Mercy

While there are plenty of sad outcomes at a hospital like this - it's the surprisingly good ones that I want to remember.

Last week we closed our Lassa ward as the rainy season has begun and this lessens the interaction between the rats who carry the terrible virus (in search of water) and humans. Based on prior years' trends, it seemed like a long shot to ask God to protect our hospital entirely from the disease but he did! We had several suspects but all eventually tested negative and we made it through this dry season without any confirmed cases here.

The first suspect (based on symptoms and a screening questionnaire) set off the procedure of setting up an isolation ward, making concentrated bleach water wash and all the needed contact precautions. She was a young girl with a persistent fever of unclear source and recent hospitalization elsewhere - both red flags. You can imagine the terror in these kids who are isolated in a room away from their family and approached only by nurses cloaked in plastic protective gear. After she eventually tested negative and we were able to do more diagnostic studies, we found that she had a perforated esophagus. When we had her drink contrast it flowed freely into her chest behind her heart. In the absence of a stent to cover the hole or complex reconstructive surgery - this would often be fatal. 

Initial leak on right, follow up swallow study on left.

She had a coexisting pneumonia and was coughing up an unreal amount of pus. It’s unclear which process came first - the esophagus issue or the pneumonia. All I could do was place a chest tube to drain the fluid around her lung and a feeding tube in her stomach for direct nutrition. She wasn’t allow her to drink or eat by mouth for weeks. 

Through the amazing mercy of God, her esophagus healed. Many weeks later - after a negative leak test and then proving she could eat again - I got this photo of her the day we took out her feeding G-tube and discharged her from our care.

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I probably spent more time with this guy than any other patient in my time here. He recently lost both of his parents and then was badly burned in a field fire in Ghana. His chance of survival in this setting was low but so many people spent so much time in his care. I lost count of how many trips to the OR and how many skin gratings we did. I dreamed of the the day that he could come back to clinic. 

Here he is on the day we discharged him back to Ghana, giving me a high five which means his burn scar contractors are not too severe.

Thanks for praying for us and our patients. We see God a work here!