Akosua's Baby

Before we moved to Ghana, often times after speaking all over the US (it seemed that way at that time!) about our call, I (Juliana) often wondered what kind of stories we would have to tell our partners on our next visit. I even wondered if there would be any. “You know, life sometimes gets in the routine without much excitement, and we just go on persevering”, I thought.

Well, I gotta tell you: excitement has not been lacking, as well as daily opportunities to share the love of Jesus that brought us here. Let me share with you one of these stories, the one of Akosua’s baby. I must warn you this is not a happy story, but then again many times they aren’t, and neither is it short, but it is a true one, worthy of reading if you want to have a peak into life in this parts.

Akosua’s baby was my second patient on that Wednesday morning. The baby was hidden by the colorful cloth that wrapped her tiny body, held by the mom. “oye yare, dokta” (she is sick, doctor). This 5 day old baby was barely there and, as I examined her, she had a cardiac arrest on the bed. Angelina (the clinic midwife and only trained nurse in the facility) and I promptly started CPR. As her heart started beating again, a chain reaction in the clinic also started: ward assistants preparing antibiotic injections and IV glucose, someone running down the hill to go call Isaac, the boat driver (since we had no truck or ambulance to take us to a hospital) and the relatives of the mom running to their village to spread the news the baby would be going to the hospital (often times the only way patients can afford the hospital bill is by collecting money from friends and family members). My hands itched for an oxygen tank and a monitor to be hooked to the newborn’s body, but there weren’t either. So, as I prepared to take Akosua and her baby on this adventure, in search for better resources to keep her baby alive and well, I stepped outside the clinic, to the waiting area. There were many patients waiting to see the doctor. Many of them, I knew, had walked many hot and long miles to make it to the clinic that morning. I looked at the lake, down the hill in the distance, I looked at Akosua’s confused eyes and, taking a deep breath I saw (I am afraid that is the most accurate way to describe, almost for my embarrassment since I don’t believe in examining patients without touching them) a dozen of patients in less than five minutes as I had the nurses write the prescriptions for the ones that could not afford coming back the next day, including the children with history of fever.

The idea to share this story came when I was riding the boat with this preemie newborn in my lap, monitoring him with my eyes and ears. The lake was so beautiful! I looked around and I saw many of the villages by the lakeside, so isolated and almost forgotten. I could not help but wonder how many babies in similar conditions were out there. After 12 minutes, we had crossed the lake to the ‘other side’ - the one with access to good roads, guest houses, cell phone signal and often times the only one tourists get to see. From there, we got a taxi that took us to the nearest hospital (St. Michael’s, a Catholic mission hospital), usually a thirty minute ride from there, but I must say not that day, it wasn’t! The driver mustn’t have seen many CPRs being performed before, because as the baby had the second cardiac arrest I could see his foot against the accelerator, all the way. In that hospital I rushed in as if I was one of their own employees, broke into one of their doctors’ consulting rooms (I politely greeted him and apologized to the patient in front of him, in Twi, which made them smile) and, with the baby in one arm and the IV fluid bag in the other, up high, briefly discussed the newborn’s condition and asked for advice: should I stop here or should I keep going to Kumasi? He gently informed me that all preemies should be referred to the teaching hospital  in Kumasi,  another thirty to forty minute ride - in a good day, without much traffic, like on Sunday mornings. It wasn’t Sunday morning...

Followed by Akosua, Akosua’s sister and Akosua’s husband, we headed towards the street, in search of another taxi to take us on our next leg of the journey. That’s when the third cardiac arrest happened, so I quickly laid the baby on the first flat surface I saw and to everybody’s surprise and joy (there was an audience) the baby fought back and let us know we should keep going on our saga. This time, a very nice man approached us and suggested we should use one of the hospital ambulances and by the way, he was an ambulance driver. We quickly negotiated the price, I checked to see if I had enough cedis in my pocket and there we went. Forty minutes later, we were at the reference hospital in  Kumasi,  the same one where I had my orientation period (while applying for my Ghanaian medical license) last year. How glad I was I knew the right avenues and staircases in what many times in the past seemed like a maize to me. We made it! After placing the baby in an incubator I handed her case to the medical officer in charge of the many preemies (and not preemies also) in the ward that day. I turned to Akosua, the mom: ‘Wo ho te sen?(How are you doing?)’ She didn’t answer. She only smiled, with the type of smile that warms your heart and says more than words are capable of.

A few notes:

• About the baby Akosua’s baby was from Adjaman, a neighboring village to Amakom. She was born prematurely and more than likely for being so small and fragile, contracted an infection (neonatal sepsis). She also had high levels of bilirrubin (the substance that makes the skin yellow, or jaundice), so high that she needed an exchange transfusion, a procedure in which blood is taken out of the child’s body and new blood, without bilirrubin, added to replace it. I am sure some of you are familiar with the procedure, the diagnosis and the anxieties that they bring. In the teaching hospital, I believe she was able to receive adequate treatment, but still did not make it. The parents came to the clinic the following week to greet me and tell me the sad news. I grieved with them, we prayed and they went on their way. Ghana still has very high maternity and infant mortality rates, and part of the reason is the lack of trained healthcare workers (mostly due to the brain drain process) in isolated areas (most of the country), and of well- equipped healthcare facilities.

• About the boat and boat driver Isaac has been working as part of the clinic staff for the last eighteen years and knows very well every bit of this lake. He leads the singing group at Amakom Methodist Church and has four beautiful children. Isaac has been so good in serving with us, no matter the time, no matter the day, he is always ready to drive that boat - although he always makes me wear a life jacket...

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Comments

[Joyce Chambless]

Juliana & Family,
Yes, I know that you,ll are in the right place.The need is so great.I may have a nurse that wants to come, but I can`t right now.Love to all, Joyce

[Carol Crisp]

Thanks to God for both of you and your unconditional love. You are both the hands, feet, and mouth of Christ. Thank you for all your devotion that you show to each person. Thank you for sharing your experiences with us.
In Christ,
Carol