Before coming to Angola, I had never thought just how frustrating medicine could be here. Being in my 2nd year of residency, I’ve learned a great deal on how to practically diagnose patients, treat them, and fix what’s going wrong with the resources available in the States. I’m beginning to realize just how much I’ve taken it all for granted. I knew things would be limited here, but just not how limited… Last week, within 2 days, 3 patients died—2 older adults and 1 baby. The older man died because of severe kidney failure. He presented with acute urinary obstruction due to a big prostate. A Foley catheter was easily placed to empty his bladder, but he was dehydrated and his kidneys had already taken a hit. He had labored breathing due to all the acid build-up in his blood. He needed fluids and lots of it. He wasn’t with it enough to actually drink it. An IV was placed but one could never placed that gave him fluids at a rate even close to maintenance—nothing that could actually help him out. He likely had electrolytes out of balance, but we can’t test for them and don’t have the medicine to replace them anyways. Within a couple days, he passed away. Really he just needed something as simple as IV fluids, which couldn’t be provided. It was very frustrating to watch.
The other older patient was an elderly lady with advanced inflammatory breast cancer. I’ve never seen anything like it. We had done a bilateral mastectomy down to nearly her ribs just for palliative care. The wound was left open with dressing changes every day. The thought was eventually to do skin grafts to cover the muscles and bones, and then let her live her last days at home—with her type of cancer, how advanced it was, and our limited resources, she had maybe a month or 2 to live. Well, in her recovery, she contracted malaria from the blood transfusions required (50% of blood given has malaria), she then developed a septic-like picture, and just did not do well. We have no means to increase calorie and protein intake besides encouraging eating. We had no means to make her anywhere well enough to promote healing. And then her wound started to smell—it was just a heart-breaking picture. We were hoping her family would take her home for further care and dressing changes, but that never happened—they assumed we could somehow make her better…
And the baby that died… We aren’t quite sure what happened. His parents brought him in with sudden respiratory distress. He had been diagnosed with malaria 2 days earlier. He had been given the proper treatment…along with some other antibiotics for an unknown reason—there were no records available to see what the doctor had been thinking. Anyways…he came in slightly blue, but his chest sounded clear. We tried to get an x-ray but the developer wasn’t working (eventually it did 2 hours later) and the ultrasound machine was broken. We had no way to do any type of imaging. We couldn’t get an oxygen saturation or vitals really because he was 3 months old and they just have older kid and adult-sized instruments to take them. We were able to give oxygen and he did seem to improve. We did get blood. His malaria was still positive and he had 44% bands on his white blood cell count—meaning he was infected with something else, but with what we couldn’t figure out. He seemed stable when we left that evening, but suddenly died later that night probably due to malaria, but only God know what else. Malaria does seem to take the lives of the young, old, and pregnant.
Although frustrating at times, good things and amazing things are happening here. Many do get better. People who would otherwise get no help are getting healed and helped for the better. What can be done on limited resources is done. (Just wanted to add some light at the end of the gloom J)
Right now, Sean and I are in Cavango. It was nearly a 12 hour drive on some rough roads at times—500 km from Lubango. Cavango is quite out in the “bush” and is a beautiful sight off a major river. Since it’s the rainy season, things are very green and lush. Cavango has a long history with the Foster family. Currently, Steve’s youngest sister, Shelley, and her husband are living and working here. There’s a medical clinic—which Sean helped build nearly 5 years ago with Samaritan’s Purse. They’re working on making a hospital here. Over 60 years ago, foreign help started here with a leprosy colony. Steve’s dad, Dr. Bob Foster came in the 1970 and developed a hospital with more of a mission station, and stayed here for a number of years… Then the war started and all was destroyed. There were many brick homes and such that are now just foundations with piles of bricks amongst the bush. Now, the Fosters, Samaritan’s Purse, and Advancing the Gospel in Angola are working to develop this mission station once again. We’ll be doing a medical clinic here for at least one full day (nurses do all the consults now) and fly back on the MAF plane. It’s so refreshing being out of the city with fresh air amongst God’s glorious creation.
We only have 1 week left here in Angola—we leave on Thursday. Time has definitely flown! We’ve sure enjoyed our time here. God has been teaching us many things about Himself, ourselves, and what He’s been doing and is doing. And, of course, we’ve been learning plenty of medicine. J Thanks for all your support and prayers. We pray you’re all experiencing God’s goodness, kindness, mercy, love, and grace. Until next time…cheers.
