The Smell of Infection, Suffering and Filth
Warning: This blog is not for the faint hearted.
A text arrives to my phone at 12:15 from Wendy. “So you ready to be a patient advocate (cause I know you are so bored!)? Gary is bringing in a lady and is asking us to go. Don’t know diagnosis or exact arrival time but around 1.”
Before I could respond, the next text comes in. “OK ETA 1240. Diagnosis 10 days (?) post miscarriage gangrenous mastitis.”
I scurry around in the kitchen trying to get lunch on the table. Racing against the clock. Racing against the now familiar sound, the drone of an approaching airplane. I’m excited. This is what I want to be doing. I’m also overwhelmed. The timing could not have been worse. My list of important things to do was long and now this…… For a change, I remember to take my overwhelming feelings and give them to the Lord. Asking Him to ordain the rest of this day and the things He would have me to do.
Pots are on the table. The plane lands. By the time I arrive at the hanger (usually I’m always a tad late…..) our patient and family and extended village neighbors/children are already in our awaiting “ambulance”. The back of a pick up truck. Gary quickly hands her over to me, giving me a brief report, telling me all he knows. The smell of infection, of suffering, of filth is overwhelming. One glance told me our patient was in desperate need of medical attention. Apparently the lady had a miscarriage about 10 days ago in a remote tribe, the baby was at about 6 months gestation. The lady’s milk came in. Now she had soccer size breasts, with evidence of gangrene. Also a baseball size lump was under her left armpit. Gary recalls bringing this same lady in on a medevac flight about 2 months ago for a large tumor like growth in her left cheek. This growth is clearly pushing into her mouth and the swelling is extended clear up to her left eye that is swollen shut with copious amounts of yellow thick drainage oozing out. Perhaps Tb also?
With that, we close the tailgate, lest any of those precious children fall out and Wendy brings our ambulance to life. The hospital sits directly behind Adventist Aviation. It is a government run hospital. Not known for it’s excellent service or it’s cleanliness or accurate diagnosis or positive outcomes. Yes, Ruham Sakit Yowari did not make it to the U.S. News best hospital list for 2015/16. We better not examine there death rates, patient safety and hospital reputation. Yet, it is what is available. It is free to the Papuans who live in the remote places. AND it is better than nothing!!!!! Within 2 minutes we are at the emergency room doors. Wendy pulls in front and I run inside to find help.
Pleasantly they had a descent stretcher and a nurse rolled it out to the truck. Clearly, he was going to allow Wendy and I to do the transfer. So climbing up into the truck bed, Wendy and I carefully grabbed ahold of a filthy, nasty, dirty thin mattress and lifted our suffering lady onto the hard stretcher. Triage room. I glance around, taking in the surroundings. A bloody gauze on the floor. 2 walls splattered with blood and stains. Another stretcher with dried blood awaits its next customer. A man on a stretcher against the wall. Very quickly the doctor approaches. He gingerly pulls back the sheet to the ladies waist. Listens to my report and leaves. He does no further assessment. He does not touch the patient. An IV is started. First try. They are great at IV’s because almost every patient gets one.
Meanwhile, the flies land continuously on our patient. We try to wave them away. Obviously, hot and in much distress she keeps throwing the filthy sheet off her infected miserable body. All the while a steady stream of people walk in and out of the ER. Family, friends, strangers, nurses, doctors, all stop and stare. There is no privacy. None. Through a doorway is a full ward of more ER patients. All able to see each other’s suffering. Between the lack of cleanliness (completely uncalled for), the lack of privacy, the lack of proper medical care, and the state of our patient, my heart is deeply distressed.
Soon another doctor comes. Her examination includes lifting the sheet and asking a few questions. Her stethoscope laying limp in her hands. Within 45 minutes antibiotics are free flowing into our patient and yet a second antibiotic is pushed in, not worrying about drugs mixing in the line. No machine to accurately drip the medicine in a timely manner. At least much needed drugs are flowing in.
In the two hours that we are with the patient we witness a man’s leg being sewn up on the bloody stretcher, and a motorcycle victim cared for also on the same stretcher. Never cleaned. Our patient struggles to sit up. Asking for water. She is restless. She cannot eat solid food due to the growth pressing into her mouth. I offer to lift the bottle to her mouth, she pushes me away, indicating that she can do it on her own. As she sits up clear fluid drips freely from the large lump under her arm. No labs are drawn. No screening done. Does this lady have TB? If so she is not isolated. There is no special air room. No TB masks and gowns and gloves. Her chest is barrel shaped. A tail tale sign…….
Throughout all this time the little children who flew out the village are playing right outside the ER door. A little drainage ditch has water. They keep throwing their water bottle caps into the water and then picking them up and putting them into their mouths. Water that is mixed with what? We could only imagine all the germs and viruses and drops of human everything mixed into the water of that drainage place.
After knowing that the village lady was being cared for, we felt we could leave. That our advocacy had reached its limit and fulfilled its purpose at this point in the journey.
We arrive to our homes. The smell of her dreadful suffering clinging to our clothes. Lingering in my nostrils. Hot water on my hands never felt so good. My clothes are tossed into the laundry. Her suffering weighs on my mind the rest of the day and next day.
News comes the next morning that our patient is being moved to a hospital 1.5 hours away (DoK Dua) for surgery. We question is she will even live through a surgery.
The following day, we learn that she was not moved because that hospital was full. Gary visits her that afternoon. He comments that the infections are responding to treatment, but that every breath is a struggle. Within hours our patient has died.
The next morning a casket and the mourning husband are loaded back onto the plane to return her to her village so that she can be buried and be mourned by those who loved and knew her.
This is our work. This is a big part of why we are here. To help the suffering. We are dreaming and praying and working towards starting clinic runs to the remote places. Using local Christian Doctors and Nurses to take preventative teaching and medicines to a people who have no access to health care. Using the plane to bring healing and hope to those who have none. This has spurred me on to return to language school so that I can move beyond my elementary understanding and push to be able to communicate at a much deeper level. Please pray earnestly that God will give us the strength and power and wisdom to know how to proceed. There are many people here who are trying to stop this work and stop the gospel from going forward. But whom shall we fear???? If God is for us, who can be against us? We need you to intercede specifically that these strongholds will be broken. We know that God longs to see EVERY TRIBE AND TONGUE worshipping before His throne. Thank you!