Monthly Archives: September 2012

Mina

I know it’s not been long since our last posting – but there have been lots of stories lately and we wanted to share another one – full of sadness and joy…

Last month, a young woman, Mina, (18 years old) was brought into the hospital.  She had come previously in May because she was becoming so weak in her legs that she was unable to walk.  The hospital staff who saw her referred her to a facility with a working ICU (in case she would need a ventilator) about 5 hours from Tansen.  Mina’s family didn’t think they could afford this, so they took her back home.

In June, Mina was brought back to the hospital here and was paraplegic, incontinent and had serious bed sores too bad to be managed here.  Our pastoral care (social services) team made arrangements for Mina to go to Kathmandu, but the parents again took her home for 6 weeks.  When they finally took her to KTM, she was denied admission to the hospital because of severe pneumonia.  She was sent to another hospital in KTM where they advised admission into the ICU.  The family decided they couldn’t afford that and came back to Tansen.

Mina was brought into the ER and was severely malnourished, short of breath because of a collapsed lung, unable to move her legs, and in pain because of terrible bedsores.  The bones were exposed and the surgeons said nothing could be done for her.  Many of the doctors were struggling at this point with many questions as this family had no money to pay for care, Mina had only a small chance to continue to live and really no hope to ever walk.  Some questions/thoughts were:

  1. Our charity budget, that some of you have contributed to, is limited. Is it ethical to use a large sum of that money for this one patient, who most likely will not have a good outcome?
  2. This patient will require intensive nursing care. Is it ethical to admit her so that less nursing care is available to other patients?
  3. If we admit her to our only isolation room, we will increase the risk to other patients by putting patients with sputum-positive TB in their midst. (In theory these patients wear masks but are not always compliant)

Still struggling with these issues, doctors admitted Mina into the hospital and gave the best care we could offer.  It was difficult not to get angry with the family who hadn’t followed medical advice – but they didn’t have money and here there are few if any options to help sick patients without funds.  If we had been able to foresee the parent’s concerns, we might have been able to keep Mina with us from the first time they brought her and maybe things might have been different.  However, she was put into the isolation room, given morphine, had as much nursing care as we could provide and was given food, emotional and prayer support.  These last items are things we can give here that people don’t get elsewhere in Nepal.

Mina continued to worsen in spite of the best efforts of the doctors and nurses.  She had to have a chest tube to drain air and pus from her chest.  Her decubitus ulcers got worse, she developed an abcess on her arm that required draining and finally pneumonia that didn’t respond to medications.

The family was told that she probably wouldn’t survive, but they decided to leave her in the hospital.  (Many people in Nepal leave with patients who are expected to die as it is cheaper to transport a live human being than a dead body.  There is also some superstition about dying in a hospital)

Mina died soon after this.

That was all the sad part.  Now for the little bit of joy at the end.  During the several weeks that Mina stayed at the hospital, she was followed by the pastoral care team who supported her and prayed with her.  During this time, she accepted Jesus as her Lord and Savior, and the head of our pastoral care department conducted a Christian funeral for Mina with the full cooperation of her parents.

So – it is good that we were able to care for Mina for awhile.  Although she died young, she is now enjoying life free from pain and with Jesus.

Thank you, God…Thank you, Pastoral Care Team….Thank you to those of you who support Tansen Hospital for people like Mina.

Advertisements

4 Comments

Filed under Uncategorized

Happy Birthday, Rachel! and Les’ Busy Day

Today (Sept. 10) is our beloved daughter, Rachel’s 25th birthday. We are so proud and thankful
for her walk with the Lord, for her beauty and musical skills, and for her gifts as a social worker.
We love you and miss you, Rachel! Happy Birthday!

It seems there is so much to write about lately – and we haven’t written much of anything!
We’ll start by telling you about the crazy day Les had yesterday. He felt as if he needed to be in
four places at once most of the day….

It started with a phone call at about 3 am Sunday morning. Les was on back up call for maternity since the on call doctor was an internal medicine doctor and doesn’t feel comfortable with maternity. The resident phoned and was distraught because a woman who had been laboring normally had ended up losing her baby because the shoulders got stuck during delivery and they couldn’t get the baby out in time to save him. Les went up right away and determined that there had been no risk factors (second baby, normal labor, etc) and that all had been done correctly…it was just a tragedy that no one could have prevented. He spent time with the other ladies who were in labor (and were asking for c-sections out of fear), and time with the grieving mom and with the staff. He was able to come home around 6 am to sleep for another hour before returning to work.

He started morning rounds on the medical ward with the resident and intern – there were 35 on the ward (in a max 32 area) and 8 – 10 other patients in halls and other areas of the hospital. While trying to get to all the patients, word came that there had been a bad bus accident and that people were on their way to Tansen hospital. About 20 – 25 people arrived to the ER and Les and the other senior docs who were in the hospital and the residents and interns were able to work their way through everyone. It was another tragedy that is too common here – a bus went off the side of the road (which means falling down a mountainside). 10 – 13 people were dead at the scene and the injured were sent to Tansen.

At the same time Les was busy in the ER, he was supposed to be starting a training course run for Nepali government health post workers. Because of the bus accident, that didn’t get started until about an hour after the scheduled time. After teaching the initial session, Les did get a break for lunch.

As soon as Les arrived back to the hospital and was starting to see patients in the clinic, he was called to talk with the husband of the woman who had lost her baby earlier in the morning. He was able to spend some time with them, but it was hard for them to understand that sometimes things don’t end up well even when everything was done correctly. He tried to encourage and comfort them as best he could.

He was then called back to the training course and he spent much of the afternoon assessing the clinical skills of the trainees by observing them seeing patients and doing physical exams. He was also supposed to be seeing patients in the clinic on his own at the same time! There were still a couple of government workers left unfinished at closing time for the out patient clinics, so he took those trainees to the ER to watch them do exams on patients there. He sent the resident and intern to the wards to do final rounds on the patients and write up notes – telling them to call him for any problems…

Les made it to the English language worship service at church only a few minutes after the 6 pm starting time – looking a bit weary. Fortunately, he just was attending this service and wasn’t scheduled to speak or have responsibilities! It was good to just worship and then chat with other attenders while drinking tea after the service.

We arrived home about 12 hours after Les had left for morning rounds – this day had been a bit long and stressful!

We are thankful for a good night’s sleep – and for your prayers which give us the strength to go on in the face of the multiple daily tasks, disasters, tragedies and joys that we encounter.

One last joy to share – this morning the surviving quadruplet came into the clinic again – she is doing very well and is almost up to 1 kg in weight!! It is so good to see her continuing to beat the odds – a miracle baby! Thanks for your continued prayers for her and her mom!

4 Comments

Filed under Uncategorized