Thursday, October 30, 2014

Post-mortem C/S

It was a first for me.  I was walking into OR#2 to do a skin graft when they wheeled the lady down the hall.  There was some commotion, more than usual.   

"What's going on?" I asked.
"This woman is dead.  She has no heartbeat but she's pregnant and the baby is still alive.  We felt it moving."

I pulled up her shirt and asked for a scalpel.  There were no scalpel handles around, so they gave me a bare #22 blade.  There were no gloves in the vicinity.  Sterile technique seemed less important at that particular moment.   Speed was the key.  I took the blade in my bare hands and cut.  In one cut I was through the skin, subcutaneous tissue and fascia.  One more cut though the uterus and I scooped out the baby.  The whole procedure probably took about 15 seconds.  It was a little girl, alive but floppy.  I spent the next five minutes resuscitating the baby, while my assistant sewed up her dead mother.  After a couple minutes of ventilating with a bag, the baby actually started breathing on her own.  After about ten minutes she was howling.

I don't know when the mother died.  She had been transferred from Irumu, a small town about 15 km down a bumpy road.  She probably died around the time they arrived at the hospital.  She was still warm.  I don't think the baby could have survived if it had been much longer.  

Apparently this woman arrived with only her husband.  I don't know whether or not there is anyone in the family who might nurse this baby.  I don't know whether this little girl will survive.  I don't know if there is anyone who will love or care for her.  Recent experience has taught me that this is a pretty demanding task.  

So, there you have it.  Tragedy and miracle, weeping and rejoicing all rolled into one.  So it goes here in Congo.  What I do know is that the urge to live is powerfully strong.  This little creature wanted to live.  

Lindsey asked me later if having my own child gave me a different appreciation for babies in general.  I wasn't sure what to say.  It's not as if I were previously against babies or anything like that.  I feel like I've always done my best to fight for their right to live.  Maybe what I didn't understand what the intensity with which you can love a little helpless being who does nothing useful for you.  It eats, sleeps, cries, poops, keeps you up at night.  It frustrates you.  It drives you mad!  Still, you would do anything you could for it.  You would die for it.  Maybe that's as close to pure love as we can approach.  Maybe it helps us understand God's irrational love for us.  Having my own child has brought it all a bit closer to home.  Seeing this little baby start breathing touched me.  

So, that's my little story for the day.  Pray for this little baby girl.  She is premature.  She doesn't have a name.  She doesn't have a mother.  It'll be a miracle if she survives...but who knows?  Maybe it's all part of Gods plan.

Warren Cooper

Monday, October 20, 2014

Trips & Chickens

October 20, 2014

It is a typical day for me in mid-October and I am cherishing my time at home as a mom.  Emmanuel gives me lots of joy.  It enjoy just watching him wiggle and exercise his legs after feeding.  He is so observant listening to bird calls and the nighttime insects and seems to always keep tabs on where his Mommy is.  He absolutely loves to eat and we are amazed at how much he has grown in just 8 weeks!  As of this week he has officially doubled his birthweight and grown 2.5inches.  His head is even larger.  I have never seen anything like it!  He seems to need less sleep
which results in a baby that goes on sleeping sprees every few days. This too will pass as he gets older. We are so thankful that he is healthy and growing!  I can't wait until he starts talking to us.

Warren and I took a big trip to Kinshasa two weeks ago to apply for Emmanuel's proof of birth, passport, and Congolese VISA.  This was a BIG trip for a little guy but we really needed to start the process in order to have the needed documents to travel back to the USA for Christmas.  We were successful and hope to receive everything in the next couple of weeks.  We had the pleasure of staying with a Congolese family, the Mobulas. 
They were so welcoming and helped to orient us to Kinshasa.  It is hard to believe that Kinshasa is in the same country where we reside....such a modern and populated city compared to dirt roads, earthen homes, little access to imported goods, no stoplights, no mail system, a more temperate climate with farmfields all around, and children wandering around everywhere.  Kinshasa has 4 lane boulevards, robots controlling traffic, banks/ATMs, a mail system, restaurants, embassies, and of course lots of outdoor cafes and markets. 

We found that everyone we met was shocked to see such a young infant in public and everyone had comments on his age and parenting advice.  We heard: "he's too young to travel, you should cover him much more (nevermind that it is 100 degrees outside), you should hold him like this, etc.....". It's funny because culturally Americans would never do this and see it as an encroachment on our personal lives.  Congolese on the other hand have plenty of advice on parenting that they will share with you. 

Our house is turning into a small farmette.  So far we have received 4 chickens (make that 5, I just received another while writing this) and a goat as gifts for Emmanuel's birth.  It is very traditional to give chickens to families of new babies.  People say that the women give nutrients to her newborn through breastmilk for a week after eating chicken.  I'm not sure, but there is probably a gram of truth in it.  Ah yes, we are definitely living village life at its' best.  Several of our Congolese friends have recently had babies, so they have been stopping by to visit with their little ones.  It's good to know that our little guy will have lots of friends.
Richard and Mapenzi with Gabriella
Florence and baby Favordi

A new, baby African grey parrot named Jorp has joined our household.  He was delivered to our house the day Emmanuel was born.  Two babies joined our family at the same time.  Jorp and Emmanuel will grow up together...African greys have the same lifespan as humans!  Over the last 8 weeks Jorp has lost his downy and grown beautiful flight feathers!  He can literally fly down the hallway the

length of the house and into one of the rooms, landing on an extended hand. In the morning if I can't find which curtain rod he is perched on I just call his name and he chirps back at me. 
A little boy and his parrot

We are looking forward to some visiting medical staff these next two months.  Dr. Bartholomew, a maxillofacial surgeon, and his wife Huyen who is a family practice doctor.  He is hoping to do some cleft lip and facial tumor cases.  Also wewelcome Dr.Ron Johanssen, cardiologist from the University of Minnesota, and his lovely wife a cardiac nurse.  We have an abundance of cardiac problems from hypertension to inherited cardiac conditions to valvular problems due to rheumatic heart disease.  We are looking forward to having our friends here with us.  Then in no time we are back to the USA and Switzerland in December/January to see family.  We know this time will just fly by, but we will cherish the days to visit and opportunity to introduce Emmanuel to everyone. 

I thought you might enjoy some of these photos of typical life in the village of Nyankunde, thanks to
Elise Cegielski (intern with Samaritan's Purse).  She visited our village this last week to capture some of the maternal-child health work going on and to learn more about our work at the hospital.  I think you'll agree that she captures the vibrant colors of the women's clothing and a bit oftheir daily lives.  The women love participating in care group activities which they consider as their "school." Women work very hard in this culture from child rearing to cooking, fetching water, working in the fields.  Life can be rather serious which is captured in many of their facial expressions.
Life is a bit serious for these children

Thank you for so many of your prayers for my health (Lindsey) and our adjustment as a couple to life with a newborn.


Lindsey & Warren & Emmanuel
Aren't the colors striking?