Saturday, January 5, 2013

Newborn Distress

Tonight I'm back in Sagam after a long set of flights from the US. I was kindly met in Kisumu by Jennifer, and after some food and running some errands in Kisumu we prepared for the trip back to Sagam. About that time I got a call from Mairead, our nurse who is volunteering at Sagam, that a newborn wasn't breathing and was undergoing resuscitation by the Kenyan nurse on duty.  We discussed how to best support the child, and I hopped in our very packed car and headed back to Sagam with the rest of the team (that now includes 4 Harvard undergraduate students that will be volunteering with us for the next 3 weeks).

After ongoing phone reports on the road from Mairead that the child was stabilizing and breathing on her own, we decided to transfer the baby to a bigger facility with neonatal trained nurses and physicians. I called a Kenyan pediatrician I know and was saddened to hear that Kenyan health workers in public hospitals were on strike regarding poor wages. If we sent the newborn to a public hospital, she would be refused entrance to the facility.  He suggested the child stay with us, since even though we aren't adequately equipped to deal with very sick neonates, at least we would try.  We double-checked with the family to see if they could afford care at a big, well-supported private hospital in Kisumu, but they could not.

I was surprised and happy to see that the little girl was alive and still breathing on her own by the time we got there. After struggling with several attempts to get intravenous access in order to start antibiotics, we were finally able to get an intraosseous line placed in her femur. This is a thick but relatively short needle that is drilled into the bone so that medicines and other fluids can be administered into the bone marrow. After being infused into the marrow, the medicine then leaves the bone via many small veins and enters central circulation, getting wherever it's needed all throughout the body.  I'm very thankful for Dr. J's donation of these needles to us.

We left the hospital sweaty, tired, hungry, but happy that the little one was still holding on. I'm not sure if she'll make it through the night. But thanks to Mairead and the rest of the Kenyan and US team, she has a fighting chance.

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