Pages from the Philips Seeking God's leading in medical missions

Preventable Disease

Today was another typical day at Makunda during which we saw 203 outpatients and performed two surgeries in the evening as well as a couple of D&Cs. We admitted another baby overnight into the ICU with pneumonia. The baby was quite fussy throughout the day but hopefully will turn the corner soon. Unlike the baby we admitted the day before with pneumonia, this baby does not seem to have heart failure as a consequence of her pneumonia.

We had another patient with malaria admitted yesterday as well. Malaria season is just starting in the area because the rains have begun (we’ve been getting torrential downpours every 1-2 days and thus we still have not had electricity for more than a few hours since we have arrived). Because of the rain, there is plenty of space for mosquitoes to breed and thus the higher incidence of malaria over the next few months. Dr. Vijay Anand and Dr. Ann have worked here almost 16 years with no malaria prophylaxis and have not gotten malaria yet and so we hope that we will be able to get through this month without acquiring this disease since we’ve also been taking malaria prophylaxis with mefloquine.

Today Dr. Ancily helped walk me through my first D&C. This was a lady in her twenties who came in with bleeding for three days. She was about five months pregnant and had expelled the fetus in the morning but because of continued bleeding finally came into the hospital. When we checked her hemoglobin on admission it was 4. Again another severely anemic patient due to excessive blood loss. I praise God again and again that this hospital is here because many of these women would have died at home if this hospital was not there to take care of them.

We have another patient on service who has a tragic story. She is 25 years old and recently began to have rapidly progressing nephritic syndrome. For those not in the medical field, nephritic syndrome is a condition in which the kidneys start to lose massive amounts of protein from the body through the urine and thus these patients become severely protein malnourished and thus develop generalized swelling over the body, a condition called anasarca. What is tragic about this lady is that ever since she developed this condition, she has been deserted by her husband and now she lives with her parents who help to take care of her. We have nothing to offer her except prayer and if God does not intervene soon she will pass away. I think working here has made me see how often we have to turn over things to God because for many of our patients there is just not much we can offer them. The same I think is true in the US but we tend to turn to God later on in a disease because we try a multitude of treatments until they all fail. Here most of the time if the first line therapy does not work that is about all we can do for them medically. For many of our patients with terminal diagnoses it has been refreshing to see the physicians address the deeper spiritual problem because even though their life on earth is short, an eternity apart from God is much longer. Many of the doctors here routinely pray for our patients on rounds for God to provide healing and they pray with the patients before each surgery to let the patients know that the outcome is totally in God’s hands. I just wish I had the faith of Jesus or Paul who could just command the lame to “get up and walk” and they would…wouldn’t that be an amazing way to show God’s incredible power to heal and save?

In the outpatient department we had another sad case of a completely preventable illness. A three year old girl came in with her parents because for the past nine days she had suddenly been unable to walk. Prior to this she was completely healthy and had met all her developmental milestones but this sudden paralysis was completely devastating to them. The diagnosis was polio, the first I’ve ever seen but something that is still present in this area. When I examined her and filled out the Indian government form for reporting polio, I discovered that not only was she very weak in her legs but her arms had lost their strength as well. How tragic that this was again a completely preventable disease with vaccinations but now she will most likely go through the rest of her life as a cripple. Seeing diseases present here like polio, diphtheria, tetanus, meningitis that are completely preventable through a simple vaccination has made me appreciate vaccinations so much. If you look at major advances in the 20th century, vaccinations alone have significantly impacted the health of entire populations. I know there are some parents in the US who don’t want to vaccinate their children because they are worried about autism (the link which has been disproven in study after study done in large populations) or other side-effects that might occur. But if only they saw what some of these completely preventable diseases did to you, then maybe they would see that the risk of side-effects is well worth avoiding being mentally retarded from meningitis, being crippled by polio, or dying of never ending muscles spasms in tetanus.

In the afternoon we did two more surgeries – one was a C-section that I assisted with and the one in which I did my first tubal ligation and the second was a benign thyroid tumor. Melissa and the kids continue to get used to life on campus. We have decided to enroll Karuna in the school here in LKG (lower kindergarden). She has been thoroughly enjoying spending some time with kids here in school and it has allowed her to start picking up some Bengali and Hindi. Melissa has been using her time to get to know some of the other campus staff and figuring out how to get food supplies for us. Several of the nursing students came over in the evening to walk with Melissa and the kids to the market so that it would be safer for them to go out. There is a nursing school on the campus here that offers a two year course in which 20 students enroll every year. They have been a big help in keeping things running at the hospital while we are in the outpatient department or overnight. Melissa will also soon starting working with the teachers in the school here to help them develop lesson plans since none of the teachers at the school have a formal degree in education. She is also helping out with some of the 6th and 7th grade English classes both to give the current teachers ideas on how to help the students develop their language skills as well as give the students a chance to hear English from someone for whom it is a first language.