The free clinic was open. One by one and family by family they came, seeking treatment for their diseases and ailments. So many of them plagued with malaria, diarrhea, and skin infections. Often times they showed us things we couldn’t fix…clubbed feet, breast tumors, blinded eyes and deaf ears. What we could fix we did, bandaging wounds, dosing malaria medicine and Tylenol, and what we couldn’t fix we just had to say…”Sorry, I have nothing for that”. It was hard to say that over and over again. I wondered if when they heard there would be health care providers and free medicine, did they think we could cure these things? The mother with the blind baby…did she think there was hope for her with us? The 8 year old that could neither walk or talk and weighed 15 pounds…did that mother think we had a magic pill that could cure all? The desperation was overwhelming, and the need was staggering. We herded them through as efficiently as possible so we could see as many as we could…and even then, some had to be turned away.
I watched her walk in the door…a tiny bundle in her arms. She was directed to sit in front of me, and when she did, I knew something was terribly wrong. The infant had a far off gaze, his head flopping like a doll over the crook of her elbow. His chest was moving rapidly, and his stomach was moving in an opposite rhythm. I reached for him, and she gladly handed him over. I placed him in my lap and reached for my stethoscope. There was something there in his eyes I recognized. Those wide set big black eyes on his small head and low placed ears. He had Down Syndrome. In my mind I guessed he was about 3 months old, and even then was small for his age. His mother handed me his medical record and said he had pneumonia. I opened the book and saw an entry from March of this year….wait. March? “How old is he?” I asked, quite fearing the answer. “Nine months” was the answer that was translated to me. My stomach sank. This tiny little frame that I could almost hold in one hand should be sitting up. He should be smiling and crawling and interacting. He should be screaming at this white person examining him. But he wasn’t. He was listless, lethargic, and sick. I took his temperature…103. I counted his respirations…50. I listened to his lungs…coarse rhonchi. His heart…a small murmur, and beating too fast to count.
Instantly, I react. In my mind I go back to the ER, but in reality I am in a dirty dark church that is a makeshift clinic today. I want to call for an Xray, for oxygen, for labs and fluids. I want to consult a cardiologist and a pulmonologist. I come back to the present. It’s just me and this very sick baby, and a few other nurses who are feverishly dealing with their own tragedies. So, I go with what I know. I unwrap him down to his diaper, explaining to the mom how dangerous it is to keep him bundled. I call for rehydration fluid and a syringe. He has a sunken fontanel, and dried cracked lips. The mother tells me he wont nurse even though he cries as if he is hungry. I dose some motrin, and prepare a ceftriaxone injection. I suspect he has pneumonia, maybe malaria. A mean jab in the anterior thigh…the little guy lets out a weak cry. No tears. This is bad. Very bad.
I call over the one in charge and tell him this one needs to go to the hospital. They tell her to wait and we will take her back with us to Jinja at the end of the day. Something tells me that’s not the right answer. My gut says to send him now. I write a note to the doctor. Arrangements are made and they are gone. I sigh heavily and call for the next patient. I will go find them in the hospital when we get back in town. Hopefully they will start the IVs and get the chest Xray, order the labs and start the fluids by the time I get there so we can know what we are dealing with. I try to push it out of my mind for now because so many others are waiting.
The day continues on, and finally comes to a close. We get on the bus and head back to Jinja. I am planning out my evening in my head. I will get a shower and supper and go to the main hospital to check on them. Surely they know something by now. Surely they are doing something right now to make him better. Surely they saw how critically ill he is.
I walk in the guesthouse and see them. What? Why are they here? I grab an interpreter and go to her. “Did you go to the main hospital?” I ask. She nods and hand me a paper. Weight 4.5 kg Diagnosis: VSD (ventricular septal defect) and Down’s Syndrome Condition: critical. Treatment plan : Digoxin and encourage fluids.
I can’t believe what I am reading. I begin rapid fire questions…”Did he get an Xray? Did they give him any other medications? Did you know he had a heart problem? How do THEY know he had a heart problem when you were there for an hour?” The mother tells me ” no” to every question. I go to reassess him…his color is poor and he is sleeping with his eyes half open. In the darkness the mother shakes him…the look on her face tells me she is thinking what I was…”Is he breathing? Is he dead?” He stirs and lets out a little whine. I ask her to nurse him. He tries to feed but is too weak.
Anger takes over me. Who discharges a critically ill child? If they don’t think this is worthy of admission, what do they think is worthy? I ask for help. Let’s take him somewhere else. I send them to a private clinic… with another note, and assurance of payment. I will be close behind to talk to the doctor, if only they can start with the x ray and labs. They go and I try to grab a plate of food to devour so I can leave. 10 minutes later they are back with this message: “If he survives the night, come back tomorrow. We don’t do xrays at night and can’t do anything for him now”. Then I realize the truth…this little one with all of his disabilities is being rejected because of them. “He isn’t “worth” messing with. He won’t have much to offer to this society…let nature take it’s course.” This is why he was getting sent away.
