heartache and hope

I don't think there is really a perfect way to describe the pediatric ward at Kamakwie. It's usually very noisy, lots of activity, and slight chaos. The ward is made up of 30ish beds, with mattresses added on the floor if needed. During the time I was there, the ward received all new beds with matching sheets and blue mosquito nets, and it looks quite nice if not a little crowded.

The ward is usually staffed by a Sierra Leonean nursing assistant and an RN which isn't much when you are dealing with dozens of transfusions, some critically ill kids, and about 100 new admissions each week. The staff are very dedicated, and so much fun to work with.

Me and Amos, the peds ward nursing assistant extraordinaire

Malaria and the severe anemia that accompanies chronic malaria infections are the main reasons kids are admitted to the hospital. According to the WHO, malaria kills a child every 45 seconds. It is the number one killer of children in Africa, and it usually affects kids under the age of 5. For example, normal Hemoglobin (the protein part of blood that carries oxygen to the body) in children is 10-14. Most of the kids admitted had a hemoglobin less than 7 and require blood transfusions because chronic malaria destroys the red blood cells making kids very weak. I even took care of a little boy with a hemoglobin of 2.3 who was really pale, had difficulty breathing, required several transfusions, but he did ok.

Because lack of finances (the average hospitalization costs $20), many parent's wait to bring their children in until they are seizing or even unconscious and at that point it's often too late inspite of everything you do. Dealing with death was hands-down the biggest challenge I faced at the hospital, but even through that God taught me so much. I think the best way to share what it was like is an exerpt from my journal that week...

"Today was difficult beyond words, but by the end of the day I was more in awe of God than I have been in a while. I worked the evening shift, and between the day shift and the evening shift, we lost 4 kids. I had to close the eyes of a 2-year old boy who died after being in the hospital less than 3 hours. I listened to a 9-month old little girl take her last breaths. In spite of doing everything we could, they were gone. My heart was crying out 'why?'. Seeing the grief of their families, hearing the cultural wailing that fills the hospital when someone dies, and seeing their faces marked with disbelief and sorrow was almost too much to bear. I felt so small, so helpless. I wondered how I was ever going to last here for 8 weeks. God showed me that I should always be this way, living in utter dependence on Him alone. Not trusting in my 'wisdom', experience, education, or abilities, but in Him and His soveriegn plan. As I was walking home, I was speechless in awe of God. I can't remember the last time I saw such a briliant night sky. Not having electricity has it's perks! You could see galaxies strewn across the sky and shooting stars. You could make out the silhouette of palm trees that blocked the light coming from the sky. God placed each one of those stars. He gave source to their light. He holds them in place. He went to the 'trouble' of making more than we can count or will ever know exist. He knows each by name. How much more His precious children! He knows the kids that died today and His Father-heart grieves for them too.

On a happier note, I have also seen countless children who seemed 'hopeless' make an amazing recovery. One little girl came in with cerebral malaria and was seizing uncontrolably even after giving several doses of medication. Finally, 45 minutes later, the seizures stopped. Over the next few days it became apparent that she probably had some mild brain damage. Over the next few weeks, her family attentively cared for her, she learned to eat again, and went home a smiley little girl.  For each of these, the heartaches and the hope, I thank God!

Blessed be your name
In the land that is plentiful
Where the streams of abundance flow
Blessed be your name

Blessed be your name
When I'm found in the desert place
Though I walk through the wilderness
Blessed be your name

Blessed be your name
When the sun's shining down on me
When the world's all as it should be
Blessed be your name

Blessed be your name
On the road marked with suffering
Though there's pain in the offering
Blessed be your name

Every blessing you pour out,
I turn back to praise
When the darkness closes in, Lord
Still I will say...
Blessed be the name of the Lord
Blessed be your name
Blessed be the name of the Lord
Blessed be your glorious name

You give and take away
You give and take away
My heart will choose to say
Lord, Blessed be your name