Having looked forward to a
quiet weekend to focus on some strategic planning and to think about my talk
next Saturday at the mission, all was changed…
yes, started off well, peaceful
enough as we had breakfast [happily Hanna is definitely now improving
though still not fully back to normal] and I simply planned to review the
neonates as we have quite a few small preterm babies.
My intended half an hour
review session ended up hours later. One
baby aged 6 weeks, born at 28 weeks gestation, and previously doing well had an
apnoeic episode and was anaemic so had to have a top up blood transfusion and
start on iv antibiotics.
30 week twins, each
weighing about 1.3kg, had been born the previous day; one doing very well but
the other had a chest deformity and severe distress and possibly an abnormal
heart. He deteriorated on nasal oxygen with continuous positive pressure and we tried a
period of hand ventilation to see if he would pick up. No ventilators here of course and no
investigations such as blood gases. We
had the father hand ventilating him for a while. However sadly he failed to improve and died.
Meanwhile a 1kg preterm
baby doing quite well but needed a cannula - no luxury of having registrars here to do the tricky practical procedures though the baby nursery nursing team are quite good at putting in iv drips in the bigger babies.
Just when I though I could
leave, a woman arrived carrying a bundle of cloths. When these were opened up, there inside was a tiny
800gram baby, very cold. He had been
born the afternoon before at a government hospital called Kambuga about 80
minute drive from here to the north-west.
They had told the mother they had no facilities to care for the baby so
to they should go to Kisiizi. This is an example of how the real healthcare is provided by the church hospitals. The baby had not even been assessed by a doctor, probably none on site on a Saturday. The baby's temperature must have
been around 30 degrees only as after a couple of hours in a very warm incubator
it was still only 32.5! I put in a
cannula and gave him some saline and dextrose and covered him with iv
antibiotics. Today he is doing quite
well and has started on tube feeds which he seems to be tolerating.
So in the evening I went
back to review the above and things seemed to be more stable. Then this morning the note arrived [see
photo] and I reviewed the baby whom I suspect has Down's syndrome and perhaps
Hirschsprung’s disease with marked abdominal distension.
I did manage to get to the
end of the morning service in the chapel and greeted some new visitors from Chester with whom Kisiizi
has a formal link. They are here for 2
weeks, a group of 6 of whom 2 have been before I think.
We had a really nice lunch
with Esther and a good chat then later I went back to talk with the parents of
the above neonate as the father had meanwhile arrived. We remember him from our time here decades ago so it was good to meet up again.
Then back home, and now, on the fourth attempt, managed to get internet access to update this blog.
Thanks to all of you who have sent encouraging feedback.
Ian and Hanna
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