This week Natalie and I (Marissa) spent our days on the post-natal unit looking after mamas and babes that we became to know and love.
Our Monday morning was a whirlwind from start to finish and our critical thinking skills were put to the ultimate test. We had two babies who were very sick and we felt spread thin as we tried to provide care for them both. These two little ones were simultaneously in respiratory distress and required our immediate attention. There was no doctor on the floor and the nurses unfortunately did not provide much help. We were initially frustrated by this and did not understand why the nurses were not as supportive as we would have hoped, but I have come to realize it is not compassion they lack but the nursing culture here is simply different. They also have less training in Zambia than we do and I believe they didn't fully grasp the severity of the situation at hand.
The first babe came to the ward with a diagnosis of severe pneumonia. This little one was no longer feeding and was coughing and vomiting frequently. Natalie and I noticed the baby was starting to go blue so we whisked her back to the NICU - which is really just a back room with some incubators - to hook her up to oxygen. There were no oxygen masks, which is what we would ideally use, but thankfully we brought infant nasal prongs in our donations from Canada. After struggling to get the oxygen to work and finding outlets that were available and not broken we were able to hook baby up to O2. We remained concerned about her her condition and continued to advocate for her treatment, but at least we knew for the time being the oxygen would help.
The NICU - lacking quite a few resources (including staff members!) compared to what we have at home.
At the same time this was going on Natalie noticed another babe on the ward who was showing signs of serious respiratory distress. As we assessed him we got increasingly worried - his lungs were full of fluid and he continued to deteriorate every minute. What started out as a mild concern quickly morphed into a medical emergency and Natalie and I knew we had to act quickly. It was in this moment and those that followed that we began to understand the true impact of low resource nursing:
There was only one oxygen tank on the ward and the baby with pneumonia was already using it, and needed it equally as bad. There were no respiratory medications available. There was no suction, which is what we needed to clear baby's lungs. The baby's temperature was low as he struggled to perfuse, but there were no more working incubators. And there was no doctor because the only doctor for the ward was called into an emergency c-section. We knew what treatment we wanted to provide, but we simply had none of it available! As Natalie stayed to monitor the baby, I took off and ran around the hospital looking for supplies on different wards that could help. Although I attempted to remain calm I was beginning to panic on the inside. I was running over and over the steps of neonatal resuscitation in my mind, and was chanting the memory aid we are taught to remember the rate to give breaths: breathe baby, please baby, breathe baby, please baby.
Although this was a scary moment and I was terrified we were going to lose this baby, it transformed into one of my highlights of the experience so far. As I ran around the hospital many of the girls saw that I was in an emergency and dropped everything to help. By the time I got back to the ward there were at least 5 girls in there putting their heads and resources together to figure out how to care for this babe. They were moving babies around in incubators - putting two together to create space - and trying to figure out how to get one oxygen tank to flow to two babies. I will never forget the image of Trisha flying down the hallway with an oxygen tank from the Male Ward, Natalie's determination to track down a doctor for an IV, or Rebekah's consoling words as she helped me stay calm amidst the chaos. We treated this as we would a code blue in Canada, and the teamwork was some of the best I have ever been a part of.
Jaclyn came to help from her ward, and Jackie came from her meeting. You can also see 3 oxygen tanks that we gathered from all over the ward, and at first we had none. We finally found 2 that worked.
Working to get oxygen to one of our wee ones.
We were scared to go home that day in fear the babies would not get the help they needed, but I am happy to say when I arrived on the ward the next day they were both alive and doing much better! I was filled with relief, followed by pride at the care we were able to provide.
I came onto the ward and saw this little one wrapped in his blankets cuddling with mum, breathing well. What a beautiful sight.
The father of the baby with pneumonia looked me in the eyes and said "Thank you, sister, for what you did for my baby. We found God when you walked in." I was overcome with emotion and I know I will hang on to this moment forever.
-Marissa and Natalie