A Day to Celebrate Children

This child was born at 28 weeks gestation (normal is 40). It has survived 5 weeks with no medical intervention and being fed by a syringe. The mother died in childbirth, but this child shows how miraculous life can be.

At the beginning of this journey Jessica and I were given Angel Cards (Oracle Cards) by our friend Sandy that we met at a non-violent communication workshop. These cards have different messages and answers on them that are suppose to guide you and your feelings. Everyday Jessica and I pulled a card from the deck to boost our moral for the day. So many times the cards would ring true about how we were feeling or to what we have discussed the previous day. The week before we went to Malawi both of us pulled the “ocean” card multiple times…I know Malawi is not on the Ocean, but Lake Malawi was the closest thing to an ocean we had been near in a long time. We have not pulled a card for almost a month because we have been away. Yesterday we decided to pull one. It was the day that I was supposed to go to the pediatric ward. I have to admit I was feeling apprehensive because I am new to pediatrics and had never been to this ward before. That day I pulled the “child” card. The card read, “You care deeply about children, and they readily respond to your love. All children, including your inner child, require love, affection, and attention. Clear and open your heart and schedule so that you can give more time and energy to the children that need you.” If that was not a sign that I needed to go to the pediatric ward I don’t know what is!!

So our main focus right now is to be clinical instructors to the students. I found first year students on the floor, green and ready to learn. I orientated myself and said hello to the family and children and student nurses. I quizzed them on a few things and we started the day.

The first sad case of the day: a one month old baby in severe respiratory distress, has not had a bowel movement in 3 weeks, and has tested positive for Malaria. 3 doctors come in, each one saying the condition is something different. Either way, one suggests the family should go to Lusaka to be treated in the intensive care unit. I plead with the other doctors to let the family go as well (as I know the outcome at Lewanika due to the lack of resources will probably be fatal). The doctors agree, however, they needed much convincing.

Case number 2: protein energy malnutrition (lack of protein or all nutrients from the diet). Almost every child in the ward was being treated for malnutrition. There was one boy who stole my heart. This child was under 3 years of age with severe Kwashiorkor, a type of protein deficiency. He had puffy cheeks, belly, and feet from the lack of protein in his diet. When I sat down with the mother to ask what the child eats on a normal day she responded, “we don’t have money for breakfast, when we can he eats nshima (a carbohydrate) sometimes with cabbage if we have it). Almost no protein in his diet and very little of other nutrients as well. He is 1 of 5 children in this family. I taught the mother simple affordable ways to include protein in her children’s diet. I hope it was something that she could incorporate into her children’s diet….

Note the round face and belly. Despite the malnutrition, he was a typical 3 year old, flirting and playing with the nurse!

The next case was heartbreaking. There was a small child that had marasmus (malnutrition where the child is lacking all nutrients) resting with his grandmother. The child was crying and crying, so I picked the child up and tried to console it. The grandmother looked at me and said something in Lozi. When I asked someone who spoke English what she had said they replied, “she says you are an angel sent from heaven.” Wow, I almost broke down and cried right then and there. The child, who weighed less than 8 kg, looked to be about 3 months old. It was very shocking when I saw the child had teeth, which indicated that it was much older. The grandmother told me that the mother had a mental illness and she would often find the child laying in the dirt with no one else around. So the grandmother started to take care of the baby feeding it milk when she could. I wish I could describe how vivacious this grandmother was, she had to be a mother again and she was smiling and dancing with no worries in her mind.

It is hard to believe this child is 8 months old. I think we all need to appreciate grandmothers more after seeing this picture!

My experience here has really taught me to be an advocate for the patient. I have also learned to question things and really use my creative cap. There was a 13 year old child (HIV positive) with pneumonia. She had difficulty breathing so we propped her bed up with a piece of Styrofoam we found on the ward. This is one of the many tools that I have learned in Africa. I can not begin to express how grateful I am for my time here. Yes it is difficult to deal with emotionally, but it has made us much stronger individuals. So please don’t worry about us, we are doing fine here, and will be home shortly!!

Lianne