One week ago Willemetta, one of the translators on the ward, went into labour. Fifteen minutes later, she had a baby.
It is most advantageous when African babies are born quickly. As Westerners, we tend not to consider the various problems that can present themselves during labour and childbirth in Africa. Sometimes, babies are born in hospitals. Many times, not. This eliminates the potential for epidurals, fetal monitoring, or crash c-sections. As I was reminded of by the translators at the baby shower we had for Willemetta on Wednesday: Someday, if and when I am pregnant and go into labour, it will be easy for me "because I am white". The whole "your life is perfect and easy because you live in America" mentality is pretty widespread amongst my African friends. I have to stop myself from becoming defensive when people imply such generalizations. The reality is that at least in this case, they are right.
On Tuesday afternoon, we got word from the outside world that a baby with gastroschisis had been born on Monday and would be coming to the ship. The thrill-seeking, adrenaline-junkie part of me got excited. I have been working on this ship for 4-months now and I can count on one hand the number of times when I have really felt "in my element". More often, I fumble my way through situations that I am slightly unsure of, asking a million and one questions, praying, and hoping that at the end of the day, my patients and coworkers remember only my dazzling personality.
But, disorders and defects in newborns is my comfort zone. So, for a very very brief moment, I was excited.
The most simple explanation of gastroschisis is intestines on the outside, instead of the inside of the baby's abdomen. As rare and visually disturbing as it can be, babies with gastroschisis born at home tend to do quite well. With our knowledge and special toys, we have become quite skilled at pushing the gastrointestinal system back where it belongs. Not to diminish the significance of the condition or imply that all babies do well; But, as a whole, outcomes are good.
The thing is, gastroschisis is still a significant issue. The surgery is a massive strain on the baby's body. Ideally, surgery should be done as soon as possible after delivery. Sometimes it is hard to fit everything back inside. It is necessary to provide IV nutrition for the baby until he can tolerate formula through his GI tract. The baby is at high risk for infection, due to the large opening in his body. The baby should be born in a high-risk delivery center, and have every precaution taken against infection. After the repair the baby's respiratory status can be compromised because there is less space for his lungs to expand. It is a process and a risk; But one that we are quite willing and competent to take at home.
Obviously, a baby born here with a gastroschisis has very little hope of the bright outcome that we offer to babies with the same condition in "America". Even with all of the expensive equipment and qualified professionals that Mercy Ships has to offer, we couldn't have saved this baby. What we could have offered him is nowhere near what it would have taken to give him a reasonable, successful outcome. It sometimes surprises me that after four months the "where you live determines whether you live or die" phenomenon continues to rip my heart out. I guess you aren't supposed to grow accustomed to that one.
Our awaited baby didn't ever arrive. Apparently, traveling in the Liberian taxi system when your intestines are outside of your body doesn't have quite the same efficacy in terms of survival as being wisked away to a sterile incubator immediately upon entry to the world. I know that we couldn't have saved him even if he had arrived. I know that it is better for him that I didn't get to show off my skills. I know that the ship of "Hope & Healing" has a specific goal and purpose and needs to function for that purpose. I know that we cannot transport America to Liberia. It just doesn't seem right knowing what is available out there and knowing that it will never make it here.
One week ago Willemetta, one of the translators on the ward, went into labour. Fifteen minutes later, she had a baby.
It is most advantageous when African babies are born quickly. As Westerners, we tend not to consider the various problems that can present themselves during labour and childbirth in Africa. Sometimes, babies are born in hospitals. Many times, not. This eliminates the potential for epidurals, fetal monitoring, or crash c-sections. As I was reminded of by the translators at the baby shower we had for Willemetta on Wednesday: Someday, if and when I am pregnant and go into labour, it will be easy for me "because I am white". The whole "your life is perfect and easy because you live in America" mentality is pretty widespread amongst my African friends. I have to stop myself from becoming defensive when people imply such generalizations. The reality is that at least in this case, they are right.
On Tuesday afternoon, we got word from the outside world that a baby with gastroschisis had been born on Monday and would be coming to the ship. The thrill-seeking, adrenaline-junkie part of me got excited. I have been working on this ship for 4-months now and I can count on one hand the number of times when I have really felt "in my element". More often, I fumble my way through situations that I am slightly unsure of, asking a million and one questions, praying, and hoping that at the end of the day, my patients and coworkers remember only my dazzling personality.
But, disorders and defects in newborns is my comfort zone. So, for a very very brief moment, I was excited.
The most simple explanation of gastroschisis is intestines on the outside, instead of the inside of the baby's abdomen. As rare and visually disturbing as it can be, babies with gastroschisis born at home tend to do quite well. With our knowledge and special toys, we have become quite skilled at pushing the gastrointestinal system back where it belongs. Not to diminish the significance of the condition or imply that all babies do well; But, as a whole, outcomes are good.
The thing is, gastroschisis is still a significant issue. The surgery is a massive strain on the baby's body. Ideally, surgery should be done as soon as possible after delivery. Sometimes it is hard to fit everything back inside. It is necessary to provide IV nutrition for the baby until he can tolerate formula through his GI tract. The baby is at high risk for infection, due to the large opening in his body. The baby should be born in a high-risk delivery center, and have every precaution taken against infection. After the repair the baby's respiratory status can be compromised because there is less space for his lungs to expand. It is a process and a risk; But one that we are quite willing and competent to take at home.
Obviously, a baby born here with a gastroschisis has very little hope of the bright outcome that we offer to babies with the same condition in "America". Even with all of the expensive equipment and qualified professionals that Mercy Ships has to offer, we couldn't have saved this baby. What we could have offered him is nowhere near what it would have taken to give him a reasonable, successful outcome. It sometimes surprises me that after four months the "where you live determines whether you live or die" phenomenon continues to rip my heart out. I guess you aren't supposed to grow accustomed to that one.
Our awaited baby didn't ever arrive. Apparently, traveling in the Liberian taxi system when your intestines are outside of your body doesn't have quite the same efficacy in terms of survival as being wisked away to a sterile incubator immediately upon entry to the world. I know that we couldn't have saved him even if he had arrived. I know that it is better for him that I didn't get to show off my skills. I know that the ship of "Hope & Healing" has a specific goal and purpose and needs to function for that purpose. I know that we cannot transport America to Liberia. It just doesn't seem right knowing what is available out there and knowing that it will never make it here.