Thursday 26 January 2012

Goodbye Kalene

I’m typing this, our final blog post, from the sunny South West of England and the sweet smell of ‘chestnuts roasting on an open fire’ drifts up the stairs. We’ve been home for over a week now and it feels quite odd to think about the life we’ve left at Kalene. It’s been lovely to be reunited with friends and family after a year away. We are enjoying drinking water straight from the tap, internet connection the speed of light, running at a sensible altitude, travelling further than the 500 metre radius of the mission compound, understanding every word spoken to us (apart from when we were in Wales!), wrapping up in winter woollies and warming our feet by the fire. I suspect the re-entry to life in the NHS will be an interesting experience when we will require much patience and grace to face the politics, waste and ungratefulness that we will no doubt encounter. Our lives may have been changed but many remain unaware of another way of life experienced by most people in this world.

In our last couple of weeks at Kalene, we had a very dramatic case to deal with. A young man of about 20 arrived after a twelve hour journey from his home in Angola, strapped to the back of a motorbike. He’d been crossing a river late at night when he was attacked by a crocodile. By looking at him, it was clear that he’d put up a fight but it was too soon to tell who had won. His most obvious injury was an eviscerated bowel. Our first job was to stabilise him as far as possible with blood and fluids before proceeding to a laparotomy. Christopher enlarged the wound to his abdomen in order to inspect and replace his small bowel. He had many other lacerations over his body, including one through to his lung, requiring a chest drain to re-inflate his lung. As the days went by, he seemed to gradually improve and we were really impressed with the nursing care he was receiving. Sadly, though, his chest was in a very bad way and he died from a pneumonia. We were very disappointed having spent so long working on him and believing that he was a survivor.



And there was also much drama on the maternity unit but this time with a happier ending! On Boxing Day, Tess and I were called to help with a breech presentation. We arrived to find the lady fully dilated and I was really excited to deliver her. The naughty baby had his hand at the back of his neck which required me to do a few manoeuvres to release the arm but once this was done, he delivered beautifully. I handed him to Tess to check him over and looked back at the lady. It dawned on me that my work was not done – and neither was hers! ‘Tess,’ I said, ‘I think there’s another one in there!’ I examined the lady to indeed find that there was another baby and that he too was breech! I ruptured the membrane and out he plopped! They were both fine and just lovely as you can see. It was such a thrill to help these little two into the world.

Two little dears - breech twins.
 
We had the opportunity to visit Sachabondu, a rural health clinic about 2 hours from Kalene. Ruth Wallis, a nurse from the UK, has run this clinic for the past 40 years and is a true inspiration. We were just having a tour of the clinic and I popped my head round the door of the delivery room. ‘Everything alright?’ I asked, to which they replied, ‘Oh, perhaps you could help us Sister?’ The lady who was delivering was a primip and had been fully dilated and pushing for sometime. I listened with a Pinard’s to find fetal tachycardia with some late decelerations. ‘We need to deliver this baby,’ I said. The head was nice and low and I thought a vacuum delivery would be appropriate. I called for my husband to supervise me (having done 2 or 3 himself, he was quite the expert!) Our ventouse apparatus looks nothing like the ones we use at home – it is a glass bottle with a bicycle pump and some tubing which you attach this metal cup to. Simple but extremely effective and at times, life saving. I selected a large cup and managed to place it on the baby’s head. With the next contraction, I pulled and the head was out, no episiotomy required. There was much singing and dancing and you can imagine my delight when the family wanted to know my name so they could name this little girl after me!
Baby Emma and her mamma.
 
Christine came to Kalene shortly after Christmas to start her TB treatment. It was lovely to have her and her granny over and to spend some time with them. She is doing very well and seems to be responding to the treatment. The course is for 6 months but we have the assurance that she is being closely monitored by Mel and Anita at Hillwood. We took them back to the orphanage just before we left Kalene and said goodbye. Although I was sad, it is wonderful to know that she and her granny are well-supported at Hillwood and that their future is bright.


Christine and her granny.

This is Robbie, enjoying a chess lesson with Christopher.

More twins! They have helpfully been labelled by the staff!

Sister Dorothy on her last day on maternity - she has worked here for over 30 years - what a legend!

Little Luwi, who was 1.2kg at birth, on the day she went home. Just beautiful.

Luwi and her mamma, Eunice.

Saying goodbye to our Kalene family.

We hope you don't mind a few of our holiday snaps! We were fortunate to spend three days down in Livingstone. Having survived Lusaka bus station (not for the faint-hearted!) and the 7 hour bus journey (also not recommended if you suffer from a nervous disposition), we were able to relax and enjoy the breath-taking Victoria Falls. Just days before our arrival, a woman had plummeted into the water when the bungy rope snapped. Needless to say, we elected to keep our feet well and truly on the ground!

Magnificent.



We got just a little wet when the heavens suddenly opened!

Afternoon tea at The Royal Livingstone (Christopher less than impressed with the teabags and UHT milk)

Baby elephants are almost on a par with black babies in terms of cuteness! Love them!
We were very blessed to get to see 2 lion cubs -they were tucked under a tree waiting for their mother to return.    
     I think it will be a while before we are able to fully process our experiences at Kalene but we know that we have returned as different people. We are passionate about serving those for whom survival is a struggle and we hope that you too have been touched by some of the stories we have shared. Despite the passing of another year, the reality of unmet healthcare needs in the developing world remains. This challenge has become very personal and real to us and isn't likely to go away. We feel very strongly that this will influence our future choices and path in life. We recognise that without the support and prayers of friends and family at home, this work would have been infinitely harder and that our ability to cope with the pressures of the hospital would have been all the poorer. Thank you for reading our blog, for emailing, for sending the briefest of messages on Facebook, for parcels, for praying and for supporting us in our work. Words cannot really express our gratitude.

'The Spirit of the Sovereign Lord is on me because the Lord has anointed me to preach the good news to the poor. He has sent me to bind up the broken hearted, to proclaim freedom for the captives and release from darkness for the prisoners, to proclaim the year of the Lord’s favour and the day of vengeance of our God, to comfort all who mourn and provide for those who grieve in Zion – to bestow on them a crown of beauty instead of ashes, the oil of gladness instead of mourning and a garment of praise instead of a spirit of despair. They will be called oaks of righteousness, a planting of the Lord for the display of his splendour.' Isaiah 61:1-3.

With love from Emma and Christopher x