The Road to Gimbie Letters

11/03/01

Dear Family and Friends,

I have not had a chance to write in a while because Dr. Rose has been away in the north, and it seems as though every time he leaves, we lose our e-mail abilities. Having him away also puts more constraints on my schedule, doing his job and mine.

In the hospital we have two visiting physicians, Dr. Shane Duffy from Ireland and Dr. Francesca Zucca from Italy. They both finished their master's degree in tropical medicine at the London School of Hygiene and Tropical Medicine a couple of months ago and they are now out here seeing these things firsthand. Dr. Duffy is a specialist in Obstetrics and Gynecology and Dr. Zucca is a specialist in Infectious Diseases. Having them here has been a real blessing.

If you have gotten any of my previous e-mails, you will know that we have our fair share of obstetric challenges here, and it is so nice to see what a real specialist in this area does about these problems. This week we have had three cases of ruptured uteruses. The uterus ruptures in women who have prolonged labor and don't deliver vaginally, and so the baby ruptures out of the uterus into the abdominal cavity. This kind of thing almost never happens in the U.S. or in Ireland or England where Dr. Duffy trained. It was quite a shock to have three in one week. The first one had to walk eight hours to get here. We don't know when the uterus ruptured on her, but probably sometime during those eight hours, and she managed to make it to our front gate and she collapsed from loss of blood with internal bleeding. Poor Dr. Duffy tried his hardest to save mom and baby, but we lost them both, sadly. Dr. Duffy was pretty discouraged.

A couple of days later, a woman came in with a dead fetus still inside. The woman had been in labor but the baby would not come out, and the reason was immediately evident. The baby was sideways in the mother's womb and the arm of the baby was coming out of the vagina. This is a very difficult situation. At first Dr. Duffy was thinking of cutting the baby up into pieces in the womb and delivering the baby that way through the vagina, but since the mom looked weak, he decided to take the mom to the OR and remove the baby by c-section. When he opened mom up, the whole baby was out of the uterus, because the uterus was ruptured. The only thing was that the baby's arm went through the hole in the uterus and poked out through the vagina. The pressure of the baby's body was keeping the mom from bleeding to death. As soon as the baby was removed, the mom started bleeding, but since she already was having surgery, it was easy for Dr. Duffy to stop the bleeding and even repair the uterus. If Dr. Duffy would have tried to deliver the baby through the vagina by cutting the baby in pieces, as he was initially planning, the mom would have likely died right in front of him on the delivery table. I am sure that was an answer to a prayer that we had not even prayed. God is good.

Finally, the final ruptured uterus just happened a couple of hours ago. Baby was already dead when mom came in, but mom was still alive and Dr. Duffy did the surgery and mom was saved, with the grace of God. Sadly the uterus was ruptured and the tear extended all the way into the bladder and the bladder was torn wide open. After hours of surgery, the mom is finally stable. She just needs our prayer for recovery, because a torn-apart bladder is a challenge to repair, and out here the risk of infection after something like this is very high.

In other areas of our hospital life, we have been able to get a little fun going here too. Dr. Duffy is a football (soccer) lover and, as in almost every town in Africa, there are several football teams. The hospital has never had a team until Dr. Duffy came out. We have a team now, pitiful though we may be. Some of our folks are rather good, actually. You need to understand that most of our team do not have enough money to buy athletic shoes and so they wear whatever shoes they have, even boots. This has not hindered them in the least. I have joined in the team since I have a pair of tennis shoes. There is something about playing football at an elevation of 6,000 feet with people that are half your age that can be humbling. The good news is that everyone was a good sport, even the teams we have played. We found ourselves laughing at ourselves and having a great time. I did find myself totally blown by the first ten minutes of play. I think I am going to have to rig some kind of oxygen backpack to keep up with those guys. Dr. Duffy found himself walking up the steps in a rather undignified groaning hobble after the first practice, but a week or two of aspirin and inactivity finally got him back out playing again. It's great. We have even managed to win a couple of games.

One final note for this week is that I am going on vacation in a week to America with the whole family. This will be the first time that we have been home for the holidays in nine years (we are beginning our tenth year of mission service in a few weeks). It will be great to let Christopher and Ian see what it is like to have a Christmas in America.

Sincerely in Christ,

Nick, Phosfe, Christopher and Ian Walters