Miracle baby

This baby truly is a miraculous story of redemption. Her young mother felt helpless and alone and decided to terminate the pregnancy (which incidentally is illegal here now although that might change with the upcoming nationwide vote August 4). The pregnancy was successfully terminated but when the mother heard her little girl cry, she decided to bring her to the hospital for care. The baby was born very premature at 900 grams. Her weight decreased further to 730 grams early in her hospitalization as she battled typical problems of premature infants like respiratory distress syndrome, infection, and difficulty feeding. Her mother demonstrated that she was very anxious about whether the child would live or not. She obviously loved her very much and regretted her earlier decision. Slowly, slowly, the little one began to tolerate her feeds and gain weight. She was weaned off oxygen at around 1 month of age. Dr. Cropsey (ophthalmology) was consulted and diagnosed retinopathy of prematurity (vision loss due to prematurity) which slowly improved over the course of her hospital stay (though she likely will still not have normal vision). The baby stayed in the hospital almost three months and throughout that time her mother faithfully came every three hours, day and night, to feed and hold her child. She was so happy when the day finally came last week for the little girl to be discharged home - now breastfeeding well and weighing over 2kg.

AIDS

An aunt brings a 4 year old child into the emergency department with difficulty breathing. He actually has been sick for the last month with fevers, cough, and difficulty breathing. The chest x ray assists us in diagnosing tuberculosis. His mother was also treated for tuberculosis a couple years ago. We test the patient for HIV and the result is positive. Because this is such a difficult diagnosis, we don’t divulge this information to the aunt but wait for the mother to arrive. The aunt tells us the boy’s father died three days ago from “pneumonia” but that he was sick for some time as well. I discuss with the mother the next day that her son has HIV and tuberculosis and she likely has HIV as well. Her two other children need to be tested. She doesn’t want to be tested yet and doesn’t want to test the other children. She asks appropriate questions about treatment and wonders if her husband also had HIV (probably so). Although there are approximately 8 family members at the child’s bedside, she does not want them to know about the AIDS diagnosis.

A father brings in his 7 year old child who can’t eat because of sores in his mouth. The boy’s mother died recently from AIDS but the boy has not been tested. He weighs 25 lbs (the average size of an 18 month old) and is severely wasted. As expected, he has AIDS. His CD4 count is 1 (normal is 800-1050) which means his immune system is not really working at all. We begin to slowly address his many infections and severe malnutrition. Thankfully, we test his father and find he does not have HIV.

In 2008 there were 33.4 million people in the world living with HIV. More than 1 million of those live in Kenya. Many of them don’t even know it. There is still a huge stigma associated with HIV/AIDS here in Kenya. (I would argue there is stigma in the U.S., too, but not to the same extent.) Because of the stigma, people don’t want friends or relatives to know their diagnosis. This makes treatment difficult. Medications are available even here that can significantly prolong life with HIV (actually funded partially through your tax dollars and the PEPFAR program – Thanks! :)), but if they’re not taken >95% of the time for life, resistance to the drugs will develop. If you feel you must travel to the clinic secretly and hide the pills from family members, it is unlikely you will be compliant with the medications. But there is progress being made. Twelve times more people are on AIDS medications in Kenya now than there were in 2004. Voluntary testing centers can be seen in towns small and large across the country. And the two children above are improving and will hopefully go home soon and return for follow up.

Territory size shows the proportion of all people aged 15-49 with HIV (Human Immunodeficiency Virus) worldwide, living there. From WorldMapper.

This map shows the number of physicians per capita. Can you find Africa?

Pfister pfamily visit

I loved having my parents and sister Lauren visit last week. It meant so much that they were willing to travel so far to experience my world. I introduced them for the first time to Africa, to Kenya, to the safari animals, to the Rift Valley, to Tenwek Hospital, to my friends and colleagues here. We enjoyed sharing life together for a week and a half - vacationing but also just hanging out, making small talk and tall talk, playing games, and seeing what life is like as a medical missionary. One of the hardest parts of living here is being so far from my family and friends in the States but it's easier knowing that my family now has a better idea of my daily routine and can picture my life. I appreciated the chance to get caught up on what's going on in their lives as well.

Lauren & I with the Tenwek waterfall

My mom, sister, and I with two clinical officers

Running with Heather

The nursery - one of the premies born at 1.5lbs, now 3.5lbs and thriving

Don't worry, they didn't let Lauren operate - but she did get to watch a C-section and now has new empathy for what mothers go through!

Three cheetahs marking a tree

The migration - wildebeast and zebras lined up to cross the river but wary of crocodiles

Overlooking the Rift Valley

The Giraffe Center in Nairobi

Lunch on safari with the Mara river and hippos behind us

Picture with rhinos

Mara Safari Club

Tenwek waterfall

We didn't forget about our missing family members Leslie, Bud, Sam, and Baby Lutz #2 - here's Leslie and Samuel on his own cheetah. Hopefully he can come see the real thing once he's a bit bigger!

Giraffe Kisses