This is the latest letter from Dr. Kristen Schmalz who served with the mission in Guinea and now serves at Compassion Evangelical Hospital. Compassion Evangelical Hospital is a non-denomination Christian hospital supported by the interdenominational Christian community.
The ministry at Compassion Evangelical Hospital is by God's grace growing. We remember Kristen in our prayers and through our TIM giving. All monies donated to TIM through our offerings go directly to the work of Compassion Evangelical Hospital.
While the medical presence of the Lutheran Church Missouri Synod mission in Guinea is primarily information, our Lutheran Church Missouri Synod missionaries are hard at work sharing the Gospel. Jane sends you regular updates on these missionaries.
We include all of them in our prayers and support.
Pastor Eberhart
FOURTH QUARTER 2009; NEWSLETTER FROM DR. KRISTEN SCHMALTZ
GUINEA, W. AFRICA
A Premie baby
-- Thanksgiving for life at Compassion Evangelical Hospital
A FAMILY IN NEED
-- AO and his wife A came to CEH several months ago with their son AO,
sick with several diseases. He had a bit
of a rocky healing course but finally was well after a week. I have maintained
a friendship through a work relationship with this construction worker who
lives in the village where I have been studying language/culture for the last
few months. I have been to their home
to visit and see little AO's progress and to let him become more comfortable
with me. Now I can speak small Pular
phrases to him without the 2 year-old boy bursting in tears at my white skin!
PREVIOUS HISTORY
--About a month ago pregnant A came to CEH with an intra-abdominal infection
that had to be operated on at the regional hospital in Mamou (HRM). I remember AO rushing around to get his work
done at CEH before accompanying his wife to the HRM and being happy for an
advance of money for this needed hospital operation. We all prayed for them as
they were ready to leave CEH. I remember
little AO crying in the village the one night I spent studying there while his
mom was in HRM... missing his mom. I went
to greeted the family in their hut & kept up to date on A's progress with
AO at daily morning bible readings and a visit to her bedside.
Everyone is busy with the rice harvest an important staple
in the Guinean diet and mine. Many of the construction workers do this work
after CEH hours and on weekends as this is their food stock for the year. During this busy time A came to CEH for
urgent treatment for malaria hoping to prevent the preterm labor that it often
induces. Last Thursday after CEH work
she walked up the hill to the village leaning on 2 of us for support. This week she progressed to severe malaria
and went into preterm (@ 32 wks.) labor.
I offered to take her, AO and 2 female family members to support her to
HRM. Never a dull moment in transporting patients!! On our way the two women wanted to stop at
the local government clinic for the vaccination of a village child they brought
with them! They all got out at the clinic
and I said we need one woman to help at delivery to do personal things, and the
other woman and vaccinated child could rejoin us at HRM. Ok... on we go to HRM.
HOSPITAL IN MAMOU
-- Upon our arrival at HRM much was
going on. There had been a recent death
in delivery of a woman & her unborn baby.
It is customary in this culture for all (the OB
doctor, staff, and everyone) to give immediate condolences to the grieving
relatives, and now I was able to do it in their Pular language. Also, a first time mom was in active labor
and the staff was calling out to her in Pular to "call if the pains get too
great and we will come." This was the
scene when we arrived, A with me, her husband AO, his mom and another village
lady with the crying vaccinated child; all of us on or by 2 stretchers
waiting. I gave A her afternoon meds as
now nurse midwives were on late afternoon lunch break. They invited me to eat "rice and sauce" with
them. I greeted and updated them on A's
situation since they operated on her a month ago. They examined her and found
her dilated and progressing in labor.
How fast would she deliver? I
went home to get items they requested: a wash basin, baby clothes &
blankets. But first we got food for
starving A, who ate a full plate of rice and sauce!! She had not eaten all day.
LIMITED SUPPLIES
AT HOSPITAL --When I returned to HRM with these items for delivery she
had had no progression of labor and was at the same stage of dilation with no
contractions. I called Dr Jean Paul to
update him. We made some plans to care for this premie along the lines that I
did at Liberia's Phebe Hospital. No incubator..no warming unit.. no
food?? I was thankful for stress given
to the unborn baby in the previous operation for infected mom, because that
induces lung development & maturity for the infant! No ventilator here..no oxygen. My NICU training of taking care of
micropremies is not practical or possible here and thankfully not necessary for
an approximately 32 week premie!
A TINY CHILD
ENTERS THE WORLD --Late at night baby boy Barry was born!! I was not there as it was precipitous and HRM
midwives were present. I heard he was a
vigorous, but small baby weighing 1500 grams. (I later was reminded by my
parents that I myself weighed in only slightly larger—3lb. 9oz.) Later at CEH, I Ballard-scale aged him at 29
weeks. Jean Paul and I consulted by
phone and gave counsel for kangaroo positioning of baby (close to mom for
warming). No incubator or lights at HRM
either. The reality in Guinea
is premies do not live unless they can suck and keep temperature without
extensive care. Dr. Jean Paul and I
dreamed of a difference he and I can make in CEH caring for needed cases like
this, during our phone talk until late at night. In the meantime we'll think chicken coop light
bulb warming "incubator" for tomorrow.
(My father, who grew up on a farm, told me about this.) We'd first try normal nursing. But we will try feeding by expressed breast
milk (if there is some) via cup or spoon if he cannot suck well. We can get formula from CEH supply and do
tube feedings if needed.
CEH COMES TO THE
RESCUE --The day after delivery I drove Jean Paul and myself to
HRM. AO, A and baby were to be
discharged that day and come to CEH. We
would work to get ready for semi-inpatient care if needed. The tiny baby was still vigorous & had
good color but had a poor suck. We'd
have to address heating & feeding issues as mom has no milk. We found
powdered formula in a CEH container. We gave directions on how to mix up with
warmed-over water left from cooking over a fire and to be given by spoon or
syringe at night. We reinforced kangaroo positioning as it is cold at night
now. The family preferred to go home and
the better suck reflex for the baby was encouraging. Our rough wooden incubator will not be ready
for a day or so and we need electricity to function the warmer light. No nurses at CEH at night. Lots of people are surprised and said to me
"you mean he is not going to die?" What a chance to teach! What an opportunity to
help care for this baby! What a gift of
life!
Thanksgiving Day at CEH -- We are
thankful!
Kristen
with baby Barry
CEH
nurses
Father
feeding Barry
Food
for Barry
Updates: CEH is
applying for blood transfusion training of lab people so we are ready when CEH
inpatient unit opens fully. And we are
working on getting biotherapy for malaria medicines ordered through the Guinea
central pharmacy. These two things will
greatly extend the scope of CEH service. Thank you for your prayers and support
for the CEH medical missionary work.
"Give
thanks to the Lord, for He is good; His love endures forever." (Ps
118:1)
In Christ, Dr. Kristen Schmaltz, MD Guineadoc@yahoo.fr
