I already don’t like this post, and I haven’t even started writing it. It goes against my blogger ethics to share personal stories like this with a broad and unknown internet audience, but I’d like to say that I have obtained permission from each person featured in this post. My friends pictured here want your help. I want your help. We both want the first world to know the rural third world reality.
Please read, and feel, and respond. I’m praying for a flood of advice from real live Peds and PTs, ER nurses and good Samaritans.
I started to post more info about this on facebook and realized that I do not have the space (or patience of thumb typing) to make this happen.
Let me start with the background info: a story of three burn victims.
Kalunga tripped into a pot of boiling water and burnt his leg from hip to toe. His mother also took him to the clinic where they also gave him acetaminophen and washed the wound with bleach water. After being discharged, his mother took him to the clinic for regular cleansings with bleach water during which Kalunga screamed so badly at the pain, breaking his parents’ hearts. They could not stand watching the clinical cleaning procedure. They kept him at home and used ash to pack the wound and after a time it got severely infected. I offered to help him clean the wound and kept Neosporin on the area, re-bandaging his leg twice a day for two weeks. His skin did heal, though the area around the knee has limited range of motion and he limps a bit when running.
Bana Miri lost consciousness and fell into an open fire. No one knows how long her arms were laying in the fire, but her flesh was incinerated to the point that we could see bone. She was referred directly to the hospital where they gave her acetaminophen and washed her wounds with bleach water. After a few days, she was discharged. The family cared for the wounds with toothpaste and ashes. After a few weeks, the family called me because her wounds were so rancid that anyone who walked into the house commented on the rotting fish smell. I took her straight back to the hospital where they continued to soak her hands and arms in bleach water. After a few more weeks of negative progress, they transferred her to a hospital in Kitwe where the doctors started talking amputation. The family pleaded that she be able keep her hands, so after getting the infection under control, the hospital sent her home. Bana Miri no longer has any functional use of her hands.
Do you hear the commonality in each story? Tylenol, bleach, end of clinical care, ashes and toothpaste, infection, and permanent damage.
When Bronwyn was burnt in similar manner a few weeks ago, many people urged me to take her to the hospital. I hope you can appreciate now why I opted not to. If Tylenol and bleach were the solution, I could have done that myself. Thankfully the water that fell on her was not fully boiling and her skin never burst and nothing got infected. We are thanking God for this mercy.
But the prompting of this post comes from a more recent story. Please keep reading.
Four days ago, Patience’s sister dropped a pot of boiling oil and the oil splashed across Patience’s legs. Her mother was not home, but the neighbor lady immediately covered the burned area with toothpaste and stared walking with her to the clinic. At the clinic, the nurses scraped the toothpaste off and kept the wound clean with bleach water. One tube of Silver Sulfadiazine was in the cabinet (and no one knows where it came from, so I’m calling that a miracle) which they put on the child’s knees until the tube ran out and they sent her home. (Note that Silver Sulfadiazine did not exist in Mansa at the time of the first three burn cases, which is why there is no mention if it in their stories.) Now at home, her mother is too afraid to hurt her child, and she has asked me to be the home aid nurse, which I am certainly not.
Naturally, I am terrified. I am terrified that her knees will not heal properly, that she will not be able to bend them. I am terrified that she will be in unnecessary pain. I am terrified that I do not know what I am doing. As I asked for help on facebook, many responded that I should take her to the hospital. I hope that the above stories shed some light on that option. The one difference in Patience’s story is that I now know about and have access to Silvadene. A newer pharmacy in Mansa now carries it and, after Bronwyn’s burn, I stockpiled. (It’s a shame that I am willing to buy this medicine, but the Ministry of Health is not. But that is a post for another day.)
Please know that all of these people are dear to us. Michael is named after my husband. Kalunga has the most contagious laugh and has been on my top-five-people-on-the-planet list for a long time. Bana Miri is the wife of one our former staff members (he stopped working with us to care for his wife full time) and she is the BEST. Patience is one of Bronwyn’s friends – they have played together since birth. These people are important to us – they are not just names or pictures or case studies.
But I am not a medical professional and other questions remain. Questions about the sloughing that the clinic seems obsessed with – scraping back the clean-but-dead tissue until her knees bleed. Questions about their wrapping technique. Questions about the Silvadene application. I don’t want this little girl to end up like the others. I cannot distance myself emotionally from this situation either. Her cries are fierce and I’ve wept for her pain. I look at her laying miserable and imagine Bronwyn and I can’t not commit to her healing.
There are complicated sub-stories woven tightly into each of these burn scenes. Stories of poverty and the daily hazard of cooking on fires. Stories of inadequate health care and sub-par patient education. Stories of apathy in resource sparse locations. Stories of traditional medicine and witch doctors and mothers that would do anything – try anything – to make their babies feel a little better.
And these are stories that also need to be told and hopefully will be told at some point. But right now the clock is ticking and I have one hour, thirty three minutes until I am due to arrive at Patience’s house to “help” her mother and my cheeks are tear stained and my hands are trembling.
This is me reaching out. Who will skype facetime with me from inside Patience’s house? Who will look at pictures and advise wisely? I have access to google and I am using it. I’m looking for specialized advice for individualized care, not because I think webMD is wrong but because I can’t stand being involved in another burn victim story without reassurance of a qualified, live person telling me that this is the best anyone could do.
And thank you.