We continue to be humbled by the patients that present to our hospital. As our time at Mbingo continues, it sometimes seems that the cases get more and more challenging. Granted, we see our fair share of typical malaria, pneumonia, viral upper respiratory infections, and thankfully, well-babies too; but we also see incredible pathology, not only secondary to late presentations, but disease processes that most people would only read about in a textbook, and not actually try to manage in person! These cases are intensely challenging, and although MBH is a good hospital, we are limited in both diagnostic capabilities and at times treatment modalities. However, we are incredibly blessed to have friends both here and back home who partner with us to help us provide the best care we can for these children and their families. These are just a few examples.
- 6-yo boy with disseminated staphylococcus (source point: left septic hip) leading to tension pneumatoceles requiring emergent chest tubes. These pneumatoceles developed rapidly over 9 days, completely compressing the right lung to where he had no air entry on the right side of his chest and his heart was beginning to be compressed as well. We are blessed to have incredibly skilled surgeons here at MBH as well as a pediatric anesthesiologist who were willing to take this child to the OR and perform life-saving surgery. He is still quite sick, but he has gone from saturating 75% on room air and breathing 70 times per minute using only one functional lung to being stable on room air and getting almost normal oxygenation and ventilation from both lungs.
Series of 3 chest X-rays over the course of 1 week
- 13 year old boy presented with a vasculitis (SLE, Wegener’s, Goodpasture’s, pauci-immune vasculitis, etc.) – acute renal insufficiency, hemoptysis, hematuria, etc. We have been able to send serum back to the US to have specialized labs performed free of charge so that we might make a true diagnosis and treat this child, who otherwise would die without ever knowing the cause of his illness. We are thankful to the volunteers who took his serum samples back to the US, the lab that has run his studies, and the countless friends we have consulted to help guide us in his management.
- Young couple with one living child and 15 other failed pregnancies – numerous spontaneous abortions and three perinatal deaths. Again, a lab in the United States was willing to run blood samples from mother, father, and the baby to perform a thorough work-up evaluating for a hemolytic disease process that might have been leading to the fetal demise. Thankfully, the newest baby has survived, and we are all so incredibly grateful to the lab staff who performed the needed studies and to the volunteers who hand-carried the serum back for proper evaluation.
These are just a handful of the numerous cases that require true teamwork and collaboration to provide care for the children. These are not bread & butter pediatrics, but they are the patients that show up on our ward on a daily basis. We are unable to make sure diagnoses and to appropriately treat many patients without additional help and support. We are indebted to our friends and colleagues around the world who have made a commitment to helping these children and families.
Thank you, and God Bless!
JR, Lindsay, and Cathen