Every once in a while, I (Scott) must chime in to tell a story via the Obstetric side of our shared building. Pull up a chair in addition to also a coffee, This specific will take a while.
This specific will be a story of creeping towards in addition to also then slowly backing away via the precipice of death – many times. This specific will be the story of Mary (not her real name).
On May 26th, one of the medical officers on our service performed what seemed like a relatively routine Cesarean Section on Mary. For reasons of which are not clear to us, she developed a severe post-operative infection a little less than a week after her surgery. The infection was so severe, she was taken back to the “operating theatre” for a re-exploration. To look for anything of which could have been left behind inside previous surgery (like a sponge or gauze). Nothing was found. The abdomen was washed out in addition to also second-line antibiotics started out.
A week later, the surgical site opened up again showing more signs of severe infection. She was taken back to theatre for another exploration. Again, no explanation found. Washed out. Closed. in addition to also taken back for more post-operative care.
At Naivasha District Hospital, we don’t hold the benefit of microbiologic cultures, so we could not culture any of the fluids or pus. We had no way of knowing what bacteria was causing This specific infection or which antibiotic would certainly best fight the infection. yet shortly before This specific event, Jennifer had sent a baby to Kijabe Hospital who was critically ill in addition to also beyond our capacity. They did blood cultures which grew a bacteria (Klebsiella) resistant to all yet two antibiotics. Based on of which culture result, we began to wonder if Mary could have been infected with This specific resistant Klebsiella (there will be a lot of traffic between the Post-Op Ward in addition to also the Newborn Unit). At This specific point, I began to doubt whether Mary might survive. She was critically ill. She should have been in an ICU, yet of which was beyond our capacity in addition to also her financial resources. in addition to also our hospital didn’t even have either of the ideal antibiotics to fight the Klebsiella. So, I decided to go to an outside pharmacy in addition to also purchased the Meropenem out of our own pocket. of which pocket will be not genuinely my own. We live in addition to also work in Kenya as the hands in addition to also feet of many generous churches in addition to also donors. via their generous support, I was able to buy a full ten days’ worth of Meropenem at a cost of about $500 (which will be about 9 months’ salary for the average person in our area).
After a few days of the Meropenem, Mary started out to improve in addition to also I began to feel hopeful, yet then I came in to change her abdominal wound bandage in addition to also found fecal material oozing via her surgical wound. Somehow, her bowel had been injured inside second exploratory surgery in addition to also currently her abdomen was filling with feces. We called the general surgeon. Understandably, he didn’t genuinely want to touch her. She’s like a hand grenade. Nobody wants to be the last one to touch her before she dies. yet finally, he was convinced in addition to also he did yet another exploratory surgery. Surprisingly, he couldn’t find the bowel injury. So, he did a colostomy on the proximal part of her gut to let the lower part “rest in addition to also heal.” This specific left her using a stump of intestine draining via the skin into an adhesive bag. in addition to also the hospital didn’t have these in stock either, so we purchased those @$12 each via the outside pharmacy (who gave them to us at his cost).
After getting the colostomy in addition to also a full course of Meropenem, Mary finally turned the corner. She began to gain strength in addition to also to eat again. She grimaced whenever the colostomy bag had to be changed, yet she much better. She got her baby back via the nursery in addition to also began breastfeeding again. The milk came back. yet she still had of which colostomy.
The surgeon said he would certainly reverse the colostomy after six weeks. of which put the surgery date perilously close to the Presidential Election. yet we thought of which could get done. in addition to also then the surgeon tragically died. of which will be a story for another time.
So, we had no consultant surgeon to reverse the colostomy. What to do? There will be a law of which government hospitals are not supposed to refer patients to private hospitals. This specific will be to prevent a conflict-of-interest scenario in which a government employee refers patients to a private facility in which they have a financial interest. yet in This specific case, I felt like Mary’s best desire was to go to Kijabe Hospital where there are competent surgeons (who I know). So I contacted Kijabe in addition to also the head of surgery agreed to take her. of which was contingent upon her clearing her bill at Naivasha in addition to also paying for her care at Kijabe. The estimate for the care at Kijabe was going to be about $1000. With the help of our donors, I thought we could handle of which. Maternity Care in Kenya will be “basically free” (subsidized by the government). Her bill at Naivasha was $5.
Mary’s experience at Kijabe was amazing. Her colostomy reversal went smoothly in addition to also she was discharged after several days. in addition to also while we anticipated to pay the bill, of which turns out they had registered with the Kenya National Health Insurance plan (NHIF) which paid the entirety of her Kijabe bill. I had given the husband $300 for the initial deposit. of which was refunded to him upon discharge in addition to also amazingly enough, he brought of which back to me. of which was a true demonstration of his thankfulness in addition to also appreciation.
Unfortunately, two days after discharge via Kijabe, Mary’s wound started out draining bloody fluid. Seriously? Yes. So she was admitted back to Naivasha Hospital – again. We dressed the wound in addition to also Mary spent the Election week inside hospital.
For ten days we dutifully dressed the draining wound in addition to also slowly yet surely the drainage dried up. Today the wound will be dry. in addition to also today Mary was discharged home. 80 days after she had her first baby.
of which’s a tale of prayer in addition to also perseverance. I don’t think we can necessarily step up with these resources in every complicated case, yet God put Mary in my path in addition to also seemed to call us to action. So thankful today for her great smile in addition to also her life.
Soli Deo Gloria.
(photo used with permission)