Medical Supplies Needed

We will be visiting a hospital in southwestern Ethiopia. They are truly providing health care to some of the most needy folks on this planet. You can read more about the Soddo Christian Hospital in this well written blog post. You can either click here to read about a recent story when they had to care for multiple high risk cases all at once under difficult conditions or you can read about it below:

Life and Death in Soddo
This is Mark Karnes MD’s newsletter that went out on January 23, 2010. We have had so much interest in this letter that we wanted to also post it on our blog. At this writing, the mother that we gave blood to is doing quite well.
January 23, 2011
15/5/2003
I wish I were writing you a witty, cheerful newsletter this week, but the fact is my heart is breaking. Let me tell you about the events of yesterday. It was not all a disaster and there were many high points during the day. It began by Dr. Stephanie Hail asking to take first call and wanting me to “have a day off.” But that is a tad optimistic; because Stephanie, at this point, does not have her Ethiopian medical license so cannot take care of patients without my supervision. Also we had been inducing our doctor from the Netherlands, Dr. Ruth for three days and I fully intended on monitoring and delivering her baby. Because of significant chronic high blood pressure issues and thanks to our ultrasound we could tell that it was very necessary for her baby to be born, even though it was three weeks early. Alice had prepared supper for her the night before and breakfast yesterday morning. I took breakfast to her at the hospital and Alice came to meet me for a walk in the town. The morning was crisp and we had a lovely walk near the orphanage doing a circle at the edge of town looking down at the Great Rift Valley spread out below us. As we walked along the dirt road we chatted with many children and stopped to play table tennis with a few of them. Just as we were nearing the hospital my cell phone rang. It was Stephanie. She told me a patient had been referred from the government hospital, a woman with twins…the first one breech. Upon arrival I saw that Dr. Ruth’s blood pressure was getting higher and necessitated other medications. We took the patient to the operating room and while Stephanie stayed with Dr. Ruth, Dr. Teddy (the PAACS surgical resident) and I did the C-section. The mother was HIV positive. I wondered as I looked at her thin, emaciated body waiting for her spinal anesthetic on the operating table just how long she would live. Would her small breasts supply the needed nourishment for her two sons? She had two other children and this would be number 3 and 4. We have excellent antiretroviral medications now, but they have to be taken. Also, would she be able to give her two sons the ARV medications every 6 hours and give them a chance to grow up and experience life?
Her surgery went well but in the meantime I was informed of another patient who can just come in whose water had broken the day before. She had a high temperature and was dilated to 5 cms., but her baby was alive. We placed her on IV antibiotics and watched to see if she would make cervical changes but thinking that most likely she would need a C-section. As we were planning her care, we received word that a woman with a ruptured uterus had just been admitted to our “ICU,” which in reality is our recovery room. This was her fifth pregnancy. She had one 7 year old girl and the rest had died. She was acutely ill having travelled over 150 kilometers to get to Soddo. Her dead baby was coming “face first,” and she could not deliver it. Her abdomen was rock hard, filled with blood and her breathing was shallow and rapid. She asked me, “Can you save my life?” I told her there is only one Savior, Jesus Christ. After praying for her we got her ready to go to the OR. As she lay on the operating table, I held her hand and our eyes locked upon each other. As the nurse anesthetist was putting her to sleep, she started vomiting and I could see bile in the endotracheal tube. I yelled, “Suction her!” The anesthetist could not ventilate her lungs and she died right before our eyes; just a few short minutes before we had been looking at each other. Now she was gone. She had told me earlier, “I came here for you to save me.”
There was no time to grieve, however, because I had to get back to Dr. Ruth and check on the other patient. Stephanie had to stay at Ruth’s bedside because of the medications she was receiving and the fact that our OB nurses were not familiar with them and did not know how to take care of an acutely ill patient. Also, we have no IV pumps by which to monitor the rate of flow of medications. I was grateful that we had Magnesium Sulfate (brought into the country by Dr. Paul Gray) to help prevent seizures.
The patient with the high fever was now dilated to 8 but the baby’s heart rate had starting decelerating. It was time to get her to surgery. We delivered a live, big baby girl. But while still in the OR we received news that another patient that had arrived with a ruptured uterus! I quickly went to the “ICU” and this patient also had traveled over 150 km. to our hospital. This was her fourth pregnancy and she had delivered one baby the day before. She could not deliver its twin and in the process had ruptured her uterus. Her bare feet were caked in mud from squatting on her dirt floor trying to deliver her baby who refused to be born. Her respirations were shallow and rapid. Her abdomen was exquisitely tender. Her blood count was dangerously low. Her mother asked me, “Please save her.” I told her husband and relatives she needed blood and called Alice to come down that her O+ blood was also needed. All gave. This time, I had a different nurse anesthetist and she put down an NG tube into her stomach before putting her to sleep, draining a tremendous amount of bile. She was successfully intubated and upon opening her abdomen I discovered a 15 cm rent in her uterus. Her abdomen was filled with blood. I grabbed a foot and delivered her stillborn baby boy. Upon closing her uterus the electricity went out and I held my hand firmly on a bleeder while waiting in the dark for our hospital generator to kick in. Ninety seconds later it did and we were able to finish the operation. The mother is still alive this morning and has one unit of my wife’s blood in her.
The highlight of last night was the delivery of Dr. Ruth’s tiny baby boy, Ephraim, all 4 ½ lbs. of him! I was so grateful we had induced her labor because upon examining the placenta afterwards a portion of it had infarcted. It was a blessing that we had a live healthy baby boy and mother.
I’m sorry this is long but wanted to share some of the events of yesterday with you. We have so many pressing needs here…good blood pressure cuffs, good light sources (I used a head light flashlight for the delivery of Dr. Ruth), decent surgical instruments that work, and an IV pump. We are desperately low in suture. These are the realities of practicing obstetrics and gynecology in Ethiopia. Thank you for your prayers and continued financial support. We cannot do this without you.
Mark and Alice