Coopers in the Congo: Winds of Change

October 25, 2018

Ebola Brings Winds of Change

"For everything there is a season, a time for every activity under heaven."' Ecclesiastes 3:1

Our hospital has experienced a lot of change these past few months, mostly related the Ebola epidemic in our province. Summer usually the busiest time in the pediatric wards at Nyankunde Hospital. The months of June and July were a bit of a whirlwind! We regularly had 80 children on the pediatric service, and 25-30 children in the nutrition program. Our hospital census tipped 130 cases which is a record for the past few years. Then along came the official news of a new Ebola epidemic in the neighboring province of North Kivu at the end of July. Our hospital admissions have plummeted dramatically since this time. This morning there are 4 hospitalized children!

Pray for our hospital and staff as they struggle to make ends meet during this Ebola crisis. I have not previously considered the impact of Ebola on the economics of an entire region. There is less transport of people and goods, and definitely less people seeking medical care. There is a lot of fear to seek care, fear of being isolated or being identified as a suspect case. To respond to all of this there are a lot of community efforts to educate the population and identify people who need medical attention. It may in fact be true that the mortality from the "fallout" of this epidemic will exceed the number of deaths from the disease itself. What I mean by "fallout" is the people not seeking care for ordinary problems, the increased cases of violence, and the patients fleeing health structures.

Although our numbers are decreased, we continue to treat children for malnutrition. We integrate them into community programs. Here are a couple of stories from the last few months. One of the stories demonstrates the need to isolate suspicious patients, but also that this too can have negative consequences.

Baby Furaha

Furaha is a special little 1.5year old girl that we met in unfortunate circumstances.

We were caring for her teenage mother who was suffering from a severe intestinal infection with bleeding and malnutrition. As we see altogether too often, young post-partum women are at an increased risk of malnutrition. We learned that this mother had fled the tribal conflict in this village in 2002 and was probably raised as a toddler in a displaced persons camp around Oicha. She had lived a difficult life already and was supporting a young baby all alone. Often new mothers are not able to take in enough calories in the post-partum period to feed their infants and remain healthy. This mother was desperately ill and continued to have on-going intestinal bleeding. She died suddenly of complications of infection and anemia. The family left the hospital to bury the mother and care for her baby. Our experience is that this doesn’t usually go well, especially when the father is unknown. Orphan babies such as this have a high risk of dying.

Unsure of where the family lived, we sent Pastor Remy out on a search to find a family in mourning. The first, second, and third trips were unsuccessful. Finally our chaplain found the father’s extended family. It turns out that a pastor and his wife in the father’s family had accepted the responsibility to raise the child. The following day the pastor’s wife agreed to come into the chaplain’s office to see what kind of support they needed.

We sat across from the pastor’s wife holding this little girl. Most toddlers at this age are able to sit independently, talk, and crawl all over the place. This little girl was content to be supported in the lap of her adopted mother, touch, and examine her hands. She seemed completely at peace and unaware of her difficult circumstances. What a grace! What were we to do to help? This was an infant who never really received significant breast milk. The baby was significantly under-weight and would qualify for a hospitalization. Yet this was a special circumstance where family bonding was so important, perhaps just as important as good nutrition. We agreed to start with initial infant formula (rich in Vitamin D) as an outpatient (in addition to solid foods) and transition to another formula in a few months. With close family follow-up, pastoral visits, and regular weights we felt we would succeed.

One of our pastors prayed over the family in Lingala and the family returned home with a stock of formula to last a month. It is such a joy to see this child find a loving home and an honor to be a small part of her story.

Chantal

Little Chantal was admitted to the hospital in August, at the beginning of the Ebola

Undergoing testing

epidemic. She had signs of malaria and sepsis (bloodstream infection). One night she got really sick and was transferred to the ICU. Then she had a bloody stool, which is reason enough to isolate someone during an Ebola epidemic. The medical team saw her from a distance for the next few days, gave oral antibiotics and malaria treatment, and observed continued fevers. She looked anemic and was barely able to sit on her own. She was refusing food and we needed to get her tested for Ebola and hopefully cleared of isolation restrictions. The testing was done just in time and it allow us to provide life-saving care. She tested negative for Ebola and was transferred directly to the ICU. She received blood, fluids, wound debridement, broad-spectrum antibiotics, and therapeutic milk.

As it turns out malnutrition was a significant medical problem for Chantal. After 3weeks she has recovered enough weight and strength to be discharged. She will continue in the outpatient malnutrition program. Many children from her village of Tumbiabo attend our weekly outpatient nutrition program. They walk for three hours to attend our programs, obtain education and 1-2kg of nutritional corn/soy flour for porridge, and then walk three hours home again. It always surprises me that people are willing to travel such long distances for our outpatient programs. Nyankunde Hospital is meeting a needed niche in the community. We provide the nutritional and social support that families need.

Watch for more frequent postings in upcoming weeks.

Keep praying for our family and the ministry of Nyankunde Hospital.