|
Field Report: June, 2008
Leyna came to the clinic on a Friday morning from the village of Rio Esteban, about 10 miles and two bridgeless rivers away from us. Tiny for her 3 months of age – slightly over 9 pounds, her mom had brought Leyna to us because she was having difficulty breathing. By the mom’s report, Leyna had been healthy until now. As a dark-skinned child of Garifuna extraction, her blue color had not attracted attention from anyone in the family. Being born in the government hospital in La Ceiba had not guaranteed that any such abnormality would have been detected. We were just about to go to town for groceries (Friday is not one of my clinic days), when Dr. Ted asked me to see her.
Leyna’s deeply blue fingers, toes, and lips were a stark contrast to the clean white of the tattered and ripped dress that covered her chest and abdomen. Her oxygen saturation was 62% (normal is 100%), and her breathing was labored, as though each breath was the last supreme effort of this infant to survive. A quick exam revealed that the child’s heart was on the right side of the chest. A tip-off for other congenital cardiac defects, a quick echocardiogram revealed that the abnormalities were almost countless (for you medical folks, she had almost every lesion in the texbook – VSD, ASD [actually a common atrium], dextrocardia, transposition, pulmonary stenosis, PDA, single AV valve with tricuspid atresia, and a slightly hypoplastic LV). She also had pneumonia, the reason the mom had been prompted to bring her to us. Immediately I knew that we could do little for her at Hospital Loma de Luz. The only chance for improving her hopes of survival was to go to the big city for a palliative shunt – a connection between her aorta and the small pulmonary artery – after recovering from her pneumonia. Such surgery would not cure her, but it would improve her condition. Forget the groceries, we needed to get her transferred to San Pedro Sula to Hospital Mario Catarina Rivas, one of only 2 or 3 hospitals in the country where someone might be able to do this surgery.
The next 2 hours were consumed by calls to the hospital in San Pedro Sula and attempts to connect Leyna’s mom with missionaries in San Pedro to help her navigate the difficult process of going to the city and finding not only the hospital but the right part of this huge complex. We were able to connect with Lynelle Fields, a missionary who worked part-time as a volunteer at this hospital. She promised to help this bewildered mom and her baby from the countryside. We hurriedly drove her to a bus in La Ceiba, and found that the connections were good. The next bus left in 10 minutes. In the states this scenario would have prompted an airlift transport, but we had to settle for a public bus. Over the next few days, Lynelle called us a number of times. Yes, the mom and baby had arrived safely. Yes, they were admitted (a rarity over the weekend in the government hospital, but my talking to the director of the hospital had oiled a few doors). But the surgeons there were unwilling to operate. In the states the surgeons would have been able to do a shunt, but not here in Honduras. So she was returned to us on the same bus. Leyna’s mom immediately brought her back to us in her tattered white dress. She still had a fever, difficulty breathing, diarrhea, and vomiting. So we admitted her for a few days, and she improved. But she still had an oxygen saturation of 72% on discharge, an ominous sign that she might not last very long. We drove them to their house in Rio Esteban. It was simple: a hard-packed dirt floor, measuring about 20 by 20 feet for the 6 people living there, dogs and chickens in the house, mud and dirt walls with pieces of cardboard for doors. Leyna’s father was a fisherman – he dove for lobsters on the ocean floor. Indeed, 10 days later Leyna returned to the hospital with saturations in the 40’s. This time she wore only a diaper. Her breathing was labored, and I was forced to tell the mom – again – that her baby might not survive. Oxygen administration did not help, nor did the medicines. She died in her mother’s arms only hours after being admitted. Nurses Penny and Ritza found a new colorful pink and blue child’s sleeper that had been donated to the hospital, and they dressed the tiny body in it. We then drove the mom, the dad, and Leyna back to their village. Leyna’s mom’s sobs were the only sounds we heard on the trip. As we plunged through the last river to reach their house, I realized sadly that Leyna was now the best-dressed child in the neighborhood.
Hospital Loma de Luz – Where Provision Meets Needs
When the recent Urology team from the Seattle area was here, many members noted that the towels provided in both the dorm rooms and for patients in the hospital were quite old and needed replacement. One of the team members generously donated some money to replace them, and specified that the money must be used for towels. Not one minute later, Judy was approached by another missionary who told her that Pastor Felipe and his wife Lydia were embarking on a sewing business, and their first project was to make – you guessed it – towels. So we immediately gave them their first order for their “micro-enterprise.” And now we have new towels for the hospitalized patients, thanks to the intersection of provisions and needs.
But I’m Not Pregnant!
We’ve always considered ourselves to be in reasonably good health, and even occasionally pridefully of youthful appearance. Until now. You see, Honduras recognizes what they call the “tercera edad” (the “third age”). Businesses are required to give a discount (20-30%, on average) to senior citizens, on proof of age greater than 60. A few months ago I was standing in a bank, waiting to pay my electricity bill. The line was long, and moving slowly. The person behind me tapped me on the shoulder and asked if I wanted to stand in the much shorter line on the far left side of the bank. I looked at the sign at the cashier’s desk which said, “This line exclusively for the pregnant and the tercera edad.” My immediate response was, “Hey, I’m not pregnant.” But then I realized that he thought that I looked too tired and too old to stand in the regular line. Pridefully, I declined. Then just last week we went into a department store in the big city 5 hours away, and when paying my bill I was asked by the clerk if I wanted my “tercera edad” discount. That clinched it! If I look that old (I am!), I might as well take advantage of the local respect for age. So “tercera edad” it is from this point onward!
Creature Feature – the Oxybelis fulgidus (Green Vine Snake)
Most folks know that I’m interested in unusual creatures, So when Mark and Heidi Merritt called me to their house on the radio a few weeks ago to report on an unusual creature, I was not surprised. They had found a green vine snake (aka Oxybelis fulgidus) in their flower garden. Very long and thin, it seemed little interested in our presence. Not knowing if it was venomous (it is, mildly), we stayed our distance taking pictures. We watched as it ate a lizard, swallowing it whole but then the moment of truth – what to do with it? We considered killing it, but we didn’t know if it might actually be a useful garden resident. So Kenton picked it up with a stick and moved it across the gulley to another field – not likely to prevent it from returning to the garden, but giving us a sense of safety.
Counting Our Blessings
Praises:
- For protection and continued safety in travel.
- For the wonderful visiting doctors helping us while we are short-handed.
- For successful furloughs for some of our missionaries.
- For great relationships among the families working here.
Prayers:
For safety in travel. This prayer never changes!
- For additional personnel - IT person, advanced math/science teacher, administrator, anesthesiologist, surgeon, nurses,
- worship leader, additional medical doctors.
- For Bob Lillard, the missionary who suffered a cardiac arrest now almost 7 months ago, and for his family.
- For success for our doctors in receiving their permanent medical licenses. This process drags along. (No recent news!).
Serving until His return,
Leon and Judy Greene
|