efforts to warm her up were very effective. We persisted to feed them every two hours, but being by hand instead of a nice mechanical pump like at home, it was almost time to feed again once we finally finished one feeding. Callie and I had hoped to sleep a little in between feedings, but shortly after 11 pm Tori stopped breathing. The head Auntie thought she had died, but I kept telling her she still had a heartbeat. She started again in a few seconds with stimulation, but her breathing became more and more labored after that. We walked over to the hospice Haven to see about getting some oxygen for her, only to learn that the only oxygen concentrator available here was being used in the women’s ward on a cardiac patient at the clinic. We discussed checking her oxygen saturation and her blood sugar, but neither of those pieces of equipment ended up being in the supply closet. So instead we walked back over to Haven 1 and rocked her. Her apnic (absent breathing) episodes became more and more frequent, and we brought her back with CPR twice, but because we could not correct the underlying problem, there was nothing else we could do. In the end we just held her and sang to her, and she died just after 3:30 that morning. There is no way to know exactly what was wrong with her; we just have to believe we did everything we could with the resources (or lack thereof) that we have.

I continued to feed Trey, and we took him to the clinic Monday morning to keep a better eye on him. We put him on antibiotics and were happy to see him tolerating the formula. Another baby, 5 months old, came into the clinic in the afternoon with febrile seizures and respiratory distress. After multiple IV sticks by Ba Janice and myself, we finally shaved his head and got one started in a scalp vein. We started a fluid bolus, slow-pushed some antibiotics, had Dr. Black do a lumbar puncture to test the spinal fluid (the only way to do that here is hold it up to the light from the window and see if it is cloudy or clear), and gave him a sponge bath to bring the fever down. We guessed it was cerebral malaria, and started him on antimalarial medication as well. This morning the night nurse told us he had died in the night. Clearly it has been a frustrating week. We brought Trey to our house last night, and Ba Janice and I took turns with the feeding shifts so I could get a few hours of sleep. He still will not take a bottle, but we have graduated him to full-strength formula and he is looking improved. He even gained a fourth of a kilo since yesterday. It makes me nervous to leave for 8 days on our Northern Zambia trip tomorrow while he’s still being fed through the feeding tube, but I pray that he is far enough out of the woods that he will make it.

We’re leaving early in the morning for a 17 hour journey (in old yellow school buses) to Mumena and a few other stops in Northern Zambia to encourage some missionaries there. We’re allowed one bag small enough to fit under our feet on the bus, so my next order of business is to determine if I can get 8 days worth of clothing into my little bag! On to packing...