It is all too much for me. I look at his lifeless little frame. I look at his mother’s face, wrought with concern and exhaustion. I look at another piece of paper that refuses to do anything for him…and I break. I leave her sight, and fall apart. I am not just crying for the one in front of me, I am crying for all the babies I have seen that I couldn’t help. I am crying for all the mothers watching their little ones suffer. My friend holds me as I sob hot and angry tears into her shoulder. “I don’t understand! How can you just refuse to save a life when you have the power to do it! Maybe he has a heart problem, maybe he doesn’t. But if he dies tonight it will be from pneumonia and dehydration not from this supposed heart problem. This is unacceptable!”
“What do you want to do?” my friend quietly asks.
“I want to try. I want to show this woman that this baby means something. His life matters to God and to us!”
“Then keep trying. Go to another clinic.”
So we go. To a pediatrician this time. I tell the entire story again. He listens quietly and answers gently, but his reply adds salt to the wound.
“ There is something wrong with his heart but I can’t be sure what. There is little that can be done. In cases like this we look at the resources we have and what they are worth spending them on. In his case, he has so little to offer society. Not to mention, he is too sick right now to do anything drastic anyhow. I know this isn’t how you do things in your country, but it is just reality here.”
I try to be respectful. “Can we try some IV fluid? If we can just hydrate him slowly, and treat the infection, then we could go from there, after all we can’t truly be sure there is something wrong with his heart or how severe it is until he has an echo and an X ray, right? “
The doctor refuses. He gives me his reasons, but I disagree. The mother again tries to nurse, but the baby…named Lincoln…Lincoln refuses. He just lays there.
Thank the Lord I had a friend there. “What does your gut tell you? “ She asks after we leave his presence.
“My gut tells me to try. That he needs fluid more than anything.”
“So, that is what you do then.”
We cross the street and walk into a dusty pharmacy. I get the IVs and supplies, and we head back to the guesthouse. I talk to the mother. I make sure she understands that we are going to try, but that Lincoln is really sick. And then I use that dreaded word…”he may die despite what we do.” But the mother is just thankful that we are trying. We get to work researching IV fluid mixtures and attempting IVs. But he is so dry. With each stick he tries to cry, but there are no tears that come. It is looking impossible. A team of prayer warriors gather around, and pray for God to intervene. We lay our hands on him, and we declare God’s promises to be sovereign over life and death.
Then my heart is flooded with peace. He loves Lincoln more than any of us. He can heal him without IVs and medicine if he chooses to. We mix some formula and rig a syringe. Slowly we try to get him to feed. At first he refuses, but then something happens…he begins to take it…and swallow it. 10 mls down. 20 mls down. Almost 30 mls down and he falls asleep. We let him rest a little and wake him up to take more. His fever is down, and his respiratory status improves. He seems content. I wonder how long it’s been since he has had that much in his belly. We show his mama how to do this, and instruct her to wake him every hour, and tell her to come and wake us if he won’t take it or if he shows any signs of danger. And we fall into bed exhausted, leaving this child in the hands of the Great Healer.
The next morning we are greeted by a smiling Lincoln. The child who the previous night couldn’t hold up his head is now able to focus on our faces and even coo a bit. It is truly a miracle. He is fever free and taking the formula well from the syringe, even nursing some from his mother also. What else can you do but praise this Great God? What else can you do but acknowledge He is the Healer and is sovereign over all? We tried all that we knew, and it failed. But the Lord, He is the One who sustained Lincoln through the night and allowed him to take the formula. And to this day, I wonder if that was His plan all along. To allow me to break-to try to do all of that on my own and fail so that HE could show HIS glory. So that He could remind me that He is giver of life and of death. That there is no case that is hopeless and that every child is worth the fight.
Arrangements were made to take little Lincoln to a malnutrition clinic at another wonderful ministry in town. He is now there receiving excellent care and nutrition. They are following up on his heart issues and will be finding out more about that soon. I believe that Lincoln’s story is meant to be told. So many are told lies from the enemy… that we aren’t worth saving or our case is hopeless. We try in our own power to help ourselves, fighting with weak human energy. But if we would only realize that the Healer is right there willing and ready to show his power. Ready to allow us to simply take the milk and rest. To allow us to wake up in the morning full of joy and hope. Lincoln has a long way to go .And so do we. The story isn’t about how long or hard our journey is. It is a story about being lost and now found. Weak but now being made strong. It’s about Him rescuing us and giving us a story to tell for His glory. And being a part of His story is the greatest privilege we could be given.