on call

Well, if yesterday was clockwork, today was... not. All of the disruption was for worthy causes, but nonetheless, it was a challenge.

Among other things, there was a hospital-wide meeting this morning, at which the interim CEO of Tenwek addressed the hospital community about the current situation in the country as it impacts us. One of the things that has been so sad to see in this country is that people's identities with respect to their tribal heritages have shown themselves somtimes to run deeper than their identities in Christ. I have to say, it really took a lot of bravery to challenge a roomful of people not to consider themselves as Kipsigis or Kisii or Luo or Kikuyu (or American!), but as Christian. But he was right: only then will we as a hospital community be able to be the light on a hill that we are called to be.

Rounds resumed after the meeting, and the next disruptions were from upstairs, as I was called to the nursery to evaluate two sick babies. One was a twin with meconium aspiration that had been born the previous day - thankfully, he actually looked a little bit better than he had - and the second was one who had developed abdominal distension overnight. X-rays had been taken earlier in the morning, and I was in the process of realizing that the child most likely had NEC (necrotizing enterocolitis) when the CBC also came back with a platelet count of 9,000 (that's really, really low). Sadly, in Kenya, there's not a lot to offer other than prayers when a baby has severe NEC, and in spite of some tweaks in management, the baby became rapidly more sick throughout the day. We were able to keep him alive until his father was able to reach the hospital, but once we stopped our active resuscitation, the baby died very quickly.

I was also summoned to two other baby resuscitations during the day; happily, both of these babies were beautiful, squirming, shrieking little things. It's a blessing to be able to be a part of the miracle of birth the way that it was intended to be, as well as to take care of those babies who need more help. By God's grace I made it through, and it's evening now, but in spite of the fact that the sun is setting, I'm on call and my day is only partly over. Pray that tonight will be quiet - tomorrow I'll need all the energy I can get. The Bemms are leaving for Nairobi for a court date in the adoption process of their daughter, Hannah (praying that it all goes as planned), and Thursdays are HIV clinic day in pediatrics. Chuck has very kindly spent part of the last couple of days compiling a packet for my use entitled "Pediatric HIV Care" that could just as easily be called "HIV Clinic for Dummies". I'm going to try to study up a little this evening beforehand... I think I'm already looking forward to bedtime tomorrow!