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Good morning!
We try so hard for good things to happen but we really can’t forget that these children’s lives are so fragile. The reality of doing surgery in places where children don’t always have access to regular checkups and healthcare makes repairing congenital heart disease e a little more difficult. They sometimes will go for years with a heart problem that we are used to detecting and treating in infancy. Meanwhile, they make a little bluer, they have no stamina, the tips of their fingers and ribcage begin to change shape, and the heart and lungs may experience some irreversible damage. Physicians and healthcare teams must make an ethical choice in caring for these children, I think. Do we risk the chance of death for a better chance of life?
This does not describe every child but I think it helped me understand what happened last night. Dr. Asunte and nurses Nancy, Atemba, Esther, and I watched over the children in the ICU. Sleeping was little David and Viona, doing well while still on the breathing machine. Veronica was sitting up drinking some water and dozing in and out. Another child, a teenager, had had a mitral valve replacement performed this afternoon by the local doctors and was writing something down for the nurse caring for her because she couldn’t talk around the breathing tube. She wanted some water.
Suddenly, I heard her nurse yell for help. The child had lost her pulse and gone into an abnormal rhythm. We immediately began to start CPR, used emergency medications, and tried to defibrillate the abnormal rhythm but without success. Dr. Myers, Dr. Cabrera, and the local doctors quickly came into the ICU and had to immediately reopen her chest, massage her floppy heart by hand and give it a defibrillating shock with the paddles. It worked! The rest of the night we worked hard to keep her stable.
As I walked home that morning after giving report to the day time nurses I couldn’t help but remember the unbelievable teamwork and dedication I witnessed among the Kenyan doctors and nurses. Kizito, one of the nurses I had been working with closely this week, had smiled and said, “This is exactly how we talked in your lecture today, no?” Their professionalism and focus led me to believe they had great experience in caring for emergencies. Whatever information you offer to teach them, they soak it up like a sponge and thirst for more.
I walked down the sunny street towards the hotel and was passing the convent girls school when I heard, “Excuse me!” being yelled from a top window. I turned my head to see a group of young, uniformed little girls giggling and waving to me. I waved and called back. After arriving to the hotel, I had breakfast and went to my room. I had no trouble falling asleep.
Our team would love to hear from you. Please send your questions, comments or words of encouragement to
Whitney Partin, R.N., partinw@lebonheur.org.
